Foley Catheters: Its uses, placement, procedure, complications and care

Foley Catheters are named for Frederic Foley, who produced the original design in 1929. The device is a flexible tube that a clinician passes through the urethra and into the bladder to drain the patient’s urine. Foley Catheters are one of the most common types of indwelling urinary catheters.

Let’s explore their uses, placement, procedure, complications, and care.

What is a Foley Catheter?

A Foley catheter is a thin, sterile tube inserted into the bladder to drain urine. Because it can be left in place in the bladder for a period of time, it is also called an indwelling catheter. It is held in place with a balloon at the end, which is filled with sterile water to prevent the catheter from being removed from the bladder. The urine drains through the catheter tube into a bag, which is emptied when full. The procedure to insert a catheter is called catheterization.

When is a foley catheter used?

A foley catheter is usually used when people have difficulty urinating naturally. It can also be used to empty the bladder before or after surgery and to help perform certain tests.

Foley catheters are used in the following conditions:

- To allow the patient to urinate if they have bladder weakness or nerve damage that affects their ability to pee.

- To allow a patient’s urine to drain if they have an obstruction in the tube that carries urine out of their bladder (urethra). For example, because of scarring or prostate enlargement.

- To drain a patient’s bladder during childbirth if they have an epidural anesthetic.

- To drain a patient’s bladder before, during, or after some type of surgery.

- To deliver medicine directly into the bladder, such as during chemotherapy for bladder cancer.

- As a last resort treatment for urinary incontinence when other types of treatment have been unsuccessful.

How is a Foley catheter placed?

The patient’s genital area is cleaned to prevent infection. The catheter is then inserted into their urethra. When urine begins to flow into the tubing, the balloon is filled to keep the catheter in place. Then, the open end is attached to a drainage bag.

What can be the complications and how to care for a patient’s foley catheter?

There can be certain risks involved in the use and insertion of foley catheters. While the catheter is being inserted, the balloon can break. In this case, the doctor will remove all the balloon fragments.

It can be a problem if the catheter balloon does not inflate after it is in place. Usually, the doctor will check the balloon inflation before inserting the catheter into the urethra. If the balloon still does not inflate after its placement into the bladder, the doctor will then insert another Foley Catheter.

After insertion, urine may sometimes stop flowing into the bag. The doctor will check for correct positioning of the catheter and bag or for obstruction of urine flow within the catheter tube.

Urine flow might get blocked in a foley catheter. To solve this, the doctor will have to change the bag or the Foley catheter, or both.

An adverse risk could be that the urethra begins to bleed. In such a case, the doctor will have to monitor the bleeding.

The Foley catheter may introduce an infection into the bladder. The risk of infection in the urine increases with the number of days the catheter is in place.

If the balloon is opened before the Foley catheter is completely inserted into the bladder, bleeding, damage and even rupture of the urethra can occur. In some individuals, long-term permanent scarring and strictures of the urethra could occur.

Bladder spasms can occur when a catheter is placed. This is a sudden intense urge to urinate and can be painful. Often, urine will leak around the outside of the catheter when a spasm occurs. Medication can be prescribed for bladder spasms.

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