7 Signs Your Catheter Might Need To Be Replaced

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1. Changes in Urine Flow or Drainage
2. Visible Buildup or Discoloration
3. Leaking Around the Catheter or Connections
4. Stiffness, Cracks, or Material Changes
5. Increased Odor During Routine Use
6. Discomfort During Routine Movement or Handling
7. Replacement Schedule Has Been Reached

Introduction

Urinary catheter care can change from day to day, which is why it requires daily monitoring. Over time, intermittent catheters can present changes in the material, buildup inside the tubing, or other changes that may become a concern. These changes are caused by a variety of things, including incorrect sizing, infection, and more. This page will explore and discuss some signs an intermittent catheter might need to be replaced, why they indicate it requires changing the catheter, and the causes behind the symptoms.

Changes in Urine Flow or Drainage

One sign an intermittent catheter may need replacing is slower, reduced, or inconsistent catheter drainage. Normally, urine should flow naturally, as a catheter helps the urine consistently drain with less discomfort and obstruction. However, with regular urine flow monitoring, you may notice the drainage consistency changing. This can be a sign of blockage or obstruction within the tube or bladder irritation.

Among other causes, obstructions can be caused by blood clots, bladder stones, and kidney stones.¹  Not only is this often a sign the catheter should be replaced, but it may also indicate possible serious bladder infections and that the patient might need additional care to resolve them.

Visible Buildup or Discoloration

Tubing obstructions can also result from encrustation, which is residue buildup of salt and minerals from urine that can accumulate in the catheter tube. One method to prevent encrustation is making sure the patient drinks plenty of fluids and avoiding dehydrating drinks like alcohol and caffeine.¹ 

Catheter discoloration can happen for a variety of reasons, including a buildup of colonized bacteria or a syndrome called Purple Urine Bag Syndrome (PUBS). Bacterial buildup and PUBS sometimes are results of contracting urinary tract infections (UTI). This can happen if the catheter is left in place for longer than recommended. Over time, if left unreplaced or treated without proper catheter hygiene, the catheter tube or bag may change color, or a visible buildup may appear.

Purple Urine Bag Syndrome (PUBS)

Purple Urine Bag Syndrome is primarily caused by a UTI in patients with chronic or long-term catheterization. The UTI produces bacterial enzymes, sulphatases and phosphatases, which produce red and blue pigments respectively. As these enzymes accumulate in the catheter tube and bag, the pigments mix to color them purple.² 

Leaking Around the Catheter or Connections

Catheter leakage can be caused by a variety of reasons, including:

• Clogged or kinked tubing, inhibiting regular urine flow
• Constipation as a full bowel presses on the bladder and catheter to interrupt proper drainage
• Incorrect catheter size or positioning, which can contribute to irritation, bladder spasms, or poor drainage

Some instances of leakage will sometimes require replacing the catheter. For example, if the catheter tube is too small, a natural correction would be to find a new catheter with the right size. To help prevent leaking later on, it is important to properly secure the connections and ensure connector compatibility after inserting the catheter.

Stiffness, Cracks, or Material Changes

Catheter flexibility is an important aspect of catheterization. While inserted catheters can cause mild discomfort in the patient, the tubing must be stiff enough to pass through the urethra for proper insertion. At the same time, it should be flexible enough to bend to the contours of the passages of the body and lessen some of the discomfort while in use.

That being said, stiff or cracked catheter tubing is often a sign that the catheter should be replaced as soon as possible. Unusually stiff tubing may crack, breaking the closed system. A cracked catheter tube can:

• Let bacteria into the sterile system, causing infection
• Leave broken fragments of the tube inside the body
• Scrape or even perforate sensitive internal tissue
• Cause encrustation and kinks, which can lead to leakage

Increased Odor During Routine Use

A catheterized patient may notice odors while the catheter is in place. Some odors are simply caused by their diet, as the smell of urine can change depending on what the person eats. Or the patient may just be dehydrated and need more fluids. However, some smells may indicate it is time to replace the catheter.

If you notice the patient’s urine has a particularly strong, foul, or fishy smell that progresses over time, they may have a catheter-associated UTI. Odor management, in this case, is best handled by further examining and testing for a UTI, cleaning the area, treating the infection (if present), and inserting a new, clean catheter.

Discomfort During Routine Movement or Handling

Catheterization can cause mild discomfort for the patient during or shortly after insertion, as they have had a foreign body inserted into a sensitive area. Catheter comfort can depend on the kind of catheter, but it can also depend on whether proper technique was employed during insertion or if the catheter is the right size. If a catheter is too big or was not inserted with the correct procedures, the patient may experience more pain or discomfort than they should. The excess pain can make even daily mobility a challenge.

Urinary catheter-related pain can also result from “involuntary bladder spasm caused by irritation of the bladder wall”³  or a catheter-associated UTI. If a patient experiences more discomfort than usual, check or test for:

• Whether the catheter is the right size
• A UTI
• Signs of a bladder spasm (cramping, intense urge to urinate, leaking urine)
• If the catheter was inserted correctly

Replacement Schedule Has Been Reached

Following a catheter replacement schedule may help avoid issues that come from prolonged use of a single catheter. Each catheter is different, and the recommended use period can depend on the type of catheter (Foley catheters, external catheters, etc.), the manufacturer, and the patient’s condition.

Make sure to check the manufacturer guidelines and prepare a stock of necessary recurring supplies to plan ahead for future catheter replacements.

Conclusion

To summarize, here are some common signs an intermittent catheter may need replacing:

• The urine flow has slowed, reduced, or become inconsistent
• Visible, noticeable buildup and discoloration
• Leaking urine around the catheter or connection points
• The catheter has become unusually stiff or cracked
• Increased or foul odor
• The patient begins to experience increased discomfort and pain
• The replacement period recommended by the manufacturer has been reached

It is important to perform regular catheter monitoring to help avoid some of the above issues. Vitality Medical carries a variety of catheters for your replacement needs, such as the Cure Intermittent Straight Tip Catheters for Men and Women. With the proper procedures, your patients can receive the care they need with confidence and comfort.