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You should only insert a catheter at the recommendation of your doctor, and if possible, have the catheter inserted by a trained medical professional. If you need to insert a catheter at home, you will need to gather the necessary supplies and insert the catheter properly, being extremely careful to follow sterile guidelines. Only insert a catheter yourself after instruction from a trained nurse or physician.[2]
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Expert Source
Robert Dhir, MDBoard Certified Urologist & Urological Surgeon
Expert Interview. 23 September 2020.
You can then address common issues that may arise with the catheter so it functions correctly.
Gathering Supplies
Purchase a catheter. Most people will need to use a 14–16 French size catheter. You can find Foley catheters at medical supplies stores, online, or through your doctor. Pediatric patients and adult males with congenitally small urethras will not tolerate catheters this large. They may need a 10 French size or smaller. If you have an obstruction, call a professional. You will be using a three-way irrigation large catheter to deal with the obstruction, and it's important to know how to insert it without pushing against the obstruction, which is difficult for someone who isn't properly trained. This process isn't recommended for self-catheterization. Some catheters come in a kit with the catheter and an antiseptic solution that you pour on the catheter to sterilize it. Follow the procedures on the kit to make sure the catheter is sterile before you use it. Check the expiration date of kits when they arrive to make sure they are still usable. While using your catheter will be difficult at first, it will get easier and more routine over time. If you have any questions, consult a nurse who is trained to deal with incontinence.
Purchase enough single-use catheters to use each one only once. Most catheters are single use because they need to be sterile. They will come in individual packages, making it easy for you to use them and then throw them away. Some catheters can be cleaned with soap and water. Discuss this with your doctor before trying to wash your catheters.
Get water-based lubricating jelly. You will need the lubricating jelly to make the top of the catheter slick. This will make it easier to insert the catheter into your penis. The lubricant for catheters should be sterile. It should not come in multi-dose packaging (such as a bottle), as once opened it must be thrown away and not used again in the future. Use single-dose packets only. Make sure the lubricating jelly is water-based, as this will be less irritating to your urinary tract.
Have a container ready for the urine. You will need a container or a urine bag ready to collect the urine once it comes out of the catheter. Use a small, deep plastic container or a bag designed to collect urine.
Use a bath towel or a waterproof pad. You will also need a thick bath towel to place underneath you to catch any urine or water during the insertion. If you have access to a waterproof pad that you can sit on, this will work as well.
Get medical gloves. Always use medical gloves whether this is an in-and-out cath or an indwelling catheter. Your hands must be clean and protected during the insertion process. You can find medical gloves at a medical supply store or online. Urinary retention already places individuals at risk for a urinary tract infection (UTI). Shoving a non-sterile instrument up the urethra practically ensures a UTI will occur. Sterile gloves and technique are preferred.
Inserting the Catheter
Wash your hands with soap and water. Start by washing your hands well with warm water and soap. Then put on your gloves before you unwrap the catheter. Make sure your hands are clean and the area around you is clean before you take the catheter out of the package. Choose an area in your home that is open and free of obstructions, like the floor of your bathroom. Make sure the floor is clean. It is important to have clean hands before you put your gloves on, as handling the gloves with dirty hands will result in unsterile gloves.
Get into a seated position. You will need to sit down with your legs bent. Place the bath towel or the waterproof pad underneath your penis once you are seated. You should have easy access to your penis with your hands. You may also decide to stand in front of the toilet if it is comfortable for you to reach down and hold your penis. You could then point the end of the catheter into the toilet so it drains into the toilet directly.
Clean the area around your penis. Wash your penis with warm water, soap, and a washcloth. Clean the area in circular motions. If you are not circumcised, pull back the foreskin and wash your penis well. Make sure you wash the head of your penis and the urinary meatus, which is the small opening where your urine comes out. Once you are done, rinse and dry your penis well. Then, place the container you are using to collect the urine next to your thigh so it is easy to access.
Put lubricating jelly on the end of the catheter. Hold the top section of the catheter and put lubricating jelly on the catheter. Cover the first 7 to 10 inches (18 to 25 cm) of the catheter with the jelly. This will make the insertion less uncomfortable.
Insert the catheter slowly. Use your non-dominant hand to hold your penis so it is straight out in front of your body. Your penis should be at an angle of 60 to 90 degrees. Hold the catheter in your dominant hand and slowly insert it into the urinary meatus, or the small opening on the top of your penis. Put the catheter around 7 to 10 inches (18 to 25 cm) into your penis using a gentle, pushing motion. Once urine starts to flow through the catheter, push the catheter up 1 inch (2.5 cm) more and keep it in place until you are done urinating. Make sure the other end of the catheter is positioned in a container or in the toilet so the urine can be collected and disposed of properly.
Inflate the collection bag on the catheter, if there is one. Some catheters have a collection bag that you need to inflate with a sterile needle once the catheter has been inserted. Use a sterile syringe to inflate the collection bag with 10 mL of sterile water. The volume of water needed to fill the bag may vary depending on the size of the catheter you are using, so always check the packaging on the catheter for the exact volume. Then, attach the collection bag to the catheter so it can hold the urine as you urinate. The inflated balloon should rest on the urethral opening of your bladder so the urine can be collected properly. Always make sure urine is flowing through the catheter before inflating the balloon.
Remove the catheter as soon as you have finished urinating. Always remove the catheter as soon as you are done urinating, as leaving the catheter in can cause urinary tract issues. To remove the catheter, pinch the top closed with your dominant hand and slowly pull out the catheter. Keep the end of the catheter facing upward so no urine drips or dribbles out. If there is a collection bag, remove the bag and dispose of it properly in the garbage. Pull your foreskin down if you are not circumcised to protect your penis. Remove and throw away your medical gloves. Wash your hands well.
Clean the catheter. If the catheter is reusable according to the manufacturer's instructions, wash it with soap and warm water after every use. Sterilize it in a pan of boiling water for 20 minutes to prevent infection and let it dry on a paper towel. Store the catheter in a clean plastic bag. If the catheter is single-use only, throw it away and use a new one next time. Throw away any catheters that appear torn, hardened, or cracked. Depending on your doctor’s recommendations, you may need to use the catheter at least four times a day to ensure you are urinating regularly.
Addressing Common Issues
Rotate the catheter if no urine comes out. You may find that no urine comes out of the catheter when you insert it. Try rotating the catheter slowly to remove any blockage. You may also try pushing it 1 inch (2.5 cm) further into your penis or pull it back slightly. Make sure the catheter opening is not blocked by the lubricant or mucus. You may need to remove it to determine this. If no urine comes out even after you rotate it, try coughing to encourage urine to flow.
Apply more lubricant if you find it difficult to insert the catheter. You may find it painful or uncomfortable to insert the catheter, especially when you are trying to push it past your prostate. You may need to put more lubricant on the catheter to make it easier to insert. Take a deep breath in and try to relax as you push the catheter in to make it easier to insert. If it is still difficult, do not force it. You may want to wait an hour and try again, focusing on staying relaxed and calm as you insert it.
See a doctor if you cannot seem to urinate or you have other urination issues. If you cannot urinate with the assistance of the catheter or you are experiencing other urination issues, like blood or mucus in your urine, see your doctor. Also see your doctor if you develop stomach cramps, your urine appears cloudy, smelly, or discolored, or you feel feverish. You may have a urinary issue that needs to be addressed before you can try using the catheter again.
Catheterize before sex if necessary. You can still have sex if you need to use a catheter. If you plan to engage in sexual intercourse, it's a good idea to catheterize beforehand to remove any urine that is present in your bladder. Always remove the catheter before having intercourse. If the urine is strong or offensive, don't have sex until you can get treatment for a possible infection.
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