It is a flexible tube used to drain urine from the bladder. The catheter is inserted through the urethra and into the bladder. It has a balloon at the tip that is inflated once inside the bladder to keep it from being accidentally pulled out. There are several different types of Foley catheters used for different purposes and patients.
Indwelling Catheters
Indwelling or long-term catheters remain inside the bladder for an extended period ranging from a few days to months. They are commonly used for patients who have difficulty emptying their bladder naturally due to conditions like spinal cord injuries, multiple sclerosis, stroke, or prostate surgery recovery. The balloon prevents the catheter from slipping out and helps ensure continuous drainage of urine from the bladder. These types of catheters require special care to prevent infections in the urinary tract.
Intermittent Catheters
Intermittent catheters are designed to be inserted briefly to drain the bladder and then removed. They are commonly used by patients with spinal cord injuries to manually drain residual urine several times a day. Intermittent catheters offer an alternative to indwelling catheters for patients who are able to self-catheterize. They reduce the risk of urinary tract infections compared to long-term use of indwelling catheters. However, intermittent catheterization must be performed regularly to avoid bladder complications.
Male External Catheters
Male external catheters are a closed drainage system that fits over the penis. They provide an alternative for male incontinence patients who cannot use or do not want to use an indwelling catheter. The external sheath collects and stores urine, which can then be emptied into a toilet. These catheters are less invasive than internal catheters but still require careful hygiene and skin care to prevent infection or irritation.
Pediatric Catheters
Specialized Foley catheters are available for pediatric patients, especially neonates and infants. These catheters are smaller in size and have features designed for comfort, safety, and drainage in young children. Some have additional safety components like antireflux valves to prevent urine from flowing back up the catheter. Proper catheter selection and sterile insertion techniques are crucial for pediatric patients due to their small anatomy.
Latex vs. Silicone
Traditionally, Foley catheters were made from latex rubber. However, many patients have a latex sensitivity or allergy. For these individuals, silicone catheters are preferable as they do not contain any latex proteins. Silicone catheters are also softer and more flexible than latex versions. They are less likely to cause urethral trauma during insertion or removal. While silicone catheters are more expensive, they reduce the risk of allergic reactions in latex-sensitive patients.
Two-Way Catheters
Two-way Foley catheters have two separate lumens or channels - one for urine drainage and one for irrigation. They allow fluid like sterile water or medicated solutions to be slowly instilled into the bladder through one lumen. Then it can exit along with urine through the other lumen. Two-way catheters are commonly used postoperatively to help rinse out clots and debris from the bladder following some urologic surgeries or procedures.
Coated Catheters
Manufacturers now offer Foley catheters coated with agents like hydrogel, silver alloy, or antibiotics. These coatings are designed to reduce friction during insertion and provide anti-infective properties once inside the bladder. For example, silver alloy coatings have demonstrated strong antimicrobial activity against common catheter-associated bacteria. Hydrogel-coated catheters create a slick surface to ease passage through the urethra. Coated catheters may lower the risk of urinary tract infections versus standard uncoated models, though more research is still needed.
Complications of Long-Term Catheterization
While catheters provide an important drainage function, long-term indwelling use can increase the risks of potential complications:
Urinary Tract Infections - UTIs are one of the most common catheter-related complications. Bacteria easily gain access to the bladder through the drainage tube. Catheters disrupt normal bladder emptying and bladder defense mechanisms against infection.
Obstruction and Encrustation - Mineral buildup can gradually obstruct the catheter drainage holes, ballooning, or entire lumen over time. This is due to irritation from the foreign body and constant exposure to urine minerals.
Trauma - The urethra is susceptible to damage, especially when catheters are not properly sized or inserted aseptically. Long-term catheterization may lead to urethral strictures or other anatomical changes.
Bypass Incontinence - In some cases, urine is able to pass or "bypass" around the catheter, soaking clothing or bedding. This happens if the catheter migrates out of optimal position in the bladder neck.
Patient Discomfort - Long-term indwelling use is frequently associated with bladder spasms, suprapubic pain or pressure, and hesitancy upon removal due to bladder muscle changes.
For most appropriate candidates, switching to intermittent catheterization or limiting indwelling dwell time as much as possible helps reduce these long-term risks and improve quality of life. Patients relying on indwelling catheters also require regular follow up care and monitoring by healthcare providers.
this article discussed different types of Foley catheters, their uses, features and complications. With appropriate selection and care, catheters effectively manage lower urinary tract symptoms for many individuals. However, prolonged indwelling use should be minimized to prevent related issues whenever possible.
