Questions about Catheters for Incontinence

Community Member

I received a message from a member of asking me several questions about catheters. Specifically, this individual suffers from overflow incontinence and is considering using a Foley catheter at night to keep his/her bladder empty, preventing nighttime accidents.

Although I have written many times about catheters, I thought there might be others who could benefit from this information, so I thought it might be beneficial to answer the message here.

First, let me state categorically that  I find having to use catheters to be very unpleasant. For me at least, they are extremely uncomfortable.

I consider catheters to be a "necessary evil," the use of which helps either with incontinence issues or infection control.

Because of a past surgery, I'm a "difficult cath" and sometimes it's impossible to get one in. Indeed, even my urologist has been unsuccessful. There have been times that they have had to use a cystoscope with a guide wire to put it in. Ouch

I use catheters for two purposes:** 1.** After Botox, my bladder is asleep, so my doctor usually sends me home with a Foley. Once the Foley is removed, (usually a couple of weeks later) then I may have to self-cath with a non-Foley for another week or two.

2. I have recurrent UTIs and so I do bladder wash once a week (along with an oral antibiotic) to keep the infection under control. In this case, I may or may not use a Foley.

I don't have to use a Foley for the bladder wash, but with the difficulty I have I don't like to get the medicine ready before I get the catheter in. If I'm not successful with cathing, the medicine is wasted. However, a non-Foley may slip out before I'm ready.

Now, on to the Foley catheter questions...** 1.** Are Foley's more comfortable? In short, no. The balloon and tip can be very irritating. When I have a Foley, it's very difficult to sleep for several reasons:

  • They are uncomfortable.
  • I have to maintain a constant position, usually on my back, as the Foley is connected to a drainage bag. It is possible to sleep on my sides but this seems to be much more uncomfortable to my bladder. I don't know why.
  • If I'm not careful, changing positions can cause the drainage tube to tug on the Foley. Believe me, bladder necks don't like this!

2. Type of material? Catheters are made from a variety of materials. Some of these are:

  • Polypropylene. These are usually for intermittent use. They are clear, with fire-polished eyelets. They tend to be somewhat harder and less flexible.
  • Rubber (Latex). These are softer and more flexible. These tend to be more comfortable, but their flexibility may make them harder to insert. However, people with allergies to latex cannot use catheters made from this material.
  • Silicone. I don't have any direct experience with silicone catheters. They tend to be more expensive, but easier to insert.
  • Some catheters have a hydrophilic gel coating on the outside that gets very slippery when wet. This makes insertion much easier, but make them more difficult to handle. I have used hydrophilic catheters, but have found their slippery nature more of a liability than an asset. I do know many people use and swear by them.

I don't have an allergy to latex, so I use rubber catheters almost exclusively.

3. Any specific brands of catheters? There are several companies that manufacturer catheters. Many make several types (size, tip design)  and coatings.   I do use one specific brand (send me a message if you want to know), but only because I found that it works for me. It might be necessary to try several different types. The designs of various types of catheters (coude, tiemann tip) also vary by manufacturer, so if a "bent tip" is required, it might be necessary to several types.

Perhaps some of these "tips" may help. I hope so.