Intermittent Catheter Pain:
Causes and Preventions

Published 2019/12/06

Intermittent catheters, while life-saving, can cause pain, irritation, and discomfort for the user. This article goes over the two most common types of pain associated with catheter usage— urethral pain and bladder spasms—as well as what caused them and how to prevent them.

1. Urethral pain

The urethra refers to the thin tube that starts at the neck of the bladder and extends down to the urethral opening located on either the head of the penis or above the vagina between the labia minora.


A catheter needs to be passed through the urethra to reach the bladder, therefore, urethral pain is one of the most common complications of repeated catheterization. 

Reasons for urethral pain during the insertion and removal of the catheter

Catheter is too rigid


To begin with, different brands and lines of catheters are composed differently to achieve different levels of stiffness. Soft catheters are more comfortable to insert, and stiff catheters are easier to insert. 


For people who have urethral stricture and enlarged prostate, they might need a stiffer catheter to pass through the narrowed urethra. But for others, especially beginner users, stiff catheters may cause discomfort, pain, or blood in urine. When that’s the case, they should opt for softer catheters. 


If you are not sure about your preference, most catheters companies offer free samples for you to try.

Catheter is not lubricated enough


It is strongly advised that you do not insert a catheter dry. The frictions can cause micro-tears along the urethra, possibly leading to pain, trauma, bleeding, and the formation of scars. Scars along the urethra, also known as urethral stricture, narrow the urethra and make future catheterization difficult. 


To prevent this, use a pre-lubricated catheter, or apply generous lubricant (such as K-Y jelly) to dry catheters before use.

You need a coudé catheter

If you have bumps along your urethra as the result of urethral stricture or enlarge prostate, a straight catheter may jab into these bumps, causing pain and trauma. A coudé catheter has a curved tip that helps the catheter go over these bumps more smoothly. Ask your doctor if coudé catheters are right for you. 

You are not used to it 


If you are a beginner, the first few times may be uncomfortable or even slightly painful because you are still not used to it. With time and practice, the process should go smoother. However, if the pain is sharp or feels intense, it can be a sign that something is wrong and you should stop catheterizing and contact your doctor. 

You are using too much force


Under normal conditions, a catheter should slide in smoothly. Nevertheless, if you feel resistance while inserting the catheter, you shouldn’t force it in. Take the catheter out and try again later. Forcing the catheter can cause trauma, scarring, and the creation of a false passage. If your bladder is full and you still cannot insert, you should seek immediate help from the emergency room.  

2. Bladder spasms

Catheters are inserted into the bladder to drain urine, which can irritate the bladder and causes bladder spasms.


Bladder spasms happen when the detrusor muscle of the bladder contracts spontaneously and intensely, which feel akin to stomach cramps and menstrual cramps. 


However, bladder spasms are not only caused by catheterization, but they are also common symptoms of neurogenic bladder. When the nerves that control the bladder are damaged by diseases such as spinal cord injuries, MS, diabetes, or stroke, the bladder would have problems with retaining or voiding urine. 


When neurogenic bladder causes urinary retention, it requires the help of intermittent catheters to empty the bladder, which can, in turn, increase the chance of bladder spasms. 


You should consult your doctor to determine the true cause of your bladder spasms. 

Bladder spasms prevention:

To prevent bladder spasms, Healthline recommends doing pelvic floor exercises, changing your diet, and getting prescribed medicine from your doctor. 


Some of the bladder-irritating foods you should avoid are:

  • Citrus
  • Sugar
  • Caffeinated drinks,
  • Tomatoes
  • Fruit juice
  • Spicy food
  • Chocolate
  • Carbonated drinks

Last but not the least, there are other causes of urethral pain and bladder spasms that are not listed in this article and are not related to intermittent catheterization. Therefore, you need to consult your doctor to determine the true underlying problem. 

Pain related to urinary tract infections

Although UTIs are not exclusively caused by catheter usage, a fair amount of catheter users find themselves having catheter-associated UTIs


Here are some painful symptoms of CAUTI

  • Burning urination
  • Pelvic pain
  • Pain in upper back and side

Other symptoms of UTIs include cloudy, dark, foul-smelling urine, frequent and strong urge to urinate despite low urine volume, fever, chills, and nausea. 


If you experience fever, chills, nausea, and pain in the upper back and your sides, these are signs of a kidney infection and you should go to the emergency room. 


CAUTIs are caused commonly caused by bacterial contamination of the catheter. Although the catheter is sterile when it comes out of the packet, it can be contaminated by your hands, bacteria around your urethral opening, your clothes, and surrounding objects. Therefore, always wash your hands with soap and water and wipe your urethral opening with antiseptic wipes before inserting the catheter. 

Use prelubricated and
add jelly for more lubrication

To decrease the risk of catheter contamination, use non-touch catheters pre-lubricated with anti-bacterial silicone oil. Try out CompactCath!