X-Plain Foley Catheter Male Reference Summary Introduction A Foley catheter is a tube that is put through the urinary opening and into your bladder to drain urine. Your doctor may have placed or may ask for a Foley catheter to be placed to drain your urine. This reference summary will help you understand what a Foley catheter is and how to care for it. Anatomy This section reviews the anatomy of the urinary system. It helps you understand where the Foley catheter is inserted and how it drains urine. Kidneys are bean-shaped organs located in the middle to lower back, on both sides of the spine. Their main function is to make urine by filtering harmful chemicals, known as toxins, out of the blood. The urine formed in the kidneys flows through tubes, called ureters, to be stored in the bladder. When the bladder is full, people feel the urge to urinate. The urine empties through the urethra. Kidney Ureter Bladder Urethra Foley Catheter Foley catheters are used when patients have difficulty passing urine or are unable to hold urine. Other names for the Foley catheter are indwelling catheter and bladder catheter. 1
A Foley catheter is made of a soft thin rubber tube with a balloon at the tip. The catheter is inserted through the urethra into the bladder to drain urine out. The urethra is the opening where urine comes out. Once the balloon is in the bladder, it is filled with sterile water to inflate it. This holds the catheter in place and prevents it from slipping out. To keep the catheter secure, the tube that connects to the drainage bag is taped to your leg. The balloon presses against the wall of your bladder. This may make you feel the need to urinate. However, the urine will drain out through the catheter and into a drainage bag. The drainage bag must be periodically emptied. For the urine to drain, the drainage bag MUST be below the level of your bladder. If you place the drainage bag higher than your bladder, you risk having the drained urine flow back into your bladder. This may cause an infection. The Foley catheter can stay in your bladder for days or weeks. Your doctor will tell you how long it will stay. You will need to learn how to take care of it and the drainage bag to prevent infections. Handwashing The most basic way to prevent and control the spread of germs is handwashing. Handwashing is a vigorous, brief rubbing together of all surfaces of the hands lathered in soap, followed by rinsing under a stream of water. How to do Handwashing: 1. Wet hands and wrists under warm running water. 2. Apply soap (antibacterial liquid soap if possible) and lather well. If bar soap used, keep separate for your own use. Rinse the soap before and after you use it to remove the lather. 3. Scrub your hands and wrists for at least 15 seconds. 4. Pay special attention to fingers, fingernails and the back of your hands. 5. Rinse hands well with your hands up. This keeps the dirty water running away from your hands. 2
6. Dry your hands using clean paper towels starting with the hands and working down towards the elbows. 7. Use the paper towel to turn off the faucet. (Remember, you turned it on with dirty hands.) Preparation Select a work area that is clean, large and uncluttered, with good lighting. Wash the work area with soap and water. Use antibacterial liquid soap whenever possible. Wash your hands and bring the supplies to the work area. Supplies Needed: Soap and water Wash Cloth or Towelettes Paper Towels for hands Clean cloth towel for Catheter Care Measuring Container Drainage and/or Leg Bag Tape Ointment if ordered Catheter Care Taking care of your skin and catheter prevents infection, reduces skin irritation and reduces odor. Your skin and catheter should be cleaned at least 3 times a day and more often if there is drainage around the catheter. As you clean, first clean the area around the penis s opening, then clean the catheter tube, and finally clean the skin around the anus. You can use a clean washcloth, warm water and a mild soap. As you clean around the penis, gently push back foreskin if present then start cleaning where the catheter enters your penis. Clean upward away from the opening. Clean again if needed with a clean washcloth. Pat your skin dry. Remember to pull the foreskin if present back over the penis. 3
As you clean around the catheter to remove blood, crust, or mucus, hold the end of the catheter tube to keep it from pulling and wash away from the catheter. Wash downward about 1/3 of the way down the catheter. Clean until all debris is removed. Thoroughly rinse all soap from the area around the catheter. Pat dry with a towel. Put any prescribed ointment around the area where the catheter enters your body. As you wash the area around the anus, do not retouch the penis with the same washcloth. You may shower if your doctor approves. Never take a bath while you have your Foley catheter. After cleaning, put used washcloths into the laundry and do not use it again until it has been washed. Tape the catheter to the thigh or abdomen to prevent pressure on the urethra. Leave some slack in the tube for leg movement. Drainage Bag The bedside drainage bag is connected to the Foley catheter by a long tube. It can be hung on a bed or chair or pinned to clothes. The bedside drainage bag is connected at night, before going to bed. When you get into bed, arrange the drainage tubing so it does not kink or loop. It is very important to keep the drainage bag below your bladder level at all times, whether you are lying, sitting or standing. Empty the urine bag when it is about 2/3 full. To empty the bedside drainage bag: 2. Remove the drainage tube from the cover. 3. Un-clamp the drainage tube. 4. Drain the urine into a measuring container or directly into the toilet if you do not have to measure the urine. 5. Do not touch the tip of the drainage tube with your hands, toilet or measuring container. 6. Clamp the drainage tube. Make sure all the urine is off the end of the drainage tube. Clean the end of the tube 4
with an alcohol pad and put the end back into the cover. Clamp the drainage tube. 7. Measure the urine if your doctor wants you to keep a record of your output. 8. Empty the container into the toilet and rinse the container with running water. 9. Wash your hands. 10. Write down the amount of urine if you are keeping a log. To disconnect the bedside drainage bag: 2. Empty the bag. 3. Clamp or pinch the catheter so no urine leaks when you disconnect the bedside bag and connect to the leg bag. A leg bag is a small drainage bag strapped to the calf that can be worn under loose fitting pants. It holds a small amount of urine and must be emptied frequently. A leg bag is worn during the day, since it is smaller and easier to manage. Do Not Wear The Leg Bag Overnight. To connect the leg bag: 2. The leg bag can be applied to the leg by standing or sitting. 3. Use the straps to fasten the leg bag to the outer part of your leg below the knee. Fasten the straps around your leg so they fit snugly but not too tight. 4. Position the leg bag so that it will not pull on the catheter when the leg is moved. Alternate placing the bag on your left and right leg. 5. Remove the cap from the top connector. Pinch or clamp the catheter before you remove it from the bedside drainage bag to stop the flow of urine. Remove the drainage bag. 6. Clean the end of the leg bag tubing with alcohol being careful not to touch the tube after it is cleaned. 7. Connect the catheter to the leg bag tubing. 8. Release the catheter once it is connected to the leg bag so the urine can start to flow. 9. Wash Your Hands. A bedside drainage bag can be used for several weeks if cleaned well everyday. 5
To clean the bedside drainage bag: 2. Wash the bag with soap and water. Swish soapy water in the bag. Rinse thoroughly with running water. 3. Rinse the bag with a solution of 1 teaspoon of white vinegar added to 2 cups of water. 4. Hang to dry. 5. Put caps on tubing and drainage ports when not in use. 6. Wash your hands. A leg bag is a small drainage bag which must be emptied frequently during the day. To empty the leg bag: 2. Remove cap from drainage port, then open valve (or clamp) at the bottom of the leg bag. 3. Drain the urine into a measuring container or directly into the toilet if you do not have to measure the urine. 4. Do not touch the tip of the drainage tube with your hands, toilet or measuring container. 5. Close the clamp (or valve) after emptying the bag. Make sure all the urine is off the end of the drainage tube. Clean the end of the tube with an alcohol pad. Put the cap on the drainage port. 6. Measure the urine if your doctor wants you to keep a record of your output. 7. Empty the container into the toilet and rinse the container with running water. 8. Wash your hands. 9. Write down the amount of urine if you are keeping a log. To disconnect the leg bag: 2. Empty the bag. 3. Clamp or pinch catheter so no urine leaks when you disconnect the leg bag. Connect the bedside drainage bag. 6
To connect the bedside drainage bag: 1. Wash your hands before connecting the drainage bag. 2. Attach the drainage bag to the bed below the level of the bladder. 3. Remove the cap from the drainage bag tubing. 4. Clean the end of the drainage bag tubing with alcohol, being careful not to touch the tube after it is cleaned. 5. Connect the drainage bag tubing to the catheter. 6. Wash Your Hands. To clean the leg bag: 1. Wash the leg bag with soap and water. Swish soapy water in the bag. Rinse thoroughly with running water. 2. Rinse the bag with a solution of 1 teaspoon white vinegar to 2 cups of water. 3. Hang to dry. 4. Put caps on tubing and drainage tube (ports). 5. Store in a clean place. 6. Wash your hands. Preventing Infections Your physician may have you take antibiotics to guard against an infection while the catheter is in the bladder. Drink extra fluid, especially water. Drink at least 1 cup or glass of fluid about every 2 hours unless your doctor gives you different instructions. Keep your catheter taped to your thigh. This will decrease the pull on the catheter and decrease irritation where the catheter enters the body. Make sure the catheter drains. Check the drainage or leg bag to make sure there is urine in the tubing and it is going into the bag. Make sure there are no kinks in the catheter or the drainage bag tubing. Keep the drainage or leg bag below the bladder and off the floor. 7
Empty the bag before it gets completely full. A full bag will not drain. Keep your bedside drainage and leg bag clean. Do not disconnect your catheter unless you are changing bags. Never remove your catheter unless instructed by your doctor. Signs of Complications Some sensations you may feel after placing a Foley catheter are normal. Some can be due to normal spasms of the bladder. They include sensation of fullness over the bladder, pain in the bladder, burning where the catheter enters the urethra, and some blood in the urine. Some leaking of urine around the catheter can be normal, especially after a bowel movement. Other signs you may see or feel could be complications and should be reported to your doctor. These are discussed in this section. They include signs of infections, bleeding, leaking, tube out and blockage. Fever or shaking chills are signs of infection. Call your doctor if your temperature is over 101 degrees Fahrenheit or 38.3 Celsius. You should also call if you notice your urine has a strong odor or bad smell or you see sediment (sand-like particles) in your urine. Call your doctor if you notice swelling, redness or pus in the urethra. When you clean your genital area, look at the opening where the catheter tube leaves the body. Call your doctor if you notice bright red blood or an increase in the amount of blood in your urine. Call if the blood or clots stops then start again. Also, call if the blood or clots in the urine do not clear with rest. Call your doctor if you notice increased leaking from your catheter if your bed or clothes become wet. Also if there is a decreased amount of urine in the drainage bag or tubing. There should always be urine in the tubing. Call your doctor if the catheter out of the penis is longer than before or if your penis is painful. 8
If the catheter is not draining, check first if the tubing is twisted, bent or if you are laying on it. Change your position and make sure the drainage bag is lower than the level of your bladder. If it is still not draining for more than 6 hours, call your doctor. Call your doctor if you have unexpected pain or burning in the urethra, bladder, abdomen, or lower back. Summary A Foley catheter is a tube that is put through the urinary opening and into your bladder to drain urine. The procedure to insert the Foley catheter is a safe one that takes about 10 minutes to complete. Drinking lots of fluids is essential to keeping the catheter unclogged. Whether you use your Foley catheter at home or at the hospital, you can help in taking care of it and preventing infection. The length and method of use of Foley catheters vary from patient to patient. Your healthcare provider is available to answer any questions you may have about your Foley catheter, how to care for it, and what signs to expect. 9
INTAKE AND OUT TAKE RECORD IN TAKE OUT TAKE DATE TIME AMOUNT IN KIND OF FLUID DATE TIME AMOUNT IN FOLEY BAG AMOUNT IN LEG BAG Large Glass 8 ounces Can of Soda 12 ounces Small ( Juice ) Glass 4 ounces Quart 32 ounces Cup 8 ounces Pint 16 ounces 10