Catheter Care After Urethroplasty

After Urethroplasty, you will have a catheter passed through the reconstructed urethra, right up to the bladder. It is intended to keep the urethra splinted while the reconstruction heals over it. In addition, some of you will have a suprapubic tube in the bladder as an additional drainage. The duration of the urethral catheter may vary depending on the type of reconstruction ranging from 3 weeks for an end to end anastomotic repair to 6 weeks for a complex reconstruction and in all likelihood you will be discharged on a catheter.

I advise all my patients to have a daily bath with soap and water and gently clean the catheter with soaped hands till it enters the urethral opening. cleaning with antibiotic solutions is not recommended as it promotes entry of more virulent bacteria in to the bladder. In addition, there should be no hesitation to gently clean the suture line in the perineum or over the penis with soap and water. After cleaning, the catheter tubing has to be fixed over the abdomen or upper thigh with a tape to pre-warn you of a sudden tug on the urethral tube in case you forget to take the bag along with you while getting up from your bed or chair.

The urobag is always supposed to be below the level of the bladder to allow proper drainage. Having the bag above the bladder will transiently hinder the drainage and allow accumulation of urine in bladder which may lead to a UTI or extravasation and wound infection.

The catheter and urobag, combined as a unit, are a closed drainage system. The lid on the bag is supposed to remain closed at all times except when you want to decant the urine for discarding. Similarly, the connector between the catheter and the bag is never to be dis-connected.

Every morning, and occasionally more frequently, you might notice discharge of some sticky mucus like material from the penis tip coming from the sides of the catheter. They are generally secretions from the urethra in response to the catheter and are harmless. Occasionally there may be larger amount of such secretions which may be the semen. They have to be simply wiped away at regular intervals.

Every morning while evacuating the bowel, you may notice a few drops of urine tracking out from the sides of the catheter. This is normal and one does not have to worry about it. Sometimes the urine comes out with intense desire to urinate (urgency). If so, you have to check the catheter for any twist or turn blocking the drainage in the tubing. If still this persists, then you have to contact your surgeon.

Occasionally you might notice a few crystals in the transparent part of the tubings. Generally, they are crystals formed after urine comes in contact with the surface of the tubings which act as foreign body for urinary crystals to precipitate. A regular intake of Vitamin C

Warning Signs to Consult : Fever, Blood discharge, Swelling in operated area or testicles, Slipping out of catheter.