Kids Health Info

Indwelling urinary catheter

  • An indwelling urinary catheter, usually called a catheter or IDC, is a tube that carries your child's urine (wee) from the bladder to a special drainage bag for disposal. This tube either comes out through your child's abdomen, called a suprapubic or SPC catheter and which is inserted during an operation, or through the urethra (the hole where urine comes out). Your doctor will tell you what type of catheter your child needs.

    Sometimes your child is required to go home after surgery with a catheter in place.

    How do I care for the catheter?

    • Always wash your hands before and after touching the catheter.
    • Keep the catheter taped securely; ask your child's nurse how to do this before you are discharged.
    • If your child has an IDC they can still have a bath or shower.
    • If your child has an SPC, a daily sponge bath is preferred. Try to keep the dressings dry.
    • Make sure the tubing does not become kinked or twisted in a spiral.  This may block the urine flow and cause pain and distress for your child.
    • Clean around the area where the catheter leaves the body with mild soapy water.
    • To help the urine drain, it is important to keep the bag below the level of the bladder, such as on the floor if your child is sitting in a chair.
    • Encourage your child to drink plenty of fluids.

    Care of the drainage bag

    The drainage bag can be strapped to your child's leg during the day. Older children may need a second bag attached at night if there is a large amount of urine being produced.

    • The night bag can be taken off in the morning, washed out with warm soapy water and reused.
    • Observe how much urine has drained and the colour (urine should be pale yellow).
    • You need to check the drainage bag every few hours and empty it when it is half full.
    • To empty the bag, open the tap over a toilet or container. Close the tap again once the bag is empty.
    • Change the bag or tubing if you notice any holes, or if the tubing keeps kinking in the same spot.
    • When changing the bag or tubing, clean the end with an alcohol swab and allow it to dry before connecting the new bag/tubing.

    Trouble shooting

    Catheter not draining

    • Check tube for kinks or twisting.
    • Check the taping on the catheter.
    • Has the catheter come out?
    • Ensure the drainage bag is below the level of the bladder.
    • Is your child drinking enough?
    • The catheter tube may be blocked and need flushing (only do this if you have been shown how to).

    Flushing of the catheter (only if you have been shown by staff before going home from hospital)

    • Wash hands with soap and water.
    • Disconnect the catheter from the bag, clean the ends with an alcohol swab and use 5-10mls of sterile normal saline in a syringe to gently flush the catheter.
    • Slowly withdraw the fluid, stop if any resistance is felt.
    • Reconnect the tubing after cleaning the ends with an alcohol swab. Repeat these steps if there is still no drainage.
    • If there remains no drainage or if the catheter is difficult to flush, take your child to your nearest hospital emergency department.

    Catheter bag/tube leaking

    • Try to find where the leak is coming from.
    • Check the tap is closed.
    • Check the tube connection going into the bag; ensure it is tightly connected.
    • If the bag or tube is damaged they will need to be replaced.

    Catheter "by-pass"

    • If you notice urine in your child's nappy or underpants, urine may be leaking around the catheter tube (this is by-passing the catheter and coming out the urethra).
    • Try flushing the catheter if you have been shown how to, and observe for further leakage.
    • If it continues to leak around the tube your child needs to be seen by their doctor.

    Catheter pulled out

    • If the catheter is accidentally pulled out, contact the hospital immediately because you may need to go to the emergency department.

    Follow-up

    If you have any questions or concerns about your child's catheter care, contact your local doctor or nearest hospital emergency department.

    Additional catheter equipment and supplies can be obtained from the Equipment Distribution Centre (EDC) at the RCH.

    Key points to remember

    Return to the emergency department if:

    • The catheter comes out before it is due to be removed.
    • The catheter stops draining and you are unable to flush it.
    • You notice a change in your child's urine e.g. smelly, cloudy or urine which contains blood (bloody in colour).
    • Your child has a fever (temperature 38.5oC and above) or increased pain.
    • You notice any discharge/pus or signs of infection, such as redness, swelling or heat of the skin  (especially around the SPC dressing).

    For more information

     

    Developed by the RCH Depts of General Surgery and Urology. First published July 2008. Updated November 2010.

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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.