Having a trial without catheter - what to expect

At some point, you may be told that your catheter is going to be removed. You might hear the phrase ‘TWOC’ being used. This simply means a ‘trial without catheter’. This is to make sure you’ll be able to pass urine without the catheter in place.

It’s important urinary catheters don’t remain in place longer than needed, because the risk of infection increases by a staggering 5% each day it stays in! This is why your catheter will be reviewed regularly and removed as soon as it’s no longer needed.

You won’t need to be admitted to hospital to have your catheter removed. It may take place on a main ward, or you may be seen in the outpatients department.

Before your catheter removal

Please follow any guidance given to you from your healthcare professional. You should be able to eat and drink normally. Once your catheter is removed, you’ll need to be monitored until the doctor or nurse is confident you’re able to empty your bladder without the catheter. This may take a little while, so it’s worth bringing a good book to your appointment to pass the time!

During your catheter removal

The healthcare professional removing your catheter will be able to explain the procedure to you and answer any questions you may have to help put your mind at ease. You’ll be in a lying down position as the catheter is removed. The nurse will start by deflating the balloon which has been holding your catheter in place inside your bladder. Don’t worry – you won’t be able to feel this, much like you couldn’t feel it when it was being inflated! Once the balloon is deflated, the catheter will be gently withdrawn. This might feel slightly uncomfortable. However, any discomfort should be momentary and you’ll be pleased to know the actual removal of the catheter itself only takes about 5 seconds!

Tips to urinate after catheter removal

The doctor or nurse who removed your catheter will want to know if you’re able to pass urine without it. You’ll be asked to drink regularly to help fill your bladder, and any urine you do pass will need to be measured. It’s advised you don’t drink too much in a short space of time or gulp your drinks, as this will impact your ability to pass urine.

Your bladder may also be scanned to make sure you’re able to empty your bladder properly. A bladder scan is similar to having an abdominal ultrasound (like in pregnancy) and the scanner placed on your lower abdomen will be able to let the nurse see if there’s any urine being held in the bladder after you’ve been to the toilet. This is referred to as ‘residual urine’.

Things to let your nurse know about:

You must speak up if you experience any of the following after having your catheter removed:

- Going to the toilet frequently
- Passing small amounts of urine each time you go to the toilet
- Lower tummy (abdominal) pain
- Having difficulty starting the flow of urine (this is called ’hesitancy’)
- Feeling like you have a full bladder and are unable to empty it properly
- Feeling pain when passing urine (dysuria).

Urinary retention

These signs above could mean you’re struggling to pass urine – otherwise know as ‘urinary retention’. If this happens whilst you’re in hospital, tell your nurse straight away. If you experience any of these symptoms when you’re back at home, ring your GP, district nurse or local Out of Hours service. Don’t delay getting in touch – acute urinary retention is very serious and the sooner you’re reviewed by a medical practitioner, the sooner you can receive treatment.

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