Entering our 50s and 60s should feel like a new chapter—one that brings wisdom, experience, and time to focus on the most meaningful areas of life. It is also a stage when some men develop health issues that require extra support. The prostate, specifically, can become the source of health concerns. Sometimes these prostate concerns are confidently alleviated through the use of catheters.
In cases where urinary retention becomes a significant problem, a urinary catheter can help manage symptoms. However, not all catheters are the same, and choosing the right type depends on your individual needs, comfort, and medical advice from your healthcare provider.
Common Prostate-Related Issues in Men Over 55
The prostate often enlarges with age, leading to a range of urinary issues, including difficulty starting urination, weak stream, frequent urination (especially at night), and, in more severe cases, urinary retention—the inability to completely empty the bladder.
- Benign Prostatic Hyperplasia (BPH): BPH, the most common prostate condition in aging men, affects 5 to 6 percent of men aged 40 to 64 and 29 to 33 percent aged 65 and older. [CL1] BPH is when the prostate gland becomes enlarged, compressing the urethra and causing lower urinary tract symptoms like frequent urination, urgency, a weak stream, and incomplete bladder emptying. BPH isn’t cancerous, but it can severely impact quality of life.
- Prostatitis: Prostatitis occurs when the prostate experiences inflammation. It can be sudden and severe or long-lasting and recurring. Symptoms include pain in the pelvic area, groin, or genitals, painful urination, and sometimes flu-like symptoms. Prostatitis can be difficult to diagnose and treat, and can lead to persistent discomfort, urinary issues, and even urinary obstruction.
- Prostate Cancer: While it often lacks symptoms in the early stages, prostate cancer can cause urinary obstruction as the tumor grows, especially if it's located near the urethra or bladder neck. Symptoms can be like BPH, including frequent urination, a weak or interrupted urine flow, and difficulty emptying the bladder. In advanced stages, prostate cancer can spread elsewhere, leading to more generalized symptoms. The need for catheterization in prostate cancer arises from tumor-induced obstruction or as part of post-treatment recovery.
Tip: Support is crucial for health and well-being. Find online and in-person support groups for men with prostate cancer. - Post-surgical recovery: Procedures aimed at treating prostate conditions, like transurethral resection of the prostate (TURP) for or prostatectomy for prostate cancer, often require temporary catheterization as patients recover. Catheters help to drain urine and keep the bladder empty while the surgical site heals, reducing the complications that could obstruct urine flow.
Patients with neurogenic bladder from SCI, Spina Bifida, or other conditions near the prostate may need to consider their prostate when choosing a catheter, especially if insertion is painful or difficult.
Catheter Tips Uniquely Designed to Navigate the Prostate
Men with an enlarged prostate or a narrowed urethra may find straight tipped catheters (also called “standard” tips) difficult or painful to insert. A type of catheter with a curved tip – named “coudé”, which is French for “bend” – was designed to navigate around a prostate’s anatomy. The coudé-tipped catheter works by bypassing prostatic obstruction, moving more easily around an obstructed or narrowed urethra, bypassing the enlarged prostate gland with less trauma and discomfort. Both foley catheters and intermittent catheters have coudé tip options available.
Learn more about coudé-tipped catheters
Some helpful tips on navigating the prostate
Types of Catheters Men Should Consider
H3: Intermittent Catheters
Intermittent catheters—sometimes called “in-and-out” catheters, as they are inserted and removed to empty the bladder, and typically disposable — are often recommended for men who have urine left in the bladder after urinating, or when there is difficulty or an inability to urinate. This type requires a certain level of hand dexterity or the assistance of a reliable caregiver.
This method emulates a more natural emptying of the bladder (compared to indwelling and suprapubic catheters). In addition, this type of catheter can be beneficial for neurogenic bladder conditions and for long-term management of urinary retention, where an indwelling catheter might cause issues.
The user inserts the catheter into the urethra, guides it into the bladder, allows the urine to drain completely, and then immediately removes the catheter. This process is repeated as needed throughout the day, typically every 4 to 6 hours, mimicking the natural bladder function.
- Benefits of Intermittent Catheters:
- They carry a lower risk of infection because they are removed immediately after use, giving bacteria less time to colonize the urinary tract.
- Users have more independence because they can manage their bladder emptying schedule, offering greater flexibility and an improved quality of life compared to being continuously connected to a drainage bag.
- Regular emptying and filling of the bladder can help maintain the natural function and tone of the bladder muscles.
- Considerations:
- Individuals with limited hand mobility or cognitive impairment may find self-catheterization challenging.
Some men prefer hydrophilic-coated catheters for easier, more comfortable insertion. These catheters c have a coating that becomes very slippery when activated with water, reducing friction and urethral irritation during insertion. Many hydrophilic catheters are ready to use out of the package, whereas some require the application of water before use.
Learn more about the clinical benefits of hydrophilic technology
Indwelling Catheters
Indwelling catheters, also called “Foley” catheters, are sometimes prescribed for shorter-term use, such as immediately following surgery or during periods of severe urinary retention for people with limited mobility. They are also useful when precise monitoring of urine output is required.
A flexible tube is carefully inserted through the urethra into the bladder. Once inside, a small balloon near the tip of the catheter is inflated with water, which holds the catheter securely in place within the bladder. The other end of the catheter is connected to a drainage bag, allowing urine to continuously exit the bladder.
- Benefits of Indwelling Catheters:
- Their continuous drainage reduces the need for frequent trips to the bathroom and provides uninterrupted bladder emptying, which is particularly beneficial for patients with severe mobility issues or those requiring constant monitoring.
- Considerations:
- They carry a higher risk of infection due to the continuous presence of the catheter in the urethra and bladder. Strict hygiene practices and proper catheter care can minimize this risk.
- When used long-term, they can lead to irritation, bladder spasms, pain, and a constant feeling of needing to urinate, even with the catheter in place.
- While modern catheters allow for some mobility, certain activities, especially vigorous ones, may be restricted to avoid discomfort or dislodging.
Suprapubic Catheters
Suprapubic catheters are surgically inserted directly into the bladder through a small incision in the lower abdomen. It is secured in place with a balloon and connected to a drainage bag. These are best suited for long-term use when urethral catheterization is not possible, causes discomfort, or leads to recurrent complications like urethral strictures, traumas, and infections. They are also a good option for men who want easier hygiene and intimacy, which might be challenging with indwelling catheters.
- Benefits of Suprapubic Catheters:
- Bypassing the urethra eliminates irritation, discomfort, and potential for urethral damage associated with transurethral catheters.
- The catheter site on the abdomen is often easier to clean and maintain, and it can be less intrusive during sexual activity compared to a urethral catheter.
- Avoids complications like urethral strictures, epididymitis, or prostatitis that can sometimes occur with long-term urethral catheterization.
- Drawbacks:
- The initial insertion involves a surgical intervention, which carries its own set of risks, including infection at the insertion site or bleeding.
- The stoma (opening) where the catheter enters the abdomen needs diligent cleaning to prevent infection.
- Over time, the stoma can enlarge, causing leakage around the catheter.
External Catheters
External catheters, also known as condom catheters, are a non-invasive option for men who are managing incontinence (also called “leakage”). Men may find condom catheters best for managing stress incontinence, urge incontinence, or functional incontinence. These catheters are worn over the penis like a condom and connect to a drainage bag, typically strapped to the leg.
- Benefits of External Catheters:
- They are not inserted into the body, making them a comfortable and low-risk option.
- Because they don't enter the urinary tract, the risk of infection is significantly reduced.
- Most men can apply and remove these catheters themselves.
- Drawbacks:
- These catheters collect urine that passes out of the urethra, but they do not help empty a bladder that cannot void.
- Improper application, wrong size, or vigorous movement can lead to the catheter coming off or leaking, especially in men with retracted penises or other anatomical challenges.
- Adhesives used to secure the condom catheter can sometimes cause skin irritation or allergic reactions. Regular skin care and proper sizing are crucial.
Safe Practices Help Prevent Complications
Regardless of the type of catheter you choose, informed decision-making and meticulous care are crucial for the successful management of urinary issues and the prevention of complications.
- Do not self-diagnose your urinary symptoms. Seeking expert help from your doctor will help determine the treatment that is best for you, which may or may not include catheterization.
- Get properly fitted, especially for specialized catheters like the coudé-tip, to prevent discomfort, trauma, and drainage problems.
- Practice hygiene to prevent infections. This includes strict adherence to hand hygiene, cleaning the insertion site, maintaining the drainage bag below bladder level, and regularly replacing bags and catheters as recommended.
- Understand your options, particularly for chronic conditions. Discuss catheter types, care techniques, and potential complications with your healthcare team. Exploring different materials and adaptive equipment can improve comfort and the quality of life.
We recognize the unique set of urological challenges that come with paralysis after a spinal cord injury. Our trained specialists with our Navigator Program – a program specifically designed to support individuals with spinal cord injury – understand your potential challenges and needs. Get support today.
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Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. For medical advice, consult your healthcare provider.
Sources:
- https://www.urotoday.com/urinary-catheters-home/intermittent-catheters/description/intermittent-catheter-types.html
- https://www.urotoday.com/video-lectures/intermittent-catheters/video/2983-can-a-catheter-tip-improve-a-difficult-intermittent-catheterization-curved-tip-catheters-diane-newman.html
- https://www.urotoday.com/urinary-catheters-home/intermittent-catheters/description/ic-best-practices-for-management.html
