Catheterization, male


Urinary catheterization is the insertion of a catheter through the urethra into the urinary bladder for withdrawal of urine. Straight catheters are used for intermittent withdrawals, while indwelling (Foley) catheters are inserted and retained in the bladder for continuous drainage of urine into a closed system.


Intermittent catheterization is used for the following reasons:

Indwelling catheterization is used for the following reasons:


As of 2002, experts estimate that approximately 96 million urinary catheters are sold annually throughout the world. Men are less likely than women to use them.


The male urethral orifice (urinary meatus) is a vertical, slit-like opening, 0.15–0.2 in (4–5 mm) long, located at the tip of the penis. The foreskin of the penis may conceal the opening. This must be retracted to view the opening to be able to insert a catheter. With proper positioning, good lighting, and gloved hands, these anatomical landmarks can be identified. Perineal care or cleansing may be required to ensure a clean procedural environment.

The male urethra is longer than the female urethra and has two curves in it as it passes through the penis to the bladder. Catheterization of the male patient is traditionally performed without the use of local anesthetic gel to facilitate catheter insertion. Glands along the urethra provide some natural lubrication. Older men may require lubrication. In such an instance, an anesthetic or antibacterial lubricant should be used.

Once the catheter is inserted, it is secured as appropriate for the catheter type. A straight catheter is typically secured with adhesive tape. An indwelling catheter is secured by inflating a bulb-like device inside of the bladder.


Health-care practitioners performing the catheterization should have a good understanding of the anatomy and physiology of the urinary system, be trained in antiseptic techniques, and have proficiency in catheter insertion and catheter care.

After determining the primary purpose for the catheterization, practitioners should give the male patient and his caregiver a detailed explanation. Men requiring self-catheterization should be instructed and trained in the technique by a qualified health professional.

Sterile disposable catheterization sets are available in clinical settings and for home use. These sets contain most of the items needed for the procedure, such as antiseptic agent, gloves, lubricant, specimen container, label, and tape. Anesthetic or antibacterial lubricant, catheter, and a drainage system may need to be added.

Catheter choices

TYPES. Silastic catheters have been recommended for short-term catheterization after surgery because they are known to decrease incidence of urethritis (inflammation of the urethra). However, due to lower cost and acceptable outcomes, latex is the catheter of choice for long-term catheterization. Silastic catheters should be reserved for individuals who are allergic to latex products.

There are additional types of catheters:

SIZE. The diameter of a catheter is measured in millimeters. Authorities recommend using the narrowest and softest tube that will serve the purpose. Rarely is a catheter larger than size 18 F(rench) required, and sizes 14 or 16 F are used more often. Catheters greater than size 16 F have been associated with patient discomfort and urine bypassing. A size 12 F catheter has been successfully used in children and in male patients with urinary restriction.

DRAINAGE SYSTEM. The health-care provider should discuss the design, capacity, and emptying mechanism of several urine drainage bags with the patient. For men with normal bladder sensation, a catheter valve for intermittent drainage may be an acceptable option.

PROCEDURE. When inserting a urinary catheter, the health care provider will first wash the hands and put on gloves and clean the tip of the penis. An anesthetic lubricating gel may be used. The catheter is threaded up the urethra and into the bladder until the urine starts to flow. The catheter is taped to the upper thigh and attached to a drainage system.


Men using intermittent catheterization to manage incontinence may require a period of adjustment as they try to establish a catheterization schedule that is adequate for their normal fluid intake.

Antibiotics should not be prescribed as a preventative measure for men at risk for urinary tract infection (UTI). Prophylactic use of antibacterial agents may lead to the development of drug-resistant bacteria. Men who practice intermittent self-catheterization can reduce their risk for UTI by using antiseptic techniques for insertion and catheter care.

The extended portion of the catheter should be washed with a mild soap and warm water to keep it free of accumulated debris.


Phimosis is constriction of the prepuce (foreskin) so that it cannot be drawn back over the glans penis. This may make it difficult to identify the external urethral meatus. Care should be taken when catheterizing men with phimosis to avoid trauma from forced retraction of the prepuce or by incorrect positioning of the catheter.

Complications that may occur from a catheterization procedure include:

The presence of residual urine in the bladder due to incomplete voiding provides an ideal environment for bacterial growth.

Urinary catheterization should be avoided whenever possible. Clean intermittent catheterization, when practical, is preferable to long-term catheterization.

Catheters should not be routinely changed. Each man should be monitored for indication of obstruction, infection, or complications before the catheter is changed. Some men require daily or weekly catheter changes, while others may need one change in several weeks. Fewer catheter changes will reduce trauma to the urethra and reduce the incidence of UTI.

Because the urinary tract is normally a sterile system, catheterization presents the risk of causing a UTI. The catheterization procedure must be sterile and the catheter must be free from bacteria.

Frequent intermittent catheterization and long-term use of indwelling catheterization predisposes a man to UTI. Care should be taken to avoid trauma to the urinary meatus or urothelium (urinary lining) with catheters that are too large or inserted with insufficient use of lubricant. Men with an indwelling catheter must be reassessed periodically to determine if alternative treatment will be more effective in treating the problem.

Normal results

A catheterization program that includes correctly inserted catheters and is appropriately maintained will usually control urinary incontinence.

The man and his caregiver should be taught to use aseptic technique for catheter care. Nursing interventions and patient education can make a difference in the incidence of urinary tract infections in hospitals, nursing homes , and home care settings.

The sexuality of a man with an indwelling catheter for continuous urinary drainage is seldom considered. If the patient is sexually active, the man or his partner can be taught to remove the catheter before intercourse and replace it with a new one afterwards.

Morbidity and mortality rates

Injuries resulting from catheterization are infrequent. Deaths are extremely rare. Both complications are usually due to infections that result from improper catheter care.


An alternative to catheterization is to use a pad to absorb voided urine.

See also Catheterization, female .



Altman, M. Urinary Care/Catheterization. Albany, NY: Delmar, 2003.

Gearhart, John P. Pediatric Urology. Totawa, NJ: Humana Press, 2003.

Hanna, P. M., S. B. Malkowicz, and A. J. Wein. Clinical Manual of Urology, 3rd edition. New York: McGraw Hill, 2001.

Laycock, J. and J. Haslam. Therapeutic Management of Incontinence and Pelvic Pain. New York: Sringer-Verlag, 2001.

Newman, Diane K. Managing and Treating Urinary Incontinence. Baltimore, MD: Health Professions Press, 2002.


Johnson, J. R. "Safety of Urinary Catheters." Journal of the American Medical Association 289(3) (2003): 300–301.

Munasinghe, R. L., V. Nagappan V, and M. Siddique. "Urinary Catheters: A One-point Restraint?" Annals of Internal Medicine 138(3) (2003): 238–239.

Wilde, M. H. and B. L. Cameron. "Meanings and Practical Knowledge of People with Long-term Urinary Catheters." Journal of Wound Ostomy Continence Nursing 30(1) (2003): 33–43.

Winder, A. "Intermittent Self-catheterisation." Nursing Times 98(48) (2002): 50.


American Board of Urology. 2216 Ivy Road, Suite 210, Chaarlottesviille, VA 22903. (434) 979-0059. .

American Foundation for Urologic Disease. 1128 North Charles Street, Baltimore, MD 21201. (800) 242-2383. .

American Urological Association. 1120 North Charles Street, Baltimore, MD 21201. (410) 727-1100. .

National Health Service of Great Britain. .

National Kidney and Urologic Diseases Information Clearing-house. 3 Information Way, Bethesda, MD 20892. (800) 891-5390. .


AdvancePCS. [cited February 28, 2003] <http://www.building> .

Harvard Pilgrim Health Care. [cited February 28, 2003] < 2/31681.html> .

Mount Clemens General Hospital, Mt. Clemens, MI. [cited February 28, 2003] .

Wayne State University. [cited February 28, 2003] .

L. Fleming Fallon, Jr, MD, DrPH


Urinary catheterization can be performed by health-care practitioners, by home caregivers, or by men themselves in hospitals, long-term care facilities, or personal homes.


User Contributions:

Mike Donahue
I was told to be careful not to fully empty the bladder when I self catheter as this could cause the bladder to colapse and/or become weak. Another nurse told me only to be careful not to empty my bladder too fast as this could cause shock. Who is right?
note: I am not a medical professional, just a long-time user of catheters.

In response to the previous comment, I typically drain my bladder fully. It doesn't take long for it to fill again. And with a Size 12 catheter, the bladder can't drain very fast. Personally, I can't get a larger one in.

For those of us who have to perform intermittent catheterization, there are some practical issues.
1) cranberry juice: drink at least two cups daily or you will get infections.
2) you can re-use catheters by storing them in a solution of 1 part vinegar to 2 parts water between use. I am not sure how long you can re-use them for. I currently am not having problems by changing them every 3 days. Perhaps someone can provide more information?
3) If you have a foley (balloon) catheter installed, you can minimize infections and other problems by simply drinking extra water. Note that this may limit your mobility as the bag will fill up quickly. However, cranberry juice taken regularly is better.
4) Coffee is a diaeretic. If you don't normally drink coffee, drinking a cup of coffee about two hours before going out will reduce the liquids in your system, lengthening the time before you need to drain your bladder (or empty your bag) again (assuming you drain immediately before going out).
5) drain your bladder when it gets full. If you don't get a full sensation, try to establish a regular schedule. I normally drain 4 to 6 times a day - more in the winter, less in the hot days of summer when I lose most of my liquids through sweat. Try to keep your bladder from getting too full (try not to be holding more than 500 ml).
larry hales
I have experienced first hand having a catheter inserted into my male body improperly. The doctor tells me the bladder that was punctured will heal on its own. What can I do?
jean-paul bellavance
How long should the catheter be kept or change?

Should it be change every 6 to 8 weeks or less or more?

How long between catheter changes? I currently change mine once a week, storing it in a vinegar and water solution between uses. Cranberry juice on a regualr basis, at least twice a day, seems to be the critical part.

Does anyone have any suggestions for re-using a catheter while on the road? I haven't found anything to store it in that doesn't leak if accidentally tipped over (e.g. reusable water bottles). And most containers are fairly bulky too.
I am wanting to know how long a silastic catheter can be used before its needs to be replaced as a long term use.
I tried replacing catheters every week and that turned out to be too long. I'm currently replacing them every 5 days - storing a vinegar and water solution between use. I suspect the reason they can't be used indefinitely is that a bacterial film builds up on them over time.

There was a recent article in either Scientific American or Discover (forget which, but it was very recent) on bacterial films that mentioned catheters and incidence of films & bladder infections on patients in hospital with permanent catheters. While not directly comparable, the build up of films is fairly fast, leading to infections often within a week.
I have a bag at nite and a leg bag in the day. Recently my bed has been wet and not sure were it is coming from, the hole outside my stomach, my Penis or what! What should i do? I wear a diper now because of this. I will be calling my doctor for advice also. bob
we do hope that you will contonue publishing this page so that lots of student my search this as it was a big for our project as a good knowledge to be store with
i recently had a foley catheter put in me after a surgery i qam hqaving geatdiscomfort and feels like it is putting pressure on me when i release urine is this normal
Intermittent cath several years. Reason, can't release sphincter due to nerve injury?Concerned about tiny pieces of tissue in urine. Not regularly, but happens now & then i.e. a month or so between occurances.

To prevent UTI, Dr. prescribed apple cider vinegar (2 tablespoons in 1/3 glass of V8 juice.
HOw painful is the insertion and extraction of catheter?
I'm anticipating this approach or keeping one in at all times, how painful and difficult is this procedure?

Thank you
In july of 2011 my 2yr old son was diagnosed with having a urachal remnant, which was a mass of abnormal tissue at the dome of his bladder. The urologist, informed me that if this mass was not removed, that later in life he could have a risk of developing cancer. It was a tough decision for me to make and to have my son go thru the surgery. I know it had to be done, and i put my trust in the doctor and the staff. Yesterday, was when my son had his surgery. It took about an hour and a half, and the doctor said my son did good, and no problems occured. After an hour of recovery from the general anesthesia, he said it would be ok for my son to go home. So of course i was happy everything went smoothly and that my baby boy would be coming home that same day. Once we were at home, my son would grab at his genitals, Complaining and crying and saying"owie owe owe!!". I was confused as to why he was grabbing at his genitals, since his surgery was nowhere near there. I figured maybe it was because he was sensitive and sore from the surgery that the pain may travel. But, later we noticed that he would only have pain and cry only when he urinated, and seemed to have an erection. So today i called his urologist, which is the one who performed the surgery and he said to go ahead and bring in my son. We went and the doctor said that my son is having this pain due to the fact that they had to insert a catheter into his urethra, so that they could fill his bladder to have it expand enough so they can go ahead and only do the one small incision right below his belly button and remove the remnant, instead of making two incisions.
I was not informed before the surgery that this catheter would be inserted so that they could fill his bladder. This catheter was not used for the bladder to be emptied/drained, it was used to fill his bladder. I was upset that i was not told about this, but at the same time relieved that it was nothing major, or an infection.
The doctor said to just make sure my son drinks plenty of water, and that the pain during urination can persist for 2 or 3 days. Has anyone had a child go thru this same thing or known of anyone having the similar surgery?? and if so, was there pain during urination because of the catheter that was used during the surgery? i just wanna know if this is normal. Any advice , opinions , sggestions will be greatly appreciated. Thank you!
It's been 10 years since urethrotomy, did self-cath for a couple months post original surgery. Though stream has been less than original over the years, but good. Just started spotting last couple of weeks. Noticed some pain when begin to urinate but is gone once flow is going. Stream appears to be about 1/2 to 1/3 of what it was 10 years ago. I was considering doing self-cath on myself again...but I don't know if it would be safe and/or conducive. I have to see my regular doctor before I go see my urologist. So it may be a week or two before I can get the real advice I need. I am worried I could be missing out on opportunity to reduce further progression by taking action now.
I was catherized for surgery and developed a bladder infection afterward. After the infection cleared up I noticed what seemed like a knot or bump in urethra. It was very painful to manipulation and it was impossible to have intercourse due to the pain. Do you think this may be due to scarring? Is it possible to leave part of the catheter inside?
I have been struggling with bph that is causing urinary retention. it seems to be getting worse and I do keep my urologist appointments but I do not want to have surgery at this point in my life and would rather never do that. none of the options seem to work for me but I also don't want to allow more damage to occur. currently I am up 2-3 times a night and going to the restroom up to ten times in a workday. I am seriously considering self cath as the best option though I cant imagine how to get past the training part. so two questions I guess 1) Is this even a possibility for bph? the only time I read about it is as a foley type when the stream stops totally I would much rather that not happen. and 2) is training seriously necessary? I really cant imagine going through that either.
i look after someone and his catheter leaks at least once a it poss he makes it happen?
My question might be unusual. Two years ago I had a spinal injury. I was catheterized for two months. after returning home and recuperating
i noticed that,,when i have sex,i can orgasm but nothing comes out anymore. Can anyone relate to this?
Im new to these things but hate using them, mostly due to pain and bleeding.
For some reason, the sphincters keep clamping down on the catheter and scrape against the eyelets, which in turn causes bleeding. I have a UTI now, which hurts like crazy. Lubricant doesn't help. I use plastic ones. I had a foley in for a week and even then I passed blood clots. I am now using intermittent ones. Why is this happening and how do I get it to stop?
I am a man with a shorter urethra and have a hard time even inserting it. Catheterization is pretty troublesome for me. I was started on a 14fr, which scraped against my bladder wall/urethral wall and hurt. 8fr, 10fr, and 12 fr cause pain too. I can't empty out my bladder completely and need to cath. so, how do I make it shop hurting?
Im 19 so it feels awkward needing to use these.
MY HUSBAND has a catheter in the hospital and his hands and arms swelled up and both of his balls and penis does that mean the catheter is bad
I have the catheter in for about week how do u stop or ease the pain u get when it moves when you move
Kenneth Ptak
This is to Noemi. I feel sorry for your son and his Doctor should have told you about everything about the surgery. I had a very bad experience n the hospital in 2014. nurses cane into my room and never say a word to me Just took my pants off and stuff a catheter in me 2 time never got in in. But getting back to your son it will burn for a few day after. He should have not had to go through that. He will be ok Take care Ken
my husband had 2 straight catherizations after knee replacement surgery. He is not able to control urges to urinate & cannot get to the bathroom in time, 2 weeks later. Has he been injured? What can be done to correct this? Thank you.
55 year old male: Had hip replacement surgery. Surgery went ok. Prior to being discharged from hospital they removed my catheter; a bit uncomfortable, but no obvious issues. Two weeks post catheter removal, I was able to attain an erection and felt discomfort and noticed my penis was bent or curved drastically to the left. Sex is uncomfortable, but possible.

Your thoughts. Is this permanent
Please help, i had surgery oct 18th 2016 on my intestines..(BCIR) i had a catheter inserted 2 times during my 21 day stay in hospitial, its been almost 2 months since my surgery and im having trouble getting seems i lost my manhood..i have weak erections during sex as well as weak orgasms with no fluid ..will this return in time? my rectum was removed . Thanks for help!
I am 79 years of age and 12 years ago ,I was diagnosed with stage prostate cancer , which resulted in a radical Prostatectomy ,A lot of things went wrong during the operation
resulting in not getting all the cancer ,I was put on a hormone needle Lupron , which kept my psa down , I kind of kept my cancer at bay now for 12 years myself by mega doses
of lipo vitamin C. I got a little lacks a few years ago , and lo behold my psa started to rise at an alarming rate , now at18.5 they call at late stage cancer , it finally got where the lupron did not work anymore 3 bone scans nothing showed , they then took a ct scan and found a trace of cancer on both my hp bones now on Xtandi a new chemo drug
however I have been wearing a catheter now for a few years as I could not control my bladder anymore ,never had much of a problem until the last 4 weeks or so , it feels like my bowel and bladder are fighting for space , I get the slightest bet of gas , and it hurts like hell somewhere in my urinary tract , it is now where my bowel has to be absolutely empty , or it starts again, like every 15 minutes or so if I sit down for a while and get up same thing , and yet my bladder is empty it feels like I have to go real bad ,and then after a minute or so goes away again just wondering anyone else ever experienced the same thing and what they did about it I wear a foley size 18 which is changed every 3 weeks
Was unable to urinate 2 days after recovering from hemorrhoidectomy. Needed ER, was fitted with foley catheter. After application of 10 cc lidocaine into uretra insertion was absolutely painless. Remind performing nurse to GO SLOW and lay down totally extended and RELAX. Removal of foley after two weeks starting with bulb fluid release, then SLOW twisting of tube, following by a very gentle but persistant pull again was painless and normal urination was resumed. Ask for experienced nurse, especially if you are afraid of pain.
Marlin Kreider
I use a closed system. I have a what is called a retracted penis. I have a problem inserting catheter I need to know proper way to insert catheter. Thanks
Left for 13 months with catheter in the hope the prostate blockage would clear . It did not. I am furious about it. Only 2 days as usual for TURP to clear. I have a figure 8 on the outlet due to the prostate hanging for so long. You can imagine what happens.
Hi, im looking for some help for my dad. He is currently waiting for surgery to remove his prostate and stones. They have put in a three way catheter but he is experiencing severe burning or stinging at eye / tip of penis. Does anyone have any suggestions to ease this pain?
Icould not urinate about a week ago. Went to ER and a cathter was inserted. It hurt so badly it was taken out a couple of days later and two days after that , I was back to the ER for another catheter inserted. Now my penis is swollen very large. I have an appointment with a urologist but it is nine days away.. They said over the phone to leave the catheter in until then. I hurts so bad. What can I do?
Andrew Amankwah
i had catheter in my penis for my operation on february 2017 and it was removed after 2 weeks.ever since to now i have pains still in my penis.WHY.
I want to know if anyone has had the catheter (men only) punctured into rectum. My father is dealing with all kinds of issues since his catheter was put in. Nurse could not get it in, called another nurse in to help and finally “poop” it was in and my dad said when he heard / felt the pop, he was in so much pain. Then began to see urine coming from the rectum and gas / air filling up his catheter bag.
Scott Miller
"Catheterization of the male patient is traditionally performed without the use of local anesthetic gel to facilitate catheter insertion.

I'm always stunned when I hear of just ramming the catheter up a much longer urethra with bends in it and a prostate to pass.

It boarders on sadistic.

On top of that, some people have been sexually assaulted via the urethra and it's NOT just a simple procedure for them.

Thank you for letting me share that.
I've doing daily cathing for years. A couple of points (Recheck with your doctor but I'm pretty sure of this) they aren't meant for reuse. In the old old days your had these horrible rubber ones that were giving people urinary tract infections like crazy and none of that felt good so use me and toss em. Selecting one that is comfortable going in and out is essential. Some I've tried were as stiff as boards and had eyelets that weren't polished. Most of those came with a packet of lube that never seemed to get on enough ot the cath to do any good. Compactcath has one that is prelubricated with a silicon lube. Its in a small package so you can have a few in your pocket. Another one I would recomend at Coloplast Compact and Compact set caths. The set has a bag attached so if you find yourself in a jam where there is not bathroom available at worst you fill the bag screw it down shut and dump it out at the next stop. The other unit is in a smaller package but the bag is seperate. If you need to look at your volume this is great. These both are prelubricated and nothing needs to be done on any of these other then unscrew one end and aim the catheter into the urethera correctly. It should enter into the bottom side of your urethera if your standing up and these should not be any pain. A big part is getting used to doing this. Once you do you should expect this to be a "nothing" experience. Unless your urethera is damaged in some way there shouldn't be any pain involved. When you push the cath up the urethera you will hit a slight obstruction at the bladder neck. Breath out and push a tiny bit harder and urine should start flowing. When the flow stops slowly pull the cath out and stop because the flow will probably start again once or twice. This fully empties the bladder. This is the goal! Fully empty when you cath. Bladders left with urine are bad news. Last warning is that there will be a last bit of urine that comes out of the cath when its first out of your urethera. Like water left in the stray if you held a finger over the top of the stray.

So is shorter form. Get a large variety of them to try. Get different sizes. 12, 14 and 16 french. The only reason to go up (16 is wider then 14) is if you have leakage around the cath. Get samples (LOTS) and Check out the stiffness and go for the ones that are most comfortable. Some are silicone tubing which works for some. Others are stiff as boards (OUCH). Make sure the brands note that the eyelits are polished. Start them at the bottom of your urethera (Not the TOP) if you get stuck near the bladder neck cough and press a little harders. *Note once you get used to them you won't need that and it will eventually stop feeling odd. Remember the goal is to empty the bladder so go slow removing the cath. If you go too fast you may have to reinsert it slightly for one of the eyelits to be up to the bladders bottom edge. If you ever do get stuck where there is no bathroom available and have to use something like the Speedy Compact Set empty the bag asap and DON'T be a jerk and just throw the full bag in the trash.

Oh and one last tip. If you have prostate cancer or a real issue getting a cath to get into the bladder get the Coude type and remember the tip should be bent up. Coloplast has a couple of new ones that they market as Coude but the tip isin't bent up its just VERY easy to get it into the bladder. That might be one to get samples of if you need that or not.

Comment about this article, ask questions, or add new information about this topic: