Overview

A catheter is a thin, flexible tube used to drain pee from your bladder. Sometimes these are put in because you need to stay in bed, but sometimes they're used as part of treatment.

If you have a catheter inserted, it'll need to be removed by a clinician. The removal of your catheter is also called a ‘trial without catheter’ (TWOC). After we have removed the catheter you’ll need to make sure you can completely empty your bladder. If you cannot, we might have to insert another one.

You might have your catheter removed if you're staying in hospital (as an inpatient), or you might come to a clinic at the hospital after you have left hospital (as an outpatient). If you’re coming into hospital to have it removed, you’ll be told which clinic you need to come to.

What to bring with you

If you’re coming in as an outpatient to have your catheter removed, please bring with you all of the medicines you take regularly. This includes prescription medicines, any you buy from a pharmacy or shop, and any herbal or homeopathic remedies.

When the catheter is removed, you'll need to stay at the hospital for a few hours while we monitor you. You should bring something to keep you occupied (but if you want to use a mobile device, please bring headphones so that you do not disturb other patients).

Before the catheter is removed

Before the nurse removes your catheter, they’ll ask you if you have recently had a poo. If you’re constipated, it might mean that you'll have trouble peeing easily too. Sometimes a full bowel can push onto the bladder and make it difficult for the pee (urine) to come out. If you’re constipated, the nurse will give you some medicine (laxative) to make you poo before the catheter is removed. This is usually a suppository (a tablet which you put into your bottom).

The nurse might test your pee for an infection. If you have an infection, they might give you some antibiotics. Make sure that you complete the whole course of antibiotics (even if you start to feel better) so that the infection is properly treated. Having an infection should not affect the removal of the catheter.

The nurse will tell you what is going to happen, and you can ask any questions you have.

When the catheter is removed

When the nurse has explained what will happen, and you’re happy to proceed, the nurse will remove your catheter. This may feel a little strange, but should not hurt. It will take about 5 seconds.

After your catheter has been removed

You’ll need to drink regularly. A glass of water or cup of tea or coffee every hour (about 1.5 litres in 24 hours) is good. Do not drink too much too quickly, or gulp your drinks, as this can lower the chance of you being able to pee.

You’ll need to pee into a jug or bedpan and let your nurse know when you have, so that they can measure it and make a note.

You can leave the ward or clinic if you want to, but you must return to the clinic if you need to pee. The nurse will need to measure your pee.

The nurse might want to scan your bladder to see if you have any pee left in it (residual urine) after you have peed.

Possible signs of urinary retention

These could be the signs of urinary retention (not being able to pee), so tell your nurse if you:

• go to the toilet often (this is called frequency)
• pass only small amounts of pee each time you go to the toilet
• have lower-tummy (abdominal) pain
• have difficulty starting to pee (this is called hesitancy)
• feel like you have a full bladder and cannot empty it properly
• feel pain when peeing (dysuria)

You should also tell your nurse if you:

• have not peed for 6 hours after your catheter has been removed
• are getting uncomfortable because you cannot pee, and feeling pain in your tummy
• feel as though you want to go to pee but cannot

The nurse might need to scan your bladder and insert another catheter. If this happens, try not to worry. Sometimes people cannot pee after having a catheter removed. The doctor or nurse looking after you will explain why it might be a problem for you at this time.

The doctor will assess you and decide if you need to have a catheter in again for a week or more to rest your bladder, or whether to take it out the next day so that you can try to pee again.

When you can leave

If you’re being seen as an outpatient, you should expect to be at the hospital for a few hours. This time will depend on how much pee you’re passing, and how much pee you have left in your bladder. The nurse will check on your progress and decide when you can go home.

The nurse will scan your bladder and might need to insert another catheter into your bladder. If you leave hospital with the catheter in, you’ll be given an appointment to come back to the hospital so that your catheter can be removed. This might be as an outpatient, or you might need to stay overnight. Alternatively, you could be asked to come to a clinic in your department to discuss what other options are available to you. These options are different for everyone, but we'll give you more information at your appointment.

After you have left hospital

When you’re at home, you should drink 6 to 8 cups of fluid a day. You should continue to look out for the signs of urinary retention.