Urinary Catheter Insertion

The urinary catheter insertion is by far – and I mean WAY far – the worst part of living with a catheter. Once it’s in, everything else is pretty painless and mainly inconvenient. Now, I’m a guy. And as such, my anatomy includes a much longer pathway from the end of the wee-pipe (yes, that means what you think it means:)) all the way to the bladder. So my experience is obviously different from that of a woman, who by physiology will have a much shorter path. I encourage women reading this article to please leave a comment below to give us the female point of view on this.

Anyway, I’m led to understand that though common, the urinary catheter insertion process is, at best, uncomfortable. Fortunately, the vast majority of folks who will go through this probably won’t even remember having it done, since it is part and parcel of undergoing surgery. So if you’ve had any kind of surgery under general anesthesia, you’ve almost certainly had a catheter put in and taken out all while you were asleep.

But if you, like me, suddenly find that you cannot go wee-wee the regular way anymore – because nothing (or very little) will come out, you will likely find yourself in the emergency room for a routine “cathing.” Here are the steps that are the most common:

1. They wipe you down to make sure everything is clean down there.
2. They squirt a cold lubricant up your willy (or female equivalent). Now, I’m willing to bet that the technology exists to warm up this lubricant before they squirt it inside you. But so far as I can tell, medical science is unwilling or unable to utilize such technology.
3. They grab hold and start threading a rubber tube up inside you, along your urethra (the tube in your body that connects the bladder to the genitals). For the lucky folks, they may even put some topical anesthetic gel inside first. I was not a “lucky folk.”
4. If you’re lucky (and honestly, this is the case for a vast majority of folks), you’ll endure some discomfort, not really terribly painful, until the catheter reaches your bladder, at which point your urine will begin to flow, giving you relief from not being able to go for so long.
5. If it’s a Foley catheter, they’ll squirt some saline into a balloon that is at the bladder end of the catheter to inflate it. This is to prevent it from falling out of you.

Here is a video of the process or urinary catheter insertion (using dummies for training purposes)

That’s pretty much the standard process. However, if you had been me at the time of attempted insertion, they wouldn’t have been able to get the catheter all the way up the urethra because there is scar tissue (called a stricture), completely blocking the way. And instead of stopping, the nurse(s) (they tried this twice, neither time with any anesthetic gel!) will just keep shoving and pushing. Yeah, I was in excruciating pain. But these nurses assumed I was just too tense and was squeezing my bladder sphincter. Nope. It was a stricture. Did they even consider that possibility? Apparently not. They just shouted at me to relax.

Anyway, I will not dwell on that. It is not the norm, and most nurses I’ve talked to since then assure me that my experience was appalling and should not have happened. So take comfort in that. The next alternative, if a catheter cannot be inserted the normal way, is to poke a hole in your abdomen underneath your belly button, and put the catheter directly into your bladder that way. This is called a suprapubic catheter. You can read all about that, and even see a  video, in my article What Is A Suprapubic Catheter?

So that pretty much covers the basics of urinary catheter insertion. Take a look at my other articles for tips on dealing with life while wearing a cath.