Spending a Week with the Foley Catheter

Let Me Introduce You to My Little Rubber Friend!

Anatomy of a Foley

Your basic Foley catheter is a deceptively simple implement. It consists of two concentric tubes, each with it’s own access. The inner tube allows urine to flow from your bladder to a recepticle, usually a plastic bag. A one liter bag may be strapped to your leg, and sometimes a 2.5 liter bag is provided for nights. I had only the smaller one. The outer tube is protected by a valve, and it is used to inflate a balloon near the tip. This balloon sits on the bottom of your bladder, makes a mostly water-tight seal, and keeps the catheter from slipping out. The balloon is inflated with a syringe using sterile water. One syringe will generally inflate to nearly golf ball size, and another can be added for security. So when having the Foley removed, it is vital that you PAY ATTENTION and ensure the person doing it removes AT LEAST THREE syringes of liquid, to ensure it’s all gone! The tip of the Foley has multiple intake ports to ensure free flow. Women, when elderly, confused, and/or sedated will often pull their catheters out, balloon and all. Men NEVER DO THIS, no matter how confused or sedated they might be.

Balloon Inflated
Actual Foley

You may observe from the diagram below that the Foley balloon sits at the bottom of the bladder, with the drain tube on top, so a man standing or sitting will never fully drain the bladder. The amount of volume taken by the balloon and the residual urine are rarely enough to cause discomfort – after the first day. Foleys are kept in sterile packaging and inserted by trained professionals using sterile gloves in a sterile field. The area in question (your junk) will normally be cleaned with a 10% iodine solution – effective and painless, but messy. Insertion is a simple procedure, and I did dozens (if not hundreds) of these when I was a CNA in the 80s. It’s one thing that has not been changed or improved by technology. I never failed to get one in, and even bailed out a female doctor or two who were having issues. They even called me back from breakfast once to do a fellow on day shift, who insisted upon a doctor. I never said I was a doctor, and we let him assume what he wanted. And EVERY SINGLE man that got one appreciated it, because they REALLY had to urinate! Not one complaint or cry of agony – just some grunting and wincing (from the patients), followed by sighs of sweet relief. The technician washes up, dons sterile gloves, drapes the area with a sterile cloth, and washes with iodine. Then he opens the sterile package and inserts the tip in the supplied sterile lubricant – usually something like KY Jelly, which is water-soluble. Then take the tip of the penis with the left hand and glide the Foley in slowly with the right. Some men with enlarged prostate will have a resistance point three quarters in, so have the patient (if conscious) exhale slowly and gently work around it. When you reach the bladder urine will flow into the bag (which hopefully is attached). Push in two more inches, inflate the balloon, and pull back gently. Clean up the area and we’re done!

When I had my cystoscope procedure in the doctor’s office, I was quite shocked to feel the tip of the scope cause a strong burning sensation all the way in, and all the way out. My catheter was emplaced during surgery, so I didn’t feel it at all. A week later when it was taken out I felt a burn similar to the scope. I discovered through some research that this burn indicates that the catheter (or scope) are being used correctly. Doing it faster avoids the burn, but causes bruising and/or bleeding which will bring pain and discomfort for days to come. I also learned that often these days the penis will be desensitized with Lidocaine jelly prior to insertion, a process that to me would seem to cause as much discomfort as it alleviates! So look forward to the burn and take it as a GOOD SIGN.

The reason I was so surprised about this is that with all the catheters I’d inserted NEVER ONCE did a man complain of burning. All I can figure is the urge to pee outweighed all other discomforts.

Another man’s perspective on catheterization may be found HERE.

Once the Foley is in you will have an urge to pee, even though most drains freely through the tube. Unless your tube is blocked (like mine was), it will pass in a couple of hours, and you will not notice it. Ironically, I only got the urge to pee after that when emptying the bag into the toilet. Don’t know if it was bending and twisting, or the mini-vacuum that draining causes, or if it was all in my mind. General movement is not much restricted, but there is something pulling on your junk every time you move, and the tip of the penis becomes quite sensitive after a couple of days. Normal TURBT recovery is two days, so most will avoid this unpleasantness. But I was misfortunate enough to have a punctured bladder, so I was on the Foley at least through the weekend – 5 days minimum. The trick to survival is to keep everything spotlessly clean, and movement of the tube should be unrestricted. Cleaning can be done with iodine (messy) or just plain water and gauze (better). How does the tube get messy? The balloon is not a perfect seal, so there may be a hint of “weepage.” Also there may be pus from any injury in the urethra, or there may be fluid from the prostate and/or testes?. How could THAT happen?

Here’s the really difficult part, guys. We all know that the penis length will change from time to time. It really has a mind of it’s own – the parasympathetic nervous system . For those that don’t wish to study 14 pages of medical slides, here’s the bottom line: Erection is initiated by the parasympathetic nervous system and maintained by the somatic nervous system. Neither of these systems are under conscious control, and until recently they were thought to be fully independent of the brain. So you cannot will yourself to an erection, and we all know to our embarrassment that you cannot willfully discontinue one. These nervous systems respond on their own accord to stimuli. When you are awake you can avoid these stimuli and avoid problems. BUT WHEN YOU ARE ASLEEP, especially after the first couple of nights and when the narcotics are done, those damn nervous systems create their own stimuli, and things get longer and shorter though the night. I’m not talking “rock hard wood” or anything, but slight engorgements followed by relaxation. So the liquid inside the urethra ends up on the tube, where it dries, and new liquid is deposited to dry – cycling over and over again through the night. This cycling/drying causes a “sandpaper effect.” Pubic hair will stick to the tube and get sucked inside the urethra through the night, requiring some care each morning. But the worst part is that at some point each night you will wake up with a mini-erection and a MAXI pain. And any cloth in the area (like gauze dressings or pajamas or whatever) may be stuck, or worse – it will be getting pulled inside the urethra on the tube by your involuntary engorgement!

I’m not talking erotic dreams or any such thing. I awoke one night in shock and pain with a full memory of the dream in progress, and it was strictly G rated! Like I said, your friend has a mind of his own and free rein to torture you all night long! And it’s not just me – the fellow in the link referenced above mentions the same thing, with no success at all in avoidance. Apparently it’s true, no matter how we were raised or what we believe or how hard we try – basically all men are horndogs!