Learning how to catheterize a child is not as difficult or as scary as it sounds. With practice, elementary school-age children can do it themselves. You may need to catheterize your child due to urinary incontinence (leakage), urinary retention (not being able to urinate), prostate conditions or as a result of surgery.

Health care providers at Norton Children’s Urology, affiliated with the UofL School of Medicine, will instruct you on how to place a catheter.

Keeping your hands, the child’s urethra area and equipment clean is important for preventing urinary tract infections.

A prescription will be provided for the catheters, which may be delivered or bought at supply stores. There are many different types and sizes, and they will be customized for your child’s needs. Other supplies may include a container to capture the urine, towelettes and lubricant. Do not use petroleum jelly.

Your health care provider will tell you how often to empty the bladder with a catheter. Typically, it needs to be done every 4 to 6 hours, or 4 to 6 times a day. Empty the child’s bladder at least first thing in the morning and just before going to bed at night.

An overly full bladder can increase the risk of infection, permanent kidney damage or other complications.

Before you begin, clean the child’s genital area with soap and water, and dry. Wash your hands thoroughly with soap and consider wearing sterile gloves. You can place an absorbent pad under the child to help contain any urine. Open the supplies’ packaging after you’ve cleaned your hands. Keep them close to you in a clean area before you begin.

How to catheterize a child assigned female at birth

• Apply sterile lubricant, available at drug stores, to the end of the catheter. Do not use petroleum jelly. Too much lubricant inside the catheter can block the flow of urine.
• The child should be on their back with the knees pointing up.
• Consider distracting the child or comforting with another trusted adult holding their hand or providing a favorite toy.
• The urethra opening will be in the same location as an adult. You’ll have to separate the labia to get clear access.
• Cleanse the area around the urethra opening with antiseptic towelettes.
• The urethra will be short and straight, making catheterization easier.
• Slide the catheter gently through the urethra, stopping as soon as urine starts to pass through it. Do not poke at it repeatedly or try to force the catheter. If it feels like the catheter is buckling, stop.
• If you miss and the catheter enters the vagina, leave it there for now. It will help you find the urethra with a new catheter.
• When it’s time to remove the catheter, pull it out gently.

How to catheterize a child assigned male at birth

• Apply sterile lubricant, available at drug stores, to the end of the catheter and another inch or two. Do not use petroleum jelly. Too much lubricant inside the catheter can block the flow of urine.
• The child should be on their back with the knees pointing up.
• Consider distracting the child or comforting with another trusted adult holding their hand or providing a favorite toy.
• Gently pull the penis straight up, perpendicular to the abdomen. Hold the sides, not underneath where the urethra is located, to avoid making it difficult to push the catheter in.
• If necessary, pull back the foreskin.
• Cleanse the urethra opening and surrounding skin with an antiseptic towelette in a circular motion.
• Move the catheter slowly through the urethra with steady pressure. You may feel some resistance to the catheter, but continue to apply steady gentle pressure without forcing it. Stop once you see urine.
• When it’s time to remove the catheter, pull it out gently.

Cleaning a Catheter

Many catheters are disposable, and most insurance companies will pay for sterile single-use catheters.

Some are designed to be reused if cleaned properly following instructions from your health care provider. If reusing a catheter, clean it after every use and do not let it touch any bathroom surfaces. Throw away the catheter when it becomes dry and brittle.

When to Call your Health Care Provider for Catheter Help

• You have trouble inserting or cleaning the catheter.
• Urine leaks between catheterizations.
• The child develops a skin rash or sores.
• Signs of infection, such as a burning sensation when the child urinates, a fever, chills or noticeable smell.