1. What is a urinary catheter?
   
2. How do I care for the catheter and position the urine bag?
3. How do I clean the genitalia?
4. How do I empty the urine bag?
5. How do I change the urine bag?

This content is developed in collaboration with the following partners:

1. What is a urinary catheter?

1. A urinary catheter is a narrow and flexible tube introduced into the bladder to drain urine.
2. It allows continuous drainage of urine from the bladder into a urine bag. It is kept in place by an inflated balloon.

2. How do I care for the catheter and position the urine bag?

1. Ensure no kinks for tubing AT ALL TIMES (refer to picture 1).
2. Ensure no tugging or pulling of the tubing to prevent injuries.
3. Keep the urine bag below the waistline. Lifting above the waistline will cause backflow of stale urine from bag into the bladder, resulting in infection.
4. Ensure the urine bag is hung and does not touch the floor (refer to picture 2 for some examples).

3. How do I clean the genitalia?

General hygiene is important to prevent infection.

For self-cleaning

1. Have a bath or shower daily.
2. Wash the area around the catheter where it exits your genital area with mild soap and water at least once a day. Keep the area clean and dry.

For cleaning by a caregiver

1. Wash your hands with soap and water.
2. Put on gloves (optional).
3. Wash the genital area with soap and water, especially where the catheter exits the urethra (refer to pictures 3 and 4 for more details).
4. Wash your hands with soap and water after cleaning.

4. How do I empty the urine bag?

a. Prepare the following required items:

1. Measuring jug with units in ml (refer to picture 5)
   
2. Two-inch micropore tape (refer to picture 6)
   
3. Urine bag and holder (refer to picture 7) - only required when the urine bag is damaged, leaking or contains heavy sediments, or when there is no urine flow
4. Alcohol swabs
5. Disposable gloves (optional)

b. Wash your hands with soap and water before and after emptying of the urine bag.

c. Wipe the drainage port with an alcohol swab.

d. Release the valve of the drainage port and drain urine into the measuring jug. Wipe the port with another alcohol swab prior to closing the valve.

e. Close the valve and wipe the drainage port with a new alcohol swab.

f. Measure the amount of urine drained if necessary.

5. How do I change the urine bag?

Change the urine bag only when it is damaged, leaking or contains heavy sediments, or when there is no urine flow.

a. Wash your hands with soap and water before and after changing of the urine bag.

b. Ensure the urine bag is empty (refer to Point 4 if you need to empty the urine bag).

c. Clean the urine catheter connector and urine bag tubing using a new alcohol swab.

d. Pinch the urine catheter tubing using your thumb and index finger. Disconnect the catheter using a twisting motion.

e. Clean the urine catheter connector with a new alcohol swab.

f. Insert the new drainage tubing into the catheter connector without touching the tubing directly.

General
Diet

1. Follow your usual diet, but try to have plenty of fruits and vegetables to prevent constipation.
2. Constipation may cause difficulty in passing urine. If constipation is a problem, please consult your doctor/nurse for advice.

Fluid intake

1. DO NOT reduce fluid intake to avoid catheterisation unless instructed by the doctor or nurse.
2. For adults
• Drink about 2 litres or 7-8 glasses of water daily.
3. For children and adolescents
   Drink adequate water daily:
   • 1.2 litres (less than 2 years old)
   • 1.2 to 1.4 litres (2 to 7 years old)
   • 1.4 to 1.6 litres (7 to 12 years old)
   • 1.6 to 1.8 litres (12 years old and above)

Caring for Your Indwelling Urinary Catheter

What happens when there is no urine draining into the urine bag and what should I do about it?

1. Maintain good urine drainage by checking for kinks or loops regularly.
2. Make sure the bag is lower than the abdomen and the catheter or tubing is not clamped.
3. Call us at the number provided if urine is still not draining despite checking for kinks and the clamp. If after office hours, visit the nearest GP clinic or our emergency departments.

Why is there leakage from the catheter and how should I solve this?

1. Catheter leakage may be due to severe constipation, bladder spasms, catheter blockage or prolonged kinking.
2. Check for kinks or loops in the catheter and tubing.
3. Call a home care nurse or go to the nearest GP/polyclinic if leakage continues.

How frequently does the urinary catheter need to be changed?

1. The frequency of change depends on the type of urinary catheter and needs to be done by trained healthcare professionals (doctors/nurses).
2. Call nurses from the Home Nursing Foundation, private nursing agencies or visit the nearest polyclinic or GP for assistance.
   

CONTACT US IMMEDIATELY IF YOU HAVE:

• Difficulty or increasing pain when inserting the catheter
• Difficulty or inability to urinate
• Bloody urine (a trace of blood is normal)
• Swelling of the abdomen
• Prolonged discomfort or pain
• Redness of skin around penis/scrotum (for males)
• Signs of infection such as:
  • Foul-smelling urine, or presence of sand-like grains in your urine
  • Persistent fever of more than 38°C or chills
  • Pain in your lower back or lower abdomen

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