Bladder pain from indwelling urinary catheterization: case study.

Indwelling urinary catheters can cause severe pain and discomfort and can impair a person's quality of life. Constipation can cause bladder emptying problems and pain if a catheter is present. If the person is constipated this should be treated. If there are no clinical indications for urinary catheterization the catheter should be removed. If the catheter is clinically necessary it may be possible for the person to use intermittent self-catheterization. If this is not possible the nurse should adopt a problem-solving approach to determine the reasons why pain is occurring. Ensuring that the catheter is the correct size, length and using an appropriate material reduces the risk of tissue damage and associated pain. Catheter drainage bags should be supported if used; this prevents traction and trauma that can lead to pain. A catheter is a foreign body and its presence may trigger bladder spasm and pain. This can be treated effectively with antimuscarinic drugs, but these should be used with caution and in small doses in older people. Treating bladder pain can make a huge difference to a person's quality of life; however, it is important to discuss treatment with the patient and obtain consent and respect the person's choices in relation to treatment.