Putting in a catheter is a common medical procedure that is often necessary, but can cause some discomfort. A catheter is a thin, flexible tube that is inserted into the body to drain urine from the bladder. Catheters provide relief when a person is unable to urinate on their own. While catheters serve an important purpose, it’s understandable to have questions and concerns about the potential pain and discomfort associated with catheter insertion.
Why are catheters used?
There are a few main reasons a doctor may recommend using a catheter:
- After surgery: Catheters are routinely used after surgical procedures to help monitor fluid output and allow the bladder to rest while it heals.
- Urinary retention: When someone is unable to fully empty their bladder on their own, a catheter can help drain urine and prevent harmful buildup in the bladder.
- Medical procedures: Catheters may be necessary during certain exams or procedures to fill the bladder with fluid.
- Chronic urine retention: Some ongoing medical conditions like spinal cord injuries, multiple sclerosis, or prostate issues can make it difficult to empty the bladder. A catheter may be needed on a regular basis.
- End-of-life care: Catheters allow urine to drain comfortably when a person is immobile or bedridden.
The most common reasons for catheter use are assisting urine flow after surgery and dealing with acute urinary retention. Catheters are only used when medically needed, not for convenience.
What types of catheters are used?
There are several different types of catheters that may be used depending on the medical situation:
- Indwelling catheters are left in place for days or weeks to provide continuous drainage into a bag. They may be needed after major surgery or for ongoing medical conditions.
- Intermittent catheters are inserted briefly to empty the bladder and then removed. People who need regular help urinating due to chronic retention may use intermittent catheters several times per day.
- External catheters consist of a thin flexible sheath applied over the penis like a condom to guide urine into a collection bag. These are an option for incontinence in men.
- Three-way catheters have extra ports to allow bladder irrigation or medication instillation in addition to drainage.
The catheter type your doctor recommends will depend on factors like your anatomy, the reason it’s needed, and duration of use.
Does catheter insertion hurt?
The short answer is that catheter insertion may be uncomfortable, but is not typically extremely painful with adequate lubrication and technique. However, the level of discomfort can vary.
Here are some factors that influence pain with catheter insertion:
- Gender: Catheter insertion tends to be less painful for males than females due to anatomy. The urethra is shorter in males.
- Lubrication: Use of a lubricating gel reduces friction and discomfort during the procedure.
- Size of catheter: Wider catheter diameters generally increase discomfort.
- Infection: Existing urinary tract infections or irritation can make catheter placement more painful.
- Provider experience: Skill of the person inserting the catheter impacts discomfort.
- Reason for catheter: Insertion may be more painful if urinary blockage or swelling is present.
- Prior catheters: Discomfort tends to be worse with the first catheter if the urethra is tight.
While everyone has a different pain tolerance, most people describe the feeling as a mild to moderate stinging or burning sensation as the catheter is advanced through the urethral opening and into the bladder. It may help to take deep breaths and try to relax the pelvic muscles during the procedure.
Pain management during catheter insertion
If you are worried about pain and discomfort from a planned catheter insertion, talk to your healthcare provider about options to help minimize pain, such as:
- Topical numbing agents applied to the urethral opening
- Lidocaine gel directly into the urethra
- Lubricating gel for easier insertion
- Smaller diameter catheters when possible
- Prescription numbing creams for women
- Local anesthetic in severe cases
For hospital catheters, doctors can prescribe medication before the procedure to help with pain and relaxation. Speak up about your worries so your care team can take steps to make you more comfortable.
Does it hurt less to insert a catheter yourself?
Self-catheterization involves inserting your own catheter instead of having a medical provider do it. This is an option some people utilize for ongoing bladder drainage when needed.
There are some potential advantages to self-catheterization when it comes to discomfort:
- Privacy and familiarity being alone may help you relax better.
- Self-paced insertion lets you control the speed and pressure.
- No need to explain discomfort or preferences to stranger.
- Can reuse the same type and size catheter.
However, the first few self-catheterization attempts may still involve some degree of stinging or burning as the urethra gets used to the process. Proper technique and lots of lubricant is still important. Over time, self-catheterization may become less painful with routine practice.
Working with a nurse to learn proper self-catheterization technique can help minimize discomfort. Let your provider know if problems with pain, bleeding, or urinary tract infections arise.
What about pain with an indwelling catheter?
Indwelling catheters that stay in place for a period of time can also cause urinary discomfort, though not from insertion since they only need to be placed once. Ongoing bladder pain or spasms may occur with an indwelling catheter due to:
- Bladder irritation from the foreign catheter tube
- Occasional bladder contractions trying to expel the catheter
- Bladder infections which are more common with indwelling catheters
- Catheter blockage or positional changes causing bladder irritation
To help reduce catheter-related pain over time:
- Ensure the catheter tube is properly secured to avoid movement and traction on the bladder
- Keep the drainage bag below the level of the bladder at all times
- Watch for signs of urinary tract infection such as foul-smelling urine, blood in the urine, fever, or pelvic pain and tenderness
- Some medications may help calm bladder spasms – speak to your doctor
Routine catheter care is important for minimizing discomfort. Speak up about ongoing pain issues so steps can be taken to keep you comfortable.
What to expect after catheter removal
Once a catheter is no longer needed and is removed, you may notice some common feelings in your urethra and bladder as your body adjusts back to normal urination:
- Stinging or burning when urinating initially
- More frequent urination for a day or two
- Mild blood in the urine for 1-2 days
- Bladder discomfort or spasms as it resumes normal function
- Incomplete emptying of the bladder
These sensations should gradually improve within 48 hours as swelling goes down and the urethra recovers. Pain relievers can help ease post-catheter soreness. Stay well-hydrated to allow the bladder to heal while producing adequate urine. Let your healthcare provider know if significant difficulties urinating or pain persist beyond a couple days after catheter removal.
Tips to minimize catheter discomfort
While some discomfort is normal with catheter use, the following tips may help reduce pain associated with catheter insertions:
- Talk to your doctor about numbing gels/creams or pain medication beforehand
- Breathe deeply and relax your muscles during the procedure
- Use lots of lubricant and go slowly
- Consider self-catheterization if ongoing use is needed
- Keep drainage bags properly positioned and secured
- Watch for signs of infections requiring treatment
- Stay well-hydrated to avoid irritation from concentrated urine
- Speak up about ongoing pain so interventions can be provided
While catheter use often causes some discomfort, doctors have many options to help minimize pain both during insertion and afterwards. Be open about your concerns so your care team can provide both emotional and physical comfort.
Catheter insertion causes varying degrees of discomfort based on individual factors, but severe pain is uncommon with proper technique. While the initial insertion may sting, ongoing pain is usually minimal with adequate care and can be treated with medication if necessary. Being open about your questions and worries allows your medical providers to take steps to minimize discomfort. With both physical and emotional support, most patients are able to tolerate short-term catheter use well.