Urinary Catheter in Children
Essential information for parents, caregivers, and healthcare professionals
What is a Urinary Catheter?
A urinary catheter is a thin, flexible tube inserted through the urethra into the bladder to drain urine. In pediatric care, these medical devices help manage various conditions when normal urination is not possible or when urine collection is needed for medical testing.
A urinary catheter is a thin, flexible tube inserted through the urethra into the bladder to drain urine. In pediatric care, these medical devices help manage various conditions when normal urination is not possible or when urine collection is needed for medical testing.
Purpose and Medical Uses
Urinary catheters in children serve several important medical purposes:
- Diagnostic purposes: Collecting sterile urine samples for testing in infants and young children who cannot urinate on command
- Monitoring urine output: Tracking fluid balance in critically ill children or during surgery
- Urinary retention: Relieving inability to urinate due to medical conditions, surgery, or anatomical problems
- Surgical procedures: During operations requiring bladder drainage or monitoring
- Bladder obstruction: Managing blockages from blood clots, debris, or anatomical abnormalities
- Neurogenic bladder: Assisting children with nerve-related bladder control issues
- Post-surgical care: After specific urological or pelvic surgeries
Types of Urinary Catheters
1. Intermittent Catheter (Straight Catheter)
A single-use catheter inserted to drain the bladder and removed immediately.
- Used for one-time urine collection or periodic drainage
- No balloon mechanism
- Reduces infection risk compared to indwelling catheters
- Commonly used for diagnostic urine samples
2. Indwelling Catheter (Foley Catheter)
A catheter that remains in the bladder, held in place by a small water-filled balloon.
- Has two channels: one for urine drainage, one for balloon inflation
- Connected to a collection bag
- Used when continuous drainage is needed
- Requires proper maintenance to prevent infection
3. Three-Way Catheter
A specialized catheter with an extra channel for continuous bladder irrigation.
- Used when bladder washing is needed (bleeding, surgery)
- Typically larger in size (16-24 French)
- Less commonly used in pediatrics
| Age Group | Typical Catheter Size | French (Fr) Measurement |
|---|---|---|
| Newborn (0-6 months) | 5-6 Fr | 1.7-2.0 mm diameter |
| Infant/Toddler (6 months-2 years) | 6-8 Fr | 2.0-2.7 mm diameter |
| Young Child (2-8 years) | 8-10 Fr | 2.7-3.3 mm diameter |
| Older Child (8-12 years) | 10-12 Fr | 3.3-4.0 mm diameter |
| Adolescent (12+ years) | 12-14 Fr | 4.0-4.7 mm diameter |
Note: 1 French (Fr) equals 0.33 mm in diameter. Healthcare providers select the smallest effective size to minimize urethral trauma.
How to Use: Step-by-Step Guide
Important: Catheter insertion should only be performed by trained healthcare professionals. This guide is for educational understanding.
Preparation
- Position the child comfortably (supine with legs slightly apart)
- Allow parent or caregiver to comfort the child
- Gather sterile equipment: catheter, lubricant, antiseptic solution, gloves, collection container
- Perform thorough hand hygiene
- Explain the procedure to the child in age-appropriate terms
Insertion Process
- Clean the genital area thoroughly with antiseptic solution
- Apply sterile lubricant to the catheter tip
- Gently insert the catheter through the urethra into the bladder
- For girls: Insert 2-3 inches until urine flows
- For boys: Insert 2-4 inches (varies with age) until urine flows
- For Foley catheters: Inflate the balloon with sterile water once in bladder
- Connect to drainage bag if indwelling catheter
- Secure catheter to prevent pulling or movement
Maintenance of Indwelling Catheters
- Keep the drainage bag below bladder level at all times
- Never let the bag touch the floor
- Empty the collection bag regularly when half to two-thirds full
- Clean hands before and after handling the catheter
- Clean around the catheter insertion site daily with soap and water
- Keep the catheter tubing free from kinks and twists
- Monitor for signs of infection or complications
Removal
- Deflate the balloon completely (for Foley catheters)
- Gently withdraw the catheter
- Clean the area after removal
- Monitor first few urinations for discomfort or blood
Precautions and Safety Measures
Key Safety Principle: Use the smallest effective catheter size and remove it as soon as medically unnecessary.
Before Insertion
- Confirm medical necessity - catheters should only be used when truly needed
- Check for urethral trauma or pelvic injury before catheterization
- Select appropriate catheter size based on age and weight
- Ensure all equipment is sterile
- Use proper anesthetic gel if appropriate to reduce discomfort
During Use
- Maintain strict hand hygiene before touching catheter or drainage system
- Keep the drainage system closed to prevent infection
- Avoid disconnecting the catheter from the drainage bag
- Position tubing to allow free urine flow without loops or kinks
- Secure catheter properly to prevent pulling or movement
- Do not irrigate catheter unless specifically instructed
Infection Prevention (CAUTI Prevention)
Catheter-Associated Urinary Tract Infections (CAUTI) are preventable. Follow these measures:
- Use aseptic technique during insertion
- Remove catheter as soon as possible - each additional day increases infection risk
- Daily assessment of continued need
- Hand hygiene before and after any catheter contact
- Keep drainage bag below bladder level but off the floor
- Empty drainage bag regularly using clean technique
- Daily cleaning of urethral area with soap and water
- Maintain closed drainage system
Potential Risks and Complications
Seek immediate medical attention if you notice: Fever, severe pain, heavy bleeding, inability to remove catheter, no urine drainage, or signs of infection.
Common Complications
- Catheter-associated urinary tract infection (CAUTI): Most common hospital-acquired infection related to catheters
- Urethritis: Inflammation of the urethra
- Bladder spasms: Involuntary bladder contractions causing discomfort
- Hematuria: Blood in urine, usually mild and temporary
- Discomfort or pain: During insertion, while in place, or after removal
- Urethral trauma: Injury to urethral lining, more common in young boys
Serious but Rare Complications
- Urethral stricture: Narrowing of urethra requiring surgical repair
- False passage: Catheter creates abnormal track in urethral wall
- Catheter knotting: Rare complication where catheter forms a knot in bladder (more common with catheters smaller than 10 Fr)
- Bladder injury: Perforation or trauma to bladder wall
- Meatal stenosis: Narrowing of urethral opening
Boys under 2 years are at higher risk for urethral complications. Gentle technique and appropriate sizing are crucial.
Frequently Asked Questions
How long can a catheter stay in a child?
Intermittent catheters are removed immediately after use. Indwelling catheters should be removed as soon as medically possible, typically within a few days. Long-term use (over 30 days) requires special management and monitoring.
Is catheterization painful for children?
Insertion may cause brief discomfort or pressure, but proper technique, appropriate lubrication, and anesthetic gel minimize pain. Most children tolerate the procedure well when performed gently by trained staff.
Can my child move around with a catheter?
Yes, with an indwelling catheter, children can move around carefully. The drainage bag must remain below bladder level and should be secured to prevent pulling on the catheter.
How do I know if the catheter is infected?
Signs include fever, cloudy or foul-smelling urine, abdominal pain, redness or discharge around catheter site, and increased urgency or discomfort. Contact healthcare provider if these occur.
Can my child bathe with a catheter?
Sponge baths are recommended. If showering is permitted, cover the catheter connection site to keep it dry. Avoid submerging in bathtub water to reduce infection risk.
What if the catheter falls out?
Do not try to reinsert it yourself. Contact your healthcare provider immediately. Cover the area with clean gauze if needed and monitor for urination difficulties.
Why is the smallest catheter size important?
Smaller catheters reduce trauma to the delicate urethral tissue, minimize discomfort, and lower the risk of complications like strictures while still allowing adequate urine drainage.
Are there alternatives to catheterization?
For urine collection, suprapubic aspiration is an alternative. For some conditions, external collection devices or intermittent catheterization may be options. Discuss with your healthcare provider.
How to Keep the Device Safe
Storage of Unused Catheters
- Store in original packaging in a cool, dry place
- Keep away from direct sunlight and heat
- Check expiration dates before use
- Do not use if packaging is damaged or opened
- Keep out of reach of children
Safety with Indwelling Catheters
- Secure tubing to prevent accidental pulling or dislodgement
- Use catheter straps or securement devices as instructed
- Ensure adequate tubing length for movement without tension
- Keep drainage system below bladder but above floor level
- Protect catheter site during sleep with proper positioning
- Supervise young children to prevent them from pulling catheter
When to Replace
- Replace intermittent catheters after each single use (do not reuse)
- Indwelling catheters typically changed every 2-4 weeks or as directed
- Replace immediately if catheter becomes blocked or damaged
- Change if infection develops or catheter malfunctions
Important Reminders for Caregivers
- Never insert or remove a catheter without proper training
- Question the need for catheter if it seems unnecessary
- Ask when the catheter will be removed
- Report any concerns or changes in your child's condition immediately
- Follow all care instructions provided by healthcare team
- Keep scheduled follow-up appointments
- Maintain a record of catheter insertion date and care activities
When to Seek Medical Help
Contact healthcare provider immediately if:
- Fever (temperature over 38°C or 100.4°F)
- No urine drainage for several hours
- Catheter becomes dislodged or falls out
- Heavy bleeding or blood clots in urine
- Severe pain or bladder spasms
- Leakage around the catheter
- Cloudy, foul-smelling urine
- Redness, swelling, or discharge at insertion site
- Child appears unwell or irritable
- Unable to deflate balloon for removal
Resources and References
For more information, consult these authoritative sources:
- CDC Guidelines for Prevention of Catheter-Associated Urinary Tract Infections
- American Academy of Pediatrics - Urinary Tract Infection Guidelines
- Textbook: "Clinical Pediatric Urology" by Kelalis, King, and Belman
- Textbook: "Comprehensive Pediatric Hospital Medicine" - Bladder Catheterization Chapter
- Your child's healthcare provider and hospital infection control team
Always consult with your child's healthcare provider for specific medical advice and guidance tailored to your child's individual needs.
Medical Disclaimer
This guide is intended for educational and informational purposes only and does not constitute medical advice. Urinary catheterization is a medical procedure that should only be performed by trained healthcare professionals. The information provided here should not replace professional medical consultation, diagnosis, or treatment.
Always consult with qualified healthcare providers regarding your child's specific medical conditions, catheter needs, and care requirements. Every child's situation is unique, and treatment decisions should be made in consultation with appropriate medical professionals.
If your child experiences any medical emergency or concerning symptoms, seek immediate medical attention. Do not delay seeking professional medical care based on information from this guide.
While every effort has been made to ensure accuracy, medical knowledge and practices evolve over time. This information is current as of the publication date and may be subject to updates as new evidence emerges.
Medically Reviewed and Checked by a Pediatrician
PediaDevices - Your trusted source for practical pediatric healthcare device information
PediaDevices - Your trusted source for practical pediatric healthcare device information
Labels: Renal-System