Probably a dumb question: "I have to pee even though I have a catheter in!"

[NurseyPoo7]

I've had a few patients tell me this. They're cath is normally draining fine, and often times their urine looks clear, no sediment, etc. I normally irrigate anyway, but they still complain. Because their urine is clear I don't suspect a UTI. What else could I do?

(Crap, I noticed I type "dump" instead of dumb. lol. Sorry, I worked last night)

[Meriwhen, ASN, BSN, MSN, RN]

back2thebooks said:

Have you ever had a catheter in --yourself? It feels, to me at least, like a constant urge to pee. I also noticed that when I was accidentally sitting on the tubing it became REALLY uncomfortable.

Actually, I only had the urge to urinate AFTER the cath was removed. The nurse kept telling me that was impossible since I had no urine in the bladder, and I kept replying that I still felt like I had to go and now would she let me go to the toilet and make myself happy. While the cath was in I felt perfectly fine.

[xtxrn, ASN, RN]

Roy Fokker said:

I have a sneaky feeling it's because of the balloon and where it sits in the bladder (once it's inflated, doesn't it sit right by the sphincter?) This puts pressure on the sphincter and the sphincter keeps telling the brain "Gotta go! Gotta go!"

We're getting these new silver-coated foley's now in an attempt to reduce CAUTIs.

cheers,

It also helps if whoever puts it in gets it in ALL the way, and doesn't inflate the balloon ON the sphincter (trust me, it hurts). Repositioning it a bit can help, but otherwise, it's more than likely spasms....if it irrigates ok, there's not much else you can do (besides the antispasm meds ?

[bxo_pt]

I first read this thread after returning home from with a catheter after a cystoscopy and a balloon dilation. I felt a constant and extreme need to pee that first afternoon. That was last Friday. It's now Wednesday and I am scheduled to have the catheter removed tomorrow morning. Feeling much better now. (I am a male with lichen schlerosis and prostate cancer).

I found that standing up and consciously deciding to pee, like I was going to make a mess on the floor really helped. I could watch the urine accumulate in the tube on the way to the overnight bag. It also seemed to help to raise my arms over my head (maybe just to stretch?). I've also been taking pyridine (?).

Anyway the urge to go slowly went away over the next few days. my only advice is that if you feel like you need to pee, stand up and pee. I also had general discomfort and itchiness, perhaps related to my LS.

[Silverlight2010]

We still use those for bladder spasms, especially for CBIs. Great stuff!

Oops, forgot to hit "quote" We use B+O suppositories that is :)

[Scarlette Wings]

This may help provide some patient education and thereby decrease the patients, and your own, anxiety. The inflated bulb often touches the inner wall of the bladder and it is that discomfort that is felt.

Other patients feel the fullness of the inflated bulb when we fill it with 10 cc water. Any movement does cause that full 10cc to push against the bladder produces the urge to void.

In other cases it is the bladder overly sensitive to a foreign object in there and it can result in bladder spasms which also adds to the need to pee feeling.

Make sure that the device is well secured and not pulling on the bladder and urethra at all. If there is more discomfort still and the patient still has to have the catheter, ask the doc for something for bladder spasms. Educating the patient, securing the tubing so no pull or trauma occur at the meatus or urethra, and possibly an antispasm med or antianxiety med will help. good luck.

I had one post surgery and the urge to pee was constant.

[umcRN, BSN, RN]

I had one recently (and let me tell you I was more concerned with the foley and a-line than I was the craniotomy!) in any case I didn't feel it at all until it got tugged slightly when PT was getting me out of bed, it didn't hurt but was more like "omg I have to pee NOW" haha. It went away as soon as I was settled, I think the cath secure is a great thing and I always make sure my pts caths are well secured (of course I work peds, if they weren't secured they likely wouldn't last long, and we also usually get them out asap as soon as the kiddos are awake).

[yuzzamatuzz]

I always thought it was a feeling patients got from the catheter being in there, but not necessarily a sign of a full bladder. When I worked as an NA on an alzheimer's unit we had a patient with a permanent cath. Because of his dementia he didn't realize he had a catheter in and would go to the bathroom and "urinate" quite frequently.

[Morainey, BSN, RN]

I wondered this same thing... usually if my patients complain of this it's because the Foley isn't draining for some reason.

[exnavygirl-RN]

Leslie, that is correct. The catheter is stimulating the meatus. This seems to be especially true in men. Even though their bladder is emptying they still feel like they "have to pee".

I can't imagine how aggravating that feeling is.

leslie ? said:

i don't know why this happens, but whenever i need to cath someone, i always warn them, "it's going to feel like you have to pee".

i believe it's a neuromuscular response to foreign object placed in the urethra.

leslie

[nurseprnRN, BSN, RN]

Not the meatus, the sphincter (look at a male: meatus is waaaaaay far removed from the sphincter; female anatomy is analogous).

[exnavygirl-RN]

I wish I had read your post before I made my previous reply. You explain it so well :-)

[exnavygirl-RN]

Yes, the sphincter!