For most people, a urinary catheter is more uncomfortable than truly painful, and insertion and removal each take only a short time. The part people often notice most is the stretch while the tube stays in, when the bladder can react to it as a foreign object. Much of that discomfort is predictable, and there are things you can ask for at every stage to reduce it.
Does Catheter Insertion Hurt
In most cases, putting a catheter in a woman is not painful.1PubMed Central. Nurses’ challenges in inserting an indwelling urinary catheter in females Women rated insertion pain at about 23 out of 100 on average, which is low but not zero.2PubMed. Factors affecting pain scores during female urethral catheterization Younger women, under 60, felt noticeably more than older women.3PubMed. Factors affecting pain scores during female urethral catheterization Women who were already in pain before the procedure tended to rate it as more painful.4PubMed. Factors affecting pain scores during female urethral catheterization
Lubricating gel that contains the numbing medicine lidocaine reduces insertion pain in both men and women.5PubMed Central. Current Trends in the Management of Difficult Urinary Catheterizations Pooled studies in women found it works better than plain water-based gel.6International Journal of Urological Nursing. Does 2% Lignocaine Gel Reduce Urethral Catheterisation Pain in Women? A Systematic Review and Meta‐Analysis In one trial, about 62% of women felt any pain with lidocaine gel, compared with 81% with plain gel.7PubMed. Lidocaine jelly and plain aqueous gel for urethral straight catheterization and the Q-tip test: a randomized controlled trial In men, a lidocaine solution run into the urethra during insertion lowered pain the most of the options tested.8PubMed Central. Effect of continuous infusion in alleviating pain during male urethral catheterization
Here is how it goes. You lie on your back while the nurse cleans the area, which can feel cold. Gel goes in first, and numbing gel works better when it has a few minutes to take effect before the tube goes in. As the tip passes, you may feel pressure or an urge to urinate, and that is normal. The tube is in within about a minute, and a small balloon holds it in place.
You can help by asking the nurse whether they use lidocaine gel and whether they can wait a few minutes after applying it. Slow, deep breathing helps the muscle around the urethra relax. If the pain is sharp rather than pressure-like, say so right away.
Men’s anatomy makes insertion harder. The urethra is longer, curves, and passes the prostate, so insertion is more likely to be uncomfortable. Most catheter pain in men comes from trouble during insertion, infection, or rubbing of the tube inside.9Medical Monks. Easing Pain From Catheters (For Men) Injuries from a catheter are uncommon, about 3 in every 1,000 men admitted to hospital.10PubMed. Incidence and prevention of iatrogenic urethral injuries When one does happen, it causes penis or groin pain, and usually bleeding.11PubMed. Incidence and prevention of iatrogenic urethral injuries
Some people feel more than the averages suggest. Clenching the pelvic floor and urethral muscle narrows the passage the tube has to slide through, and anxious people often tighten up without noticing. If the tube meets resistance, a pause to relax and a fresh try with more gel is a normal response, but the tube should never be forced. A dry or irritated urethra can make the tube feel sharper too, especially with a current urinary infection, so mention burning or recent infections to the person inserting the catheter.
What It Feels Like While the Catheter Is In
Between about half and nine in ten people with a catheter feel irritation of the bladder caused by the tube.12PubMed Central. Catheter-Related Bladder Discomfort: How Can We Manage It? It can feel like burning or pain above the pubic bone or in the penis, or a strong urge to urinate even though the bladder is draining.13PubMed Central. Catheter-Related Bladder Discomfort: How Can We Manage It? The bladder muscle can squeeze involuntarily against the catheter, and the tip can rub the bladder wall once urine drains.14PubMed Central. Catheter-Related Bladder Discomfort: How Can We Manage It?
The false urge has a simple cause. The catheter tip sits inside the bladder and the balloon rests near the bladder opening, and the bladder’s stretch sensors can read that as fullness. If urine is still flowing into the bag, the urge does not mean the tube is blocked. Trying to push urine out will not help and can make the muscle squeeze harder. Urgency tends to be strongest in the first hours after placement and often eases as your body gets used to the tube, though it may come back in waves.
After surgery on or near the bladder, prostate or pelvis, the area is sore and sensitive, so the bladder reacts more strongly to the tube. Spasms are a known side effect, and they often bring a cramping feeling low in the belly that comes and goes rather than staying constant. The care team expects to hear about them.
Bladder-calming medicines such as oxybutynin and tolterodine lower the chance of discomfort after surgery.15PubMed. Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study In one trial, discomfort dropped from about 58% of patients to about a third.16PubMed. Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study Solifenacin also reduced spasms after urethra surgery with few side effects.17PubMed Central. Interventions for the Management of Bladder Spasms in Adults with Indwelling Urinary Catheters: A Nursing Practice-Oriented Systematic Review18PubMed Central. Strategies for the prevention of catheter-related bladder discomfort
Spasms may cause urine to seep around the tube, because the bladder squeezes harder than the tube can drain at that moment. It does not mean the catheter is in the wrong place. If there is leaking and no urine at all is draining into the bag, the tube may be blocked or kinked and needs checking.
A different kind of pain comes from the catheter itself, which can inflame the bladder, and an infection can add tenderness in the lower belly.19PubMed Central. A catheter-associated urinary tract infection mouse model to study bladder dysfunction and pain Fever, cloudy or foul-smelling urine, or worsening pain suggest infection. Rubbing of the tube can also chafe the urethra, especially if it is pulled or moved.20Medical Monks. Easing Pain From Catheters (For Men)
A few habits cut down the rubbing. Secure the tube to your thigh so it doesn’t tug. Keep the bag below your bladder and avoid twists in the tubing. Drink enough fluid, unless you’ve been told otherwise, so your urine stays dilute.
Does Catheter Removal Hurt
Removal normally takes a few seconds, with at most mild discomfort.21Circle Health Group. Do Catheters Hurt? What to Expect From Insertion to Removal The nurse first empties the balloon through a small port. You’ll usually be asked to breathe deeply as the tube slides out,22Circle Health Group. Do Catheters Hurt? What to Expect From Insertion to Removal ideally breathing out slowly while it is pulled gently. You may feel a brief urge to urinate. Many men describe it as a slithery feeling that sometimes stings.23Continence Product Advisor. Do Catheters Hurt? What to Expect From Insertion to Removal
Removal can sting more if the deflated balloon has formed a ridge.24PubMed Central. Nurses’ challenges in inserting an indwelling urinary catheter in females If it feels like the tube is catching, ask the nurse to check that the balloon is fully emptied.
The urethra lining has been in contact with the tube for hours or days, so it can be tender, and the tube sliding along it can sting briefly. The longer the catheter has been in, the more likely the urethra is to feel sore, but the soreness is typically short-lived. Men often notice it along the length of the penis, while women usually feel it at the urethral opening.
Relaxing the pelvic floor helps the tube slide out. Letting your legs fall open and breathing slowly helps. Ask the nurse to tell you before they pull so you are not bracing at the wrong moment, and stay still with slow breathing until the tube is fully out rather than watching what is happening.
What Is Normal After the Catheter Comes Out
Your bladder and urethra may be irritated for 24 to 48 hours afterward.25St. Joseph’s Healthcare Hamilton. Urinary Catheter You may hesitate, urinate often, feel stinging, have pinkish urine, or leak.26St. Joseph’s Healthcare Hamilton. Urinary Catheter These problems should ease after you urinate a few times.27St. Joseph’s Healthcare Hamilton. Urinary Catheter Burning should resolve within 24 to 72 hours.28PazonaMD. Common Urinary Catheter Side Effects after Removal29Hangzhou Bever Medical Device Co., Ltd.. What to Expect After a Catheter is Removed: Female Patients
Because the tube has kept your bladder empty, the usual feeling of fullness can take a little while to return. A weak or slow stream at first is common and normally improves over the day.
Light pink or slightly tinged urine for the first one or two urinations is common, from tiny scrapes in the urethra. Pink that fades with each trip to the toilet is reassuring. Urine that gets darker, looks like red wine, or carries clots is a different thing and should be reported, as should blood that persists.
To ease the first day, drink steadily so urine is less concentrated, and urinate when you feel the urge instead of holding. Wear a pad if leaking is likely. A warm bath may soothe stinging. Call your doctor if you cannot pass urine within several hours of removal, if burning lasts beyond about three days or gets worse, or if fever, chills, or flank pain appear.
Catheters Through the Belly Instead
A suprapubic catheter goes into the bladder through a small opening in the lower belly instead of the urethra. After prostate surgery, about 40% had penis pain with it versus 62% with a standard catheter.30PubMed. Suprapubic tube compared with urethral catheter drainage after robot-assisted radical prostatectomy: A systematic review and meta-analysis Overall pain was similar between the two,31PubMed. Suprapubic tube compared with urethral catheter drainage after robot-assisted radical prostatectomy: A systematic review and meta-analysis and bladder spasms were no different either.32PubMed. An Assessment of Patient Comfort and Morbidity After Robot-Assisted Radical Prostatectomy with Suprapubic Tube Versus Urethral Catheter Drainage
The tube comes out through a small opening in the skin, so the soreness is around the site, which can feel tender or look slightly red while it heals. With no tube running through the urethra, there is no rubbing there, which is why penis pain is lower. The tube still sits in the bladder, so bladder irritation and spasms can still occur.
Placing one means a small cut in the skin, usually under local numbing or anaesthetic, and sometimes during other surgery. Your surgeon may choose it if the urethra is narrowed, injured or being operated on, or if a catheter will be needed for a long time. Changing it later goes through the same opening and is usually quick once the channel has healed.
Do IV Lines, PICC Lines and Epidurals Hurt
Without numbing, people rated IV insertion about 7 out of 10 in one study.33PubMed. A randomized, crossover comparison of injected buffered lidocaine, lidocaine cream, and no analgesia for peripheral intravenous cannula insertion Lidocaine cream cut that to about 3, and a numbing injection to about 1.34PubMed. A randomized, crossover comparison of injected buffered lidocaine, lidocaine cream, and no analgesia for peripheral intravenous cannula insertion Anxiety strongly tracks with pain, and past bad experiences raise both.35PubMed Central. Determinants of pain, anxiety and patient satisfaction during intravenous injection: a cross-sectional study
Most of the discomfort is a brief sharp sting as the needle passes through the skin, then a pressure or tugging as the thin tube is slid in. Once the plastic tube is in and the needle is out, the line itself should feel like very little, though the site may ache a little. Sharp, burning or spreading pain, or later swelling around the site, should be reported because the line may have slipped out of the vein.
Staying warm and hydrated helps veins show up, so there are fewer attempts. Looking away and breathing slowly can ease the sting, and many people find a distraction helps. If you tend to faint during needles, tell staff so you can lie down for it.
A PICC line is a longer thin tube placed in an arm vein and threaded toward the heart, so it can stay for weeks or months. The arm is numbed before the small cut,36Vascular Wellness. Do PICC Lines Hurt and you may feel pressure rather than sharp pain as the tube is threaded. Mild soreness at the site for about two days is common.37Vascular Wellness. Do PICC Lines Hurt Tugging or shifting the line during activity can cause pain.38Vascular Wellness. Do PICC Lines Hurt A strong or growing pain should be reported.
People expected epidural pain at about 5 out of 10 but felt about 2.39PubMed. Expected and experienced pain during epidural catheter insertion A brief shooting pain during an epidural wasn’t linked to lasting numbness or tingling.40PubMed Central. Radiating pain during epidural needle insertion and catheter placement cannot be associated with postoperative persistent paresthesia: a retrospective review After a heart procedure through the groin, everyone in one group reported pain where the tube was removed.41Bahrain Medical Bulletin. Common Complications Associated with the Femoral Sheath Removal After Cardiac Catheterization According to Type of Technique: Comparative Study Bearing down as though straining reduced that pain markedly,42PubMed. Effects of Valsalva Maneuver on Pain and Vasovagal Reaction During the Removing of Femoral Arterial Sheath After Percutaneous Coronary Intervention: A Randomized Controlled Trial and IV pain relief or anxiety medicine before removal lowered it too.43PubMed Central. Pain relief for the removal of femoral sheath after percutaneous coronary intervention
Catheters in Children
In children, lidocaine lubricant cut pain from about 66 to 21 out of 100.44PubMed. Effectiveness of lidocaine lubricant for discomfort during pediatric urethral catheterization In young children, though, lidocaine gel made no clear difference,45PubMed. Does lidocaine gel alleviate the pain of bladder catheterization in young children? A randomized, controlled trial and pain scores were high in young children even with numbing.46PubMed. Randomized Clinical Trial of Lidocaine Analgesia for Transurethral Bladder Catheterization Delivered via Blunt Tipped Applicator in Young Children
Children often cannot tell what will happen, so fear and the unfamiliar feeling can add to the pain. Young children also cannot hold still easily, which can make insertion longer or harder.
Before the test, explain honestly in simple words that it will feel like pressure and be over quickly. That helps more than promising it will not hurt. Let your child bring a favorite toy or blanket to hold, and ask whether you can stay in the room, as many hospitals allow this.
During it, ask staff whether numbing gel can be used. Stay close and use distraction such as a screen or song, and keep your words calm and simple.