A urinary catheter, most often a Foley catheter, is a flexible tube inserted through the urethra into the bladder to drain urine. This device is held in place by a small, sterile water-filled balloon anchored inside the bladder. The procedure is typically associated with a sensation of pressure or mild discomfort, rather than severe pain. The entire process of removal is fast, usually taking only a few seconds, which helps to minimize the subjective experience of discomfort.
The Sensation During Catheter Removal
The moment of catheter removal is often described as a strange, quick sensation. Many patients report a feeling of pressure in the urethra and bladder as the deflated tube begins to exit the body. This feeling is not sharp pain but an awareness of the tube sliding along the delicate lining of the urethra.
Some patients describe a “slithery feeling” or a brief, momentary sting as the tip passes through the narrowest parts of the urinary tract. This stinging sensation is due to the friction of the tube against the irritated urethral tissue, which was already sensitive from having the foreign object in place. The discomfort is fleeting, lasting only a few seconds, and the relief of having the device out often quickly overshadows the brief physical sensation.
Factors Influencing Discomfort Level
The level of discomfort experienced during catheter removal can vary significantly among individuals due to several physiological and technical factors. The condition of the urethra and bladder lining is a primary source of variation, as tissue can become irritated the longer the catheter has been in place. Long-term catheter use may lead to slight inflammation, making the tissue more sensitive to the friction of the tube being pulled out.
The size of the catheter, measured in French units (Fr), also plays a role, as a larger diameter tube may have caused more distension of the urethra. Bladder spasms, which are involuntary contractions of the bladder muscle, can be intensified by the foreign object. Issues with the balloon, such as incomplete deflation or the formation of mineral deposits known as “cuffing,” can also create resistance and increase the potential for a painful sensation.
The Removal Procedure and Patient Preparation
The removal process begins with the healthcare provider ensuring the patient is in a comfortable, relaxed position, typically lying flat on their back. The most important step is confirming the complete deflation of the retention balloon, which anchors the catheter inside the bladder. A syringe is attached to the balloon port, and the sterile water is allowed to drain passively to ensure the balloon returns to its smallest size.
Once deflation is confirmed, the provider will gently pull the catheter out with a smooth, continuous motion. Patients are often coached to take a deep breath in and then exhale as the catheter is pulled, as this technique helps to relax the pelvic floor muscles and the urethra. If any resistance is met during the gentle pull, the procedure is immediately stopped, and the provider will verify that all the water has been drained from the balloon.
Immediate Post-Removal Sensations and Care
After the catheter is removed, the body must adjust to voiding urine naturally again, leading to several common, temporary sensations. The most frequent symptom is dysuria, or a temporary burning and stinging sensation when first urinating. This sensation is a result of the irritated urethral lining coming into contact with urine and should typically resolve within 24 to 48 hours.
Patients may also notice a temporary increase in the urgency and frequency of needing to urinate, as the bladder muscle readjusts to filling and emptying without the tube. To aid recovery, patients are encouraged to increase their fluid intake, as this dilutes the urine and helps to flush the urinary tract. A healthcare provider should be contacted immediately if a patient is unable to pass urine within about eight hours, experiences severe, persistent pain, or develops a fever.