Urinary catheters: what they are and how to look after onePeshab ki catheter: yeh kya hai aur us ki dekh bhaal kaise karein

Yeh kya hai aur kyun lagayi jati hai

Peshab bahar nikalne ke liye bladder mein catheter daali jati hai. Is ki teen bunyadi qismein hain:

• Urethral catheter: peshab ki nali (urethra) se guzar kar jati hai. Bladder ke andar paani se bhara chhota ghubara (balloon) use phisalne se rokta hai.
• Suprapubic catheter: pait ke neeche ki jild mein chhote se suraakh se seedha bladder mein daali jane wali nali. Yeh us waqt use hoti hai jab urethra istemal nahi ho sakti, ya jab catheter lambay arsay ke liye chahiye ho.
• Intermittent catheter: aisi catheter jo insaan din mein kayi baar khud daalta hai aur foran nikal deta hai (neeche khud catheter lagane ka hissa dekhein). Is mein ghubara nahi hota aur kuch andar nahi rehta.

Catheter us waqt lagayi jati hai jab bladder khali nahi ho pata (dekhein urinary retention ki guide), operation ke dauran aur baad bladder khali rakhne aur khoon ya paani nikalne ke liye, peshab ki sahi paimaish ke liye, ya jab bladder kharab ho aur jild aur gurdon ko bachana ho (dekhein neurogenic bladder ki guide).

Lagane se pehle aur lagane ke dauran

• Team aap ko batayegi ke aap ko catheter kyun chahiye aur woh kitni der rehne ki umeed hai. Agar yaqeen na ho to poochhein.
• Kisi bhi allergy ke baare mein batayein, latex ya gel se allergy samet, taake sahi catheter chuni jaye.
• Urethral catheter ke liye: aap peeth ke bal letate hain. Jild saaf ki jati hai aur urethra mein sunn karne wali gel lagayi jati hai. Catheter aahista se bladder mein daali jati hai, peshab nikalta hai, aur phir ghubara bhara jata hai. Yeh takleef deh hota hai lekin aam tor par jaldi ho jata hai.
• Suprapubic catheter ke liye: yeh chhota operation hai jo aam tor par local ya poori bay-hoshi mein hota hai. Team alag se samjhayegi.

Catheter ke saath rehna aur us ki dekh bhaal

• Catheter ya thaili ko chhoone se pehle aur baad mein sabun aur paani se haath dhoyein. Infection se bachne ka yeh sab se aham tareeqa hai.
• Thaili ko bladder se neeche rakhein taake peshab neeche behta rahe aur wapas na aaye. Din mein taang par bandhi jane wali chhoti thaili istemal karein, is tarah ke nali khinche nahi, aur raat ko bari thaili.
• Thaili jab taqriban do tihayi bhar jaye to neeche ki tonti se khali karein, aur tonti ko farsh ya kisi gande cheez se na lagne dein.
• Catheter ke aas paas ki jild roz halke sabun aur paani se dho kar sukha lein. Mardon mein dhone ke baad khaal (foreskin) ko aahista peeche kar ke dobara aage kar dein.
• Kaafi paani peeyein, siwaye is ke ke aap ko kam peene ko kaha gaya ho. Is se peshab saaf rehta hai aur nali chalti rehti hai.
• Nali ko khinchein nahi. Use is tarah bandhein ke woh ghasiti na rahe, aur kapray pehente ya harkat karte waqt ehtiyaat karein.
• Shuru mein nali ke aas paas se thoda reesna, bladder ke spasm aur khoon mile peshab ho sakta hai. Agar nali se peshab aana band ho jaye to fauran madad ka dabba dekhein.
• Jinsi taluq, kaam aur kasrat: bohat se log yeh jaari rakh sakte hain. Apni surat-e-haal ke mutabiq team se mashwara karein.

Khud saaf tareeqe se catheter lagana (CISC)

Kuch logon ka bladder theek tarah khali nahi hota lekin unhein hamesha ke liye catheter lagi rakhne ki zaroorat nahi hoti. Woh din mein kayi baar khud patli catheter bladder mein daalte hain, peshab nikalne dete hain aur catheter nikal dete hain. Ise clean intermittent self-catheterisation (CISC) kehte hain. Yeh aksar us bladder mein hota hai jo khali nahi hota (dekhein neurogenic bladder ki guide) ya botulinum toxin ke ilaaj ke baad (dekhein botulinum toxin ki guide).

• Nurse aap ko sikhati hai aur jab tak aap mutmain na ho jayein aap ko mashq karte dekhti hai. Bohat se log ise umeed se aasaan paate hain.
• Haath dhoyein, catheter ko aahista se tab tak daalein jab tak peshab na aaye, dhaar band hone tak rukein, phir aahista se nikaal lein aur jaisa sikhaya gaya ho phenk dein ya saaf kar lein.
• Is se bhara hua bladder, reesna aur infection ka khatra kam hota hai us bladder ke muqable mein jo khali nahi hota. Saath hi nali hamesha andar nahi rehti.
• Team se poochhein ke kitni baar karna hai, kaunsi catheter istemal karni hai aur saman kahan se milega.

Mumkina masail

• Peshab ka infection sab se aam masla hai aur catheter jitni der rahe khatra utna barhta hai (dekhein peshab ke infection ki guide). Har tabdili ke ilaaj ki zaroorat nahi hoti, lekin bukhar, dard ya bimar mehsoos karna zaroori hai.
• Rukawat: nali lothron, talchhat ya mudne se band ho sakti hai aur peshab nali ke aas paas se reesne lagta hai ya aana band ho jata hai. Dekhein ke nali mudi hui na ho aur thaili bladder se neeche ho.
• Bladder ke spasm aur catheter ke aas paas reesna ka ilaaj ho sakta hai, is liye team ko batayein.
• Bladder ki pathri ya urethra ko nuqsan bohat der catheter lagi rehne se ho sakta hai.
• Ghubara bhara hone ki halat mein catheter ka ghalti se khinch jana urethra ko zakhmi kar sakta hai. Aisa ho to madad lein.

Catheter badalna aur follow-up

• Lambay arsay ke liye lagi catheter baqaida waqfon se badli jati hai, aam tor par nurse ke zariye. Poochh lein ke kitni der baad aur kahan.
• Catheter nikalna: jab zaroorat na rahe to ghubaray se paani nikal liya jata hai aur nali phisal kar bahar aa jati hai. Team baad mein dekh sakti hai ke aap peshab kar sakte hain ("trial without catheter").
• Saman ki fehrist aur apni nurse ya unit ka phone number saath rakhein taake pata ho kise phone karna hai.

Aam sawalaat

What it is and why it is used

A catheter is passed into the bladder to drain the urine out. There are three main kinds:

• Urethral catheter: passed through the urine tube (urethra). A small balloon filled with water, just inside the bladder, stops it slipping out.
• Suprapubic catheter: a tube placed through a small opening in the skin of the lower belly, directly into the bladder. It is used when the urethra cannot be used, or when a catheter is needed for a long time.
• Intermittent catheter: a catheter passed by the person themselves a few times a day and removed straight away (see clean intermittent self-catheterisation below). There is no balloon and nothing stays in.

Catheters are used when the bladder cannot empty (see the urinary retention guide), to keep the bladder empty and drain blood or fluid during and after an operation, to measure urine accurately, or to protect the skin and kidneys when the bladder is damaged (see the neurogenic bladder guide).

Before and during insertion

• The team will explain why you need it and how long it is likely to stay. Ask if you are not sure.
• Tell them about any allergies, including to latex or to gels, so that the right catheter is chosen.
• For a urethral catheter: you lie on your back. The skin is cleaned and an anaesthetic gel is put into the urethra. The catheter is passed gently into the bladder, urine drains, and the balloon is then filled. It is uncomfortable but is usually quick.
• For a suprapubic catheter: this is a small operation, usually done under local or general anaesthetic. The team will explain it separately.

Living with a catheter and looking after it

• Wash your hands with soap and water before and after touching the catheter or bag. This is the most important way to prevent infection.
• Keep the bag below the level of your bladder, so urine drains down and does not flow back. Use the leg bag during the day, strapped or held so the tube is not pulled, and the larger bag at night.
• Empty the bag when it is about two-thirds full, using the tap at the bottom, and do not let the tap touch the floor or anything unclean.
• Wash the skin around the catheter once a day with mild soap and water, and dry it. For men, gently move the foreskin back and then forward again after washing.
• Drink enough fluid, unless you have been told to limit it. This helps keep the urine clear and the tube flowing.
• Do not pull the tube. Secure it so it cannot drag, and take care when dressing or moving.
• Some leaking around the tube, bladder spasms and blood-stained urine can happen at first. See the urgent help box if the tube stops draining.
• Sex, work and exercise: many people can carry on with these. Ask the team for advice about your own situation.

Clean intermittent self-catheterisation

Some people have a bladder that does not empty properly, but do not need a catheter to stay in. Instead they pass a thin catheter into the bladder themselves, a few times a day, let the urine drain, and take it out. This is called clean intermittent self-catheterisation (CISC). It is often used in a bladder that does not empty (see the neurogenic bladder guide) or after botulinum toxin treatment (see the botulinum toxin guide).

• You are taught by a nurse, who watches you practise until you are confident. Many people find it easier than they expected.
• Wash your hands, pass the catheter gently until urine flows, wait until the flow stops, then slowly withdraw it, and dispose of it or clean it as taught.
• It lowers the risk of a full bladder, leaking and infections, compared with a bladder that does not empty. It also avoids a tube staying in all the time.
• Ask the team how often to do it, which catheters to use, and where to get supplies.

Possible problems

• Urine infection is the commonest problem and risk goes up the longer a catheter stays in (see the urinary tract infection guide). Not every change needs treatment, but fever, pain or feeling unwell does.
• Blockage: the tube can become blocked by clots, sediment or kinks, and urine then leaks around it or stops draining. Check the tube is not kinked and that the bag is below the bladder.
• Bladder spasms and leaking around the catheter can be treated, so please tell your team.
• Bladder stones, or damage to the urethra, can happen with a catheter left in for a long time.
• Accidentally pulling the catheter out with the balloon still full can injure the urethra. Seek help if this happens.

Changing the catheter and follow-up

• A catheter left in for a long time is changed at regular intervals, usually by a nurse. Ask how often and where.
• Removing a catheter: when it is no longer needed, the water is drawn out of the balloon and the tube slides out. The team may check that you can pass urine afterwards (a "trial without catheter").
• Keep a list of supplies and the contact number for your nurse or unit, so you know who to call.

Common questions