What is a catheter?
If you have problems emptying your bladder, your health professional may suggest using a catheter. A catheter is a thin, hollow tube that’s used to drain urine from your bladder. There are a few different types of catheter available – intermittent, indwelling and suprapubic. They are all inserted and used in slightly different ways. Catheters may be used when needed (intermittently), or on a more permanent basis.
Intermittent catheters are inserted into your bladder through the urethra – the tube that allows urine to pass out of your body. You carry out this process yourself by guiding a thin, hollow tube through your urethra and into your bladder until urine starts flowing out of the tube. The other end of the tube is left open so your urine can either be drained into a toilet or collected in a bag. Once the urine stops coming out of the tube, the catheter can be removed and disposed of. You’ll usually need to carry out this process several times a day – this is known as clean intermittent self-catheterisation (CISC).
Using a catheter can seem daunting at first. It’s completely normal for it to take a little bit of getting used to – expect it to take some time and lots of practise before you feel fully confident. Your nurse or continence advisor will go through the process with you and fully support and reassure you until you feel confident using a catheter independently.
Catheters can be a really positive and life-changing step for some people. They can give you better control over your bladder, reducing the impact your bladder symptoms have been having on your daily life and improving your confidence. Using an intermittent catheter can also reduce the number of urinary tract infections as they ensure the bladder fully emptied.
Using catheters means my bladder empties properly, and I get less of those awful water infections.
The process of inserting an intermittent catheter requires you to have good manual dexterity and for this reason, they are not suitable for everyone. If this process would be difficult for you, your health professional may suggest an indwelling catheter instead.
Long-term catheter use
Long-term catheters are normally only used when other treatments you have tried have not been successful. They can be useful if you lack of control of your bladder, both during the day and at night.
There are two types of long-term catheter:
- indwelling urinary catheters
- suprapubic catheters.
Indwelling urinary catheters are similar to intermittent catheters – they consist of a tube that’s guided through the urethra and into the bladder. However rather than being removed after each use, an indwelling catheter is kept in place by a small, inflatable balloon attached to the bladder end that stops it falling out. Your urine drains out the other end of the tube and into a bag which is usually attached to your leg using Velcro straps. The bag can easily be emptied into a toilet when it’s full. At night, the catheter may be attached to a night drainage bag that hangs by the side of your bed.
Some indwelling catheters come with a valve, rather than a bag, so you can empty your bladder directly into a toilet. When the valve is closed, your urine will collect in your bladder until the catheter is emptied.
Your nurse or continence advisor will fit the catheter for you and teach you how to manage and empty it. This will reduce the risk of hygiene problems when changing drainage devices, which can cause urinary tract and urine infections. Indwelling catheters usually need to be replaced at least every three months.
There are different types of indwelling urinary catheters and they are only available on prescription from a doctor.
A suprapubic catheter is a more long-term approach to bladder problems. It’s inserted directly into your bladder through a hole in your abdominal wall and is left in place. This is a surgical procedure carried out by a urologist. Once inserted, your urine is collected in a bag that is attached either to the side of your body or your leg – it can be easily emptied when full. Some people prefer suprapubic catheters as they are less intrusive, are usually easy to manage and allow full sexual activity. Suprapubic catheters are usually changed every six to eight weeks. There can sometimes be problems with healing at the point where the catheter is inserted into the body. There is also the risk of urine infections if the drainage bag is not changed cleanly.
Suprapubic catheter is fantastic for the waterworks – and saves energy by not having to get to the loo in time, 10 times a day.
- London: NICE; 2012. Full guideline Urinary incontinence in neurological disease: management of lower urinary tract dysfunction in neurological disease.
- World Journal of Neurology 2013;31(6):1445-1450. Summary Impact of intermittent catheterization on the quality of life of multiple sclerosis patients.
- Neurourology and Urodynamics 2018;Nov 29 Summary Bladder management experiences among people living with neurologic disease: A systematic review and meta-synthesis of qualitative research.
Urinary tract infection (UTI)
It is important to find out if you have a urinary tract infection as it can make MS symptoms such as spasticity or thinking problems worse and may trigger an MS relapse.
Managing your bladder
Order or download our book that looks at why bladder problems can be part of MS and provides a practical approach to their management.
Bladder problems are common symptoms in multiple sclerosis but successful treatment is available and lifestyle changes can make a real difference.
Sexual problems for women with MS
Sexual difficulties are common in women with MS. You may be reluctant to talk about these problems, but there is support available.
Sexual problems for men with MS
Sexual difficulties - particularly erectile dysfunction and difficulty reaching orgasm - are common in men with multiple sclerosis. Help is available.