Urologists are the plumbers of the human body. And just like the pipes in your home, your urinary tract can develop leaks and back-ups. The treatment . . . urinary catheters . . . ugh.
Saying the word “catheter” can make even the most stoic patient wince in anticipatory pain. No one likes a tube in their private area. Including the urologist who has to place or manage the catheter.
Once these medieval torture devices are placed, a number of questions can arise:
“Why is a urinary catheter necessary?”
“How far are you sticking that thing inside me?”
“Can you knock me out for this?”
These are all fantastic questions. But you’re here because you want to know what the urinary catheter side effects are after removal. Hopefully the physician who placed the catheter has already answered those other questions (and if not maybe you need a visit with a VirtuCare expert).
Let’s guide you through what to expect on that big day when your doctor asks “would you like to have your urinary catheter removed?” We’re guessing your answer is “heck yes!” (or something more colorful). Here’s what to expect with some tips to minimize the side effects.
Side Effect #1: Burning
You just had a tube in your pee hole. It’s not very happy. The lining of the urinary tract is very sensitive to irritation. Anyone who’s had a urinary tract infection can attest to this.
Although burning with urination is common after urinary catheter removal, it is typically short-lived. Burning should resolve within 24-72 hours. If it doesn’t you may have a urinary tract infection (see below).
The best way to help your urinary tract recover is hydration with water. This is not the time to drink your pot of coffee or six Mountain Dews. Caffeine, acid, and sugar are all bladder irritants. They may prolong the fire in your pee hole.
If you need a little more relief, then phenazopyridine (available OTC as AZO at your local pharmacy) is a great resource. It soothes the inflamed lining of your urethra. But be forewarned, it also turns your pee bright orange so don’t freak out.
Side Effect #2: Frequent urination
Your bladder is not happy right now. Another symptom of it’s irritability is frequent urination. You may find yourself going more urgently as well.
If you find yourself going every 10-15 minutes, then something serious may be going on (keep reading below). However some mild worsening of urinary frequency for a few days is expected.
Sometimes this is self-inflicted. Water intake is important, but you may be drinking TOO much water. Aim for 60-80 ounces of water a day. This is a general guideline and may not apply to everyone. The elderly or people with heart/kidney disease may need to drink less. Younger, active people, especially if they are sweating, may need to drink more.
Occasionally, your doctor may prescribe an overactive bladder medication if the urinary frequency is more severe. However, this should be done with caution if the cause of the frequent urination is due to a UTI or urinary retention.
Side Effect #3: UTI
A urinary catheter is a highway for bacteria to drive right up into your bladder. In fact, 100% of patients will have bacteria in their urine after 7 days with a urinary catheter. Lucky for most folks, not all of the bacteria lead to an actual infection.
A urinary tract infection, for those of you fortunate enough to never have had one, typically causes severe burning with urination, frequency and urgency. Occasionally after a urinary catheter, a UTI may become more serious. Fevers, chills, back pain could be signs of a kidney infection (pyelonephritis) or even worse, sepsis.
Well that sounds horrible. Shouldn’t we give all patients antibiotics prior to catheter removal to prevent UTIs? A 2013 review paper from the British Medical Journal looked at several studies attempting to answer this question. They concluded that antibiotics will decrease the likelihood of a UTI by 5.8%.
Is it worth putting every patient with a urinary catheter antibiotics to lower the likelihood of a UTI by less than 6%? The medical community is not convinced. Overprescription of antibiotics has led to resistant bacteria and needless side effects (e.g. yeast infections, upset stomach).
A better strategy may be to consider preventative antibiotics in patients with certain medical conditions who are more prone to a “bad infection” (e.g. elderly, diabetics).
How do you know if you have a UTI after urinary catheter removal? If urinary burning or frequency is severe and lasts more than a couple days, it’s probably a good idea to get checked out. In an ideal world you leave a urine sample locally to check for bacteria before starting antibiotics. On the other hand, if access to a doctor is challenging, then consider a telemedicine visit (this is our expertise with VirtuCare).
Side Effect #4: Blood in urine
Hematuria is the fancy doctor term for blood in the urine. Since a tube was just rubbing against your bladder, some bleeding should be expected.
If the urine is pink or a light red, then you shouldn’t worry too much. Drink plenty of water and this will clear up in a couple of days. Bright red or thick urine with clots should prompt a call to your local doctor.
Serious bleeding is rare after a routine catheter placement so don’t sweat this. It is usually seen in patients who’ve had previous radiation or major pelvic surgery.
Side Effect #5: Inability to urinate
One reason a urinary catheter may have been placed is an inability to urinate. After some “bladder rest” and a new medication, it may be time for a voiding trial (fancy doctor term for let’s give you a chance to pee on your own). Now the question remains, can you urinate on your own?
Urinary retention typically presents with inability to urinate at all. This is accompanied by pain, pressure and no urine passage for 4-6 hours. But sometimes you can urinate, just not to completion. Lastly, urinating every 10-15 minutes because you’re full and overflowing can be a sign of a full bladder.
The best way to tell if the voiding trial was a success is to have an ultrasound performed after catheter removal.
The management of urinary retention is beyond the scope of this current article, but if this sounds like you, and you need a 2nd opinion, a VirtuCare expert is only a few clicks away.
Now what if you didn’t have a urinary catheter for this reason? Can you still develop urinary retention? The answer is yes. Usually this is seen in men with an enlarged prostate. The catheter can cause prostate swelling making urine passage a challenge.
Depending on the specifics, you may need a one time in-and-out catheter or another internal urinary catheter placed (oh no). For more mild cases of incomplete bladder emptying, a medication alone (e.g. alpha blocker like tamsulosin) may be enough.
We hope that you found this information helpful. At VirtuCare, we believe patient education is a key component to great medical care. The more you know, the better prepared you can be when you see blood in the urine or feel an explosion brewing in your bladder.
Urinary catheters are a necessary evil in healthcare. As you anxiously approach that happy day when it’s removed, now you can anticipate which side effects may occur and how to handle them.
If you still have any questions, then a VirtuCare expert is here to help. And don’t worry, we haven’t figured out how to virtually place a catheter . . . yet.