Addressing the problems of long-term urethral catheterization: part 2.

This is the second of a two-part article and addresses the problems encountered throughout the life of a catheter from those relating to its insertion, through the time when it is in situ, to those associated with its removal. Catheters can cause discomfort and reasons for this are discussed including latex allergy, atrophic changes in women, blockage or bypass. The draft National Institute for Health and Clinical Excellence infection control guidance is discussed with reference to catheter maintenance solutions. Sexuality can be an unvoiced concern to patients with catheters in situ and clinicians are encouraged to discuss such issues with the patient, where relevant. Issues including catheter expulsion, bladder spasm and difficulties in catheter removal, including the non-deflating balloon and cuffing are addressed. The article concludes that although every patient is an individual with a unique set of problems, learning how to address one series of difficulties will help when dealing with subsequent challenges.