When you had any surgery, did your doctor or anyone explain the problems that can happen with Foley catheters? I bet the answer is no. Mine didn’t either and yet twice I went through so much pain and anguish because of a defective catheter or the nurse who put it in me was not paying enough attention.
You may wonder why I am writing about this now, but I have been reading back over my very long journey through five surgeries and the hell I went through because of pelvic mesh and it reminded me of
the pain and agony I had because of Foley catheters. I realized I had never written a blog about this issue and yet women need to be aware of how bad this can be. So I searched for a good article to explain things for you to read first. Here are some of the things that can happen and you need to be aware of them and speak out if anything happens to you.
I had never actually looked up complications from catheters and this prompted me to do so. I was shocked at how many complications there can be although I know how painful it is when dealing with it. At the time I could not find a urologist to touch me and only the E.R would help. Your normal doctor can’t do anything because they don’t know how, so when you know you have so much pain with the catheter in you, then I will tell you to get to the E.R as soon as possible.
Mesh complications are so bad for many of us and the Foley catheter becomes a way of life sometimes for many, many weeks at a time after surgeries However without understanding what you need to know, you will suffer needlessly when doctors refuse to help. I have been in terrible predicaments after surgeries and no urologist wanted to help me, so when understanding about these things, it could change your life before serious complications and infections arise.
Now I will share with you what I have learned about possible complications. I did a lot of reading to find the best information, so first what kind of complications can arise?
You will note what the ‘doctor’ will do, but I found the only ones who actually do anything are the nurses.
The balloon can break while the catheter is being inserted. In this case, the doctor will remove all the balloon fragments.
The balloon does not inflate after it is in place. Usually the doctor will check the balloon inflation before inserting the catheter into the urethra. If the balloon still does not inflate after its placement into the bladder, the doctor will then insert another Foley catheter.
Urine stops flowing into the bag. The doctor will check for correct positioning of the catheter and bag or for obstruction of urine flow within the catheter tube.
Urine flow is blocked. The doctor will have to change the bag or the Foley catheter or both.
The urethra begins to bleed. The doctor will have to monitor the bleeding
The Foley catheter may introduce an infection into the bladder. The risk of infection in the urine increases with the number of days the catheter is in place. This is why this is so important. I had a catheter for nine weeks after the mesh implant and I had so much infection drugs no longer worked and the pain was terrible. Then she did another surgery to cut the sling in the center and then I was told I had to self-cath. My life became a nightmare.
If the balloon is opened before the Foley catheter is completely inserted into the bladder, bleeding, damage and even rupture of the urethra can occur. In some individuals, long-term permanent scarring and strictures of the urethra could occur.
Bladder spasms can occur when a catheter is placed. This is a sudden intense urge to urinate and can be painful. Often, urine will leak around the outside of the catheter when a spasm occurs. Medication can be prescribed for bladder spasms. This happened to me.
Any pink or red urine or bleeding from the urethra
Symptoms do not go away
Symptoms of infection
- Burning sensation upon urination
- Urgency and frequency
- Increased lower abdominal pain
- Foul-smelling discharge coming from the urethra or in the genital area
- Redness or swelling in the genital area
- Pain in the urethral area or genital area
If the patient is sent home with a Foley catheter or has had a catheterization performed, he or she should go to the hospital’s emergency department if they notice the any of the following:
- Bleeding from the urethra
- Nausea and vomiting
- Symptoms of infection such as urinary frequency urgency, or pain or burning sensation; blood in urine; fever; increased lower abdominal pain; or foul-smelling discharge
- Symptoms of acute urinary retention such as urinary hesitancy, straining to void, decrease in size and force of the urinary stream, interruption of urinary stream, sensation of incomplete emptying of the bladder I could see the blood in the bag and knew I was in trouble.
- Irritative symptoms such as urinary frequency, urgency, pain or burning; increased urination at night; or wetting the bed at night I had spasms and urinary frequency and urine would pass even when the catheter was in me. It is a big warning signal that something is wrong.
One of the most commonly performed invasive procedures in hospitalized patients is urethral catheterization with a Foley catheter. It has been estimated that 10% to 15% of hospitalized patients will undergo Foley catheter drainage at some time during their admission. Foley catheters are used routinely for both short- and long-term drainage of the urinary bladder and have been associated with a great many complications including infections, catheter encrustation, catheter blockage, bladder spasms, balloon rupture, leakage, and retained catheter.3 These complications occur more commonly with chronic indwelling catheters but can happen with short-term use as well. The retained Foley catheter is a vexing problem that many physicians are likely to encounter by during their careers. The purpose of this article is to review the methods available for the removal of retained Foley catheters caused by balloons that will not deflate and provide the family physician with strategies for managing this problem.
I know this sounds odd, but once a catheter has been used in you after a surgery it is wise to make a note of size. This is because if you have to do any self-cath, you need to make sure you are given the correct size, How they come up with size I had no idea, but I found the following.
- What size catheter should I put in my patient?
I’ve never quite understood where the French catheter sizes come from – anybody know? Smaller is smaller, and bigger is bigger, unlike IV catheters, in which bigger is smaller – right? I mean, a higher number means a smaller bore IV catheter, but a bigger foley. Goofy.
Anyhow – after a little looking, it turns out (as if life wasn’t complicated enough), that the French scale corresponds to diameter in millimiters, divided by three. Say what? It means a size 3 French tube has an outer diameter of 1mm. An 18 French has a diameter of 6mm. Oh! Well why don’t they just call it a six then? Jeeze!
Usually a 14 gauge Foley is the smallest we’ll put in – they drain pretty slowly, and they probably plug more easily, being so narrow. Most of the catheters I place are 16’s, occasionally an 18 if the smaller ones are leaking along the urethral path. Doesn’t happen often. They do get bigger – but that stuff we leave to urology…
I still have some self-caths so I went to check the size I used when I was doing it. It was size 14.
Something very important. After I had complications and could not find a urologist to help, I finally found a new personal care physician (PCP) and she was great. She was highly concerned because a catheter had been in me four and a half weeks by that time, so she sent home health care nurses to my home to change it. If you can’t get help make sure you ask for a home health nurse. They are wonderful. I found this information.
How long can a Foley catheter stay in?
We often leave them in as long as they seem clean. We don’t do routine survey cultures, although they’re frequently cultured anyhow when our patients spike fevers…
Should they be routinely changed?
It looks like people with long-term catheter needs have them changed every month.
Something else you may worry about.
Is a Foley sterile or not?
Yes, they absolutely are. Remember all that about how urine is sterile? – the whole urinary path is sterile. On the inside and with normal urine flow, it stays that way. The kidneys make urine, it collects in the bladder, it gets drained out promptly, and nothing gets back in through the urethra… no problem. So what happens when you put in a tube?
I can tell you I went through a lot of pain because of a Foley catheter which was not working properly and I would tell any woman who is having pain when she tries to walk with a Foley catheter in her, to get to the E.R as soon as possible and tell them you KNOW there is a problem with the catheter and you need it changed. After mine was finally changed I could walk without pain. So don’t let anyone tell you there is nothing wrong.