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Urinary Catheter Types: How to Choose the Right Catheter

Continence Despina Moshopoulos
Urinary Catheter Types: How to Choose the Right Catheter

What Are Urinary Catheters?

Urinary catheters are flexible tubes inserted into the bladder to help drain urine when someone cannot do so naturally. They can be temporary (for surgery recovery) or long-term (for ongoing medical conditions).

In Australia, around 15–25% of hospitalised patients will require a urinary catheter at some stage during their stay, often following surgery or to manage acute urinary retention. Long-term catheter use in the community is also common, particularly among older adults and people with neurological conditions. Research shows that approximately 40–50% of catheterised patients will experience some form of catheter-associated complication, most often urinary tract infections (UTIs).

Catheters play an important role in maintaining health, dignity, and comfort for people with urinary retention, mobility issues, or neurological conditions. For carers, understanding how catheters work and their proper management is essential to reducing risks and ensuring quality of life for care recipients.

Types of Urinary Catheters and Their Uses

Indwelling Catheters (Foley) 

These remain inside the bladder for continuous drainage, held in place by a small balloon. They are suitable for longer-term use, but require close monitoring to avoid infection.

Intermittent Catheters (In-and-Out)

These are inserted several times a day to empty the bladder and removed immediately after use. They allow greater freedom, lower infection risk than long-term indwelling catheters, and are often used by people with spinal cord injuries or certain neurological conditions.

External Catheters (Condom or Sheath)

Worn over the penis like a condom, these collect urine into a drainage bag. They are non-invasive and reduce infection risks but are only suitable for some men.

Suprapubic Catheters

Inserted directly into the bladder through a small incision in the lower abdomen, these are typically for long-term use when urethral catheters are unsuitable. They are easier to clean and maintain for some patients and carers.

Pro Tips for Catheter Placement and Management

  • Insertion: Catheters should only be inserted by trained healthcare professionals to ensure safety.

  • Secure placement: Proper taping and securement devices help prevent pulling or movement that could cause pain or infection.

  • Monitoring: Regularly check urine flow, colour, and bag fullness. Healthcare professionals also monitor for signs of infection, leaks, or blockages.

  • Hygiene: Daily cleaning of the area around the catheter and careful hand hygiene for carers are crucial in reducing infection risks.

Complications and Risks of Urinary Catheters

Catheter-Associated Urinary Tract Infections (CAUTIs)

These are the most common complication. Symptoms may include fever, cloudy urine, strong odour, or discomfort. Prompt medical attention is vital.

Skin Irritation and Pressure Injuries

Where the catheter touches the skin, irritation or sores may develop. Regular checks and protective dressings can help.

Leakage, Blockages, and Discomfort

Kinks in the tube, bladder spasms, or sediment build-up can cause problems. Carers should ensure the tubing is not twisted and that bags are emptied regularly.

How to Choose the Right Urinary Catheter Type

Selecting the right catheter is not a “one-size-fits-all” decision. It depends on the person’s health condition, how long the catheter will be needed, and individual preferences regarding comfort and lifestyle. Carers play an important role in working with healthcare professionals to ensure the most suitable option is chosen from the range of available urinary products.

Duration of Use: Short-Term vs Long-Term Needs

For many people, catheters are only needed for a short period — for example, during recovery from surgery or while treating acute urinary retention. These are usually managed with indwelling catheters that are removed after a few days.

However, for individuals with ongoing medical conditions such as multiple sclerosis, spinal cord injury, or chronic urinary retention, long-term urinary products such as suprapubic or intermittent catheters may be recommended because they reduce the risks associated with prolonged urethral catheterisation.

Medical Condition and Diagnosis

The underlying medical condition is one of the most important factors in choosing the right catheter. For people with prostate enlargement or obstruction, a suprapubic catheter may be more suitable if urethral passage is difficult. For those with spinal cord injuries, intermittent self-catheterisation is often encouraged, as it allows greater independence and reduces infection risks. People with progressive neurological conditions, such as Parkinson’s disease or multiple sclerosis, may require long-term solutions and close monitoring, often alternating between indwelling and suprapubic catheters depending on how their condition develops over time.

Catheter Size, Material & Gender-Specific Needs

Catheters come in a range of sizes, measured in French gauge (Fr). Selecting the correct size is important because a catheter that is too large can cause trauma, while one that is too small may not drain effectively. Materials also play a significant role. Latex catheters are flexible but unsuitable for people with latex allergies. Silicone catheters are commonly used for long-term catheterisation and are less likely to encrust, while hydrogel-coated catheters provide additional comfort and may lower infection risk. Gender and anatomy also affect the choice of catheter, with women often requiring shorter devices, and men sometimes benefiting from longer designs or external (condom) catheters. Having a broad range of urinary products available allows for personalisation to ensure both effectiveness and comfort.

Skin Sensitivity, Risk of Infection, and History of Irritation

For people prone to urinary tract infections or those with sensitive skin, specialist catheters designed to reduce friction and irritation may be necessary. Carers should monitor for redness, allergic reactions, or skin breakdown around the insertion site. In cases where urethral irritation becomes an ongoing issue, switching to a suprapubic catheter may improve comfort and reduce trauma. This highlights the importance of matching the right urinary product to the individual’s unique medical history and sensitivities.

Comfort and Lifestyle Considerations

Beyond medical need, comfort and lifestyle play a central role in selecting the most appropriate catheter. Active individuals may prefer intermittent catheters because they allow greater mobility and freedom, as there is no need for a continuously attached drainage bag. For people with limited mobility or higher care needs, indwelling or suprapubic catheters may provide a more practical solution. Carers should take into account the person’s daily routine, their ability to manage their own care, and how the catheter will fit into their lifestyle. Ultimately, the right choice of urology products balances clinical necessity with personal comfort and dignity, ensuring the best possible quality of life for the care recipient.

Final Thoughts: Find the Fit That Works for You

Catheters are an important medical tool but require careful selection and management. For carers and care recipients, understanding the types, risks, and lifestyle considerations helps make informed choices. Always seek medical guidance to ensure the safest and most comfortable solution.

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Tags: Continence, Urology