Catheter related problems can be any of the following issues that can happen in patients who have a long term catheter. Patients tend to choose this option of having a long term catheter to manage the inability of the bladder to hold or empty due to various other underlying causes and conditions.
- Frequent possibility of urinary infections and inflammation in the bladder due to the foreign body irritation from the catheter on the bladder lining. Generally the bacteria tends to live in harmony with the bladder which is called colonisation. Of course if there is any clinical infection which is manifested by pain and other symptoms of infection including fever, that will need to be treated promptly. Otherwise simple presence of bacteria in the urine of the catheterised patient does not need to be treated. This is called a symptomatic bacteriuria. Unless the patient has any underlying conditions of defective immune system or the patient is pregnant there is no need in treating the presence of bacteria in the urine without any symptoms.
- Stone formation in the Bladder: The catheter tends to cause irritation of the bladder which causes production of mucus substances which in conjunction with the salts in the urine can produce stones. These stones tend to be soft and flaky and causes the obstruction of the eyes of the catheter. This could result in the bladder spasms and frequent leakage of the urine around the catheter and need for the replacement of catheter more frequently than usual time for a long term catheter which is up to 12 weeks.
- Presence of a catheter can also lead to reduction in the physical activity levels due to discomfort in some group of patients. However majority of the patients who choose to have a long term catheter tolerate having a catheter.
- Women who have a catheter in the urethra on a long term basis may cause further damage to the urethra and the urethra may become wide open and tends to expel the catheter. This can also cause intractable leakage of urine. Therefore, in women who are expected to have long term catheters, the preferable option would be to insert a catheter through a small hole in the lower abdomen by an ultrasound scan guidance. This is called super-pubic catheter.
Choosing to stay on a long term catheter should not be easy choice taken by patients or the doctors. Every possible attempt should be given to manage the bladder without a catheter. The other avenues of managing would be by using a self catheterisation or using appropriate treatments for the bladder outlet obstruction in men by either prostate operations or bladder neck operations if they have a functional bladder. Having a long term catheter increases the risk of complications mentioned above and significantly compromises the quality of life.