Intermittent self-catheterisation (ISC) is considered the preferred way to empty the bladder when it cannot empty fully on its own, as it carries fewer long-term risks than an indwelling catheter.1 Whether you need ISC for a few weeks or for many years, most people find that catheterising soon becomes part of their normal routine. While complications can occur, they are often preventable with good technique and the right equipment.
The complication people worry about most is a urinary tract infection (UTI), and it is also the one seen most often.2 Using a new single-use catheter each time, washing your hands before catheterising, emptying your bladder regularly, and following a good clean technique all help to reduce the risk.1 If you are getting repeated infections, don’t simply accept them as part of catheterising. Ask your healthcare professional to review your technique, catheter choice and any other possible causes.
It isn’t unusual to notice a small spot of blood when you’re first learning to catheterise or if the urethra becomes irritated. This often settles on its own. Bleeding that continues, becomes heavier, or happens regularly should always be checked, as it may be a sign of infection or a narrowing of the urethra.1
Trying to force a catheter when it doesn’t pass easily can cause damage to the urethra. If you meet resistance, stop rather than push harder. A well-lubricated or hydrophilic-coated catheter may improve comfort during insertion and may reduce irritation and urethral trauma compared with uncoated catheters.3 If catheterisation becomes increasingly difficult or painful, seek advice promptly.
Another possible long-term complication is the development of bladder stones. These can cause recurrent UTIs, blood in the urine, bladder discomfort, or increasing urgency. Although bladder stones are more common in people who catheterise long term than in the general population, they remain less common than in people with long-term indwelling catheters.1Any of these symptoms should be investigated.
The good news is that serious complications are uncommon. Using the catheter that suits you best, following a clean technique, avoiding unnecessary force, and seeking advice if something doesn’t seem right will go a long way towards protecting your bladder health.4
When should you seek help?
Speak to your healthcare professional if you experience:
- Recurrent urinary tract infections
- Persistent or heavy bleeding
- Increasing pain or difficulty passing the catheter
- Blood in the urine that does not settle
- Fever, chills, or feeling generally unwell
References
- European Association of Urology Nurses. (2024). EAUN guideline: Urethral intermittent catheterisation in adults—Evidence-based guidelines for best practice. https://nurses.uroweb.org/guidelines/urethral-intermittent-catheterisation-in-adults
- D’Ambrosio, F., Pappalardo, C., Scardigno, A., Medico, M. D., Risuleo, P. E., Orsini, F., Ricciardi, R., De Vito, E., Ricciardi, W., & Calabrò, G. E. (2026). Silent Burden of Urinary Tract Infections in Intermittent Catheter Users with Neurological Disorders: A Scoping Review. Diseases (Basel, Switzerland), 14(2), 58. https://doi.org/10.3390/diseases14020058
- Prieto, J., Murphy, C. L., Moore, K. N., & Fader, M. (2021). Intermittent catheter techniques, strategies and designs for managing long-term bladder conditions. Cochrane Database of Systematic Reviews, (10), CD006008. https://doi.org/10.1002/14651858.CD006008.pub5
- Ginsberg, D. A., Boone, T. B., Cameron, A. P., Kaufman, M. R., Keays, K., Patel, D. P., & colleagues. (2021). Adult neurogenic lower urinary tract dysfunction: AUA/SUFU guideline. The Journal of Urology, 206(5), 1097–1105.