I have had two hip-replacement surgeries, and was smart enough to recover from only one with a Foley catheter. The Foley catheter is a thin and sterile tube that is inserted into your bladder to drain urine. A Foley catheter can be left in place for a length of time, and is useful in dealing with a variety of problems, from alleviating the effects of an enlarged prostate to, in my case, helping someone urinate after a serious surgery. While women can have a Foley catheter inserted to allow them to urinate, I will focus on its use in men, because its use on me initially gave me great pause.
When I had my first hip-replacement in 2001, my greatest worry was having a Foley catheter placed in my bladder. My wife, who is a nurse, assured me that I would want to be catherized with a Foley, since the powerful narcotics I would be on would make it difficult for me to urinate after the surgery. But the fear that most men have about anything going up into that region of my anatomy took over. My wife told the surgeon to be sure to have a Foley inserted while I was still under anesthesia, which he promptly forgot to do. When I woke up, I could not pee while on my back, and since it was so difficult to stand immediately after such an operation, and I was too chicken to have a Foley catheter inserted up my urethra, the long tube that comes down from the bladder, I suffered. When I had my other hip replaced in 2005, I broke down and allowed a Foley to be inserted after the surgery, and despite my apprehension, I hardly felt a thing. The relief it provided made my stay in the hospital that much easier and stress free, as I did not have to worry about urinating.
There is a balloon on the end of the Foley catheter that goes into your bladder, which is a sac that stores the urine that comes down from the kidneys. The purpose of this balloon is to hold the Foley catheter in your bladder. Once the Foley has been threaded through your urethra, the balloon is inflated and filled with sterile water. The balloon will press against the sides of the bladder, but this shouldn’t be painful. The Foley catheter is now set up inside the bladder, and urine should begin to flow down the tube through the urethra and into a sterile drainage bag that hangs on the bedside. If you are sent home with a Foley catheter, you will be equipped with a drainage bag that attaches to your leg so you can remain mobile.
When the Foley catheter is removed, the balloon is deflated by inserting a syringe into the catheter valve on the outside and pulling back, taking the sterile water from the balloon. The Foley is then pulled out, and as painful as this sounds, you will experience only minor and temporary discomfort. Foleys are used under many different medical circumstances. When urinating becomes difficult due to neurological conditions, an enlarged prostate, after surgery, or when anything keeps the bladder from emptying properly, a Foley is an option. Sometimes a physician wants to closely monitor the urine output in a patient or collect a sterile urine specimen to diagnose, and they will employ the use of a Foley catheter. In home care, Foleys are used for incontinent patients to help them avoid wetting their beds, reducing the risk of bedsores and skin breakdown from exposure to their own urine.
There are some risks involved with a Foley catheter, which was invented in the 1930s in Boston by a surgeon named Frederic Foley. The balloon can break while the catheter is being inserted, and the doctor will then have to remove the balloon fragments. The balloon may not inflate once it is in your bladder, even though it is always checked beforehand. The faulty Foley will be removed and a new one will replace it. If the catheter tube becomes obstructed, it will have to be cleared or replaced to allow urine flow. Perhaps the greatest risk involved with the use of a Foley catheter is the chance of an infection being introduced to the bladder.
In my case, a Foley catheter was well worth the risk. Urinary retention after surgery is very high, a side effect when morphine is used to kill the pain. After I woke up from my first surgery without a Foley, urinating became a nightmare and very stressful. The difference between my urinating problems after my first and second surgeries, one without a Foley catheter and another with one, was like night and day. The individual who put my Foley catheter in was so accomplished, I barely felt a thing, except quite foolish that I had been so worried about what is a very simple and often necessary procedure.
