An indwelling urinary catheter, commonly known as a Foley catheter, is a flexible tube inserted through the urethra into the bladder for continuous urine drainage into an external collection bag. This device is used for patients who cannot empty their bladder naturally, require precise output monitoring, or are undergoing certain surgical procedures. Accidental dislodgement is a concern, and understanding the causes and proper reaction is important for preventing injury and infection.
How Indwelling Catheters Stay in Place
The mechanism preventing an indwelling catheter from sliding out is a small, inflatable retention balloon near the tip. Once the catheter is advanced into the bladder, a healthcare provider injects sterile water (typically 5 to 10 milliliters) into a separate port to inflate the balloon.
The inflated balloon rests at the base of the bladder, securing the device against the internal bladder neck. This internal anchor prevents the catheter from being pulled out during normal movement. Stability relies entirely on the integrity and correct inflation.
Common Reasons Why Catheters Come Out
Accidental dislodgement occurs when the internal retention mechanism fails, often due to securement issues or mechanism failure. The most frequent cause is external traction, a sudden or sustained pull on the visible tubing. This happens when the tube is caught on bed rails, furniture, or if the patient forgets to disconnect the drainage bag.
If the catheter is pulled while the balloon is still inflated, it can cause a traumatic extraction and potential injury to the urethra. Another major cause is slow leak or deflation failure of the balloon. A faulty valve or micro-punctures can cause the sterile water to gradually leak out, shrinking the balloon until the catheter falls out spontaneously.
Dislodgement also stems from improper securement of the tubing outside the body. Catheters should be secured to the thigh or abdomen using specialized straps or adhesive devices. These devices absorb external tension before it reaches the internal anchor. Failure to use them correctly allows external pulls to transfer directly to the balloon, making accidental removal likely.
What to Do If the Catheter Falls Out
If an indwelling catheter accidentally falls out, remain calm and assess the situation for any signs of bleeding or pain. The primary action is to not attempt to reinsert the catheter yourself. Reinsertion can cause trauma, increase infection risk, or result in incorrect placement, as it requires sterile technique and specific medical knowledge.
The next step is to contact a healthcare provider (nurse, doctor, or urologist) to report the dislodgement. When reporting, mention the amount of water the balloon was filled with, if known, and whether the catheter appeared intact. Until a professional can replace the catheter, manage urine leakage with absorbent pads or undergarments. A medical professional will determine if a new sterile catheter can be safely inserted or if further assessment is required.