Revision date: March 2012
A useful method for women to locate the urethral meatus (the spot where the
urethra exits the body and the point to insert a catheter) is to
use a finger to feel the area while urinating. If possible,
look with a mirror. Touch the spot. Remember what it
feels like and where it is. While this method may seem a bit
gross, it is easy and very helpful. One of IPA’s women members
has graciously provided some detailed instructions below.
Also, all catheters are not created equal, and women may require one whose
diameter is smaller, e.g., a 10 FR vs. a 14 FR. Catheters
are available in a number of different styles, sizes, and materials.
Anyone who decides to try them will need to do some experimenting
to find which kind works best. Follow this link to specific instructions and tips on catheter use for women.
Women are more susceptible to urinary tract infections (UTIs or cystitis) following
catheterization. Antibiotics (e.g., Bactrim, Septra) can be prescribed
for use as a preventative or treatment to alleviate the symptoms.
There are other things that can be done to reduce the risk of infection,
such as drinking plenty of fluids—especially cranberry juice—at
the first opportunity after using a catheter.
Note: Always have a doctor or nurse instruct you on catheter use
before trying it yourself. If you encounter any difficulty
or problems with using a catheter, see your doctor for help, as
there may be a physical problem that requires medical attention.
Schedule an appointment with a urologist, urologic nurse, or gynecologist.
Ask the person to teach you to cath STANDING UP. Some doctors
will teach a patient lying down with a mirror, and that will be
quite impractical in a restroom. When you’re in a public
restroom stall you likely won’t want to cath sitting down on the
toilet (not the cleanest place) with your hands and the catheter
dangling in the bowl.
After some practice, it’s just about as easy as changing a tampon.
Here's how to do it:
First you have to be pretty comfortable with your body (I guess this is kind
of graphic. Wash hands with soap and water before going into the
stall, but don't try this in public until you master it practicing
To find the urinary opening it's located at the very top of the vagina but
just below the clitoris. That means that with one finger in the
vagina pressing up just a little bit (really not at all because
you just want to be at the top of the vagina, if you press you
will press the opening closed and you don't want that) now the
opening will be located just above your finger but below the clitoris.
So after I wash my hands and go in the stall I first have to get set up. This
means taking out the catheter (from a plastic bag in my purse)
and putting some lubrication (KY jelly) on the end while it's
still in the bag. If you happen to be wearing a skirt, just pull
it up and neatly tuck the bottom hem in the waistline so it stays
out of the way. Then you can pull down your panties or if wearing
jeans just pull everything down.
Then if you’re right handed take the catheter loosely coiled in the right hand
with the tip between thumb and forefinger sticking out about an
inch or so. Then bend your knees to squat just a few inches to
get more room. With the left hand use the ring finger and index
finger to spread the outer lips and place your middle finger just
inside the vagina (with the finger pad facing up) to serve as
a guide. Then with the right had put the catheter tip in just
above the left middle finger and that's it. After an inch or so
the urine begins to flow so make sure the other end of the catheter
is over the toilet or you will get wet! (Yes that is the voice
of experience.) The first few times you will probably have to
probe around a little bit or a lot with the catheter tip before
you find the right opening but you can feel something different
when it goes in. Not painful as much as it is surprising to feel
something there so you will know it.
Also when you first learn at home it helps to put your left foot up on a small
stepstool or the side of the tub when you're trying to find the
MORE IMPORTANT DIRECTIONS
Now that I thought about it and actually watched myself do it a couple of times
the job of the left hand is actually very subtle and complicated
and I think I can give a better explanation. Probably that’s why
most women don’t learn how to do this but it’s really very easy
once you learn how you don’t even think about it at all that’s
why I didn’t write it earlier.
What I didn’t say is that after the left middle fingertip (only the tip) is
resting comfortably in the vagina (do this first) the middle finger
actually gives a lot of DOWNWARD TRACTION on the vagina side walls
to pull the urinary opening down open.
To do this is complicated because if you just pull down nothing will happen
(your finger will just slide down.) To accomplish this you’ll
need to experiment with pressing against your pubic bone to get
the friction needed, as described below.
So while your ring finger and index finger are holding the outer lips back
they also have to squeeze the side walls of the vagina against
the middle finger so that when the middle finger pulls down the
top part of the vagina stretches down and the urinary opening
stretches open. Does that make sense? I know this sounds very
complicated because how can the ring finger and index finger hold
one part open while squeezing another part closed at the same
The answer is to do this you need to press IN with your index finger and ring
fingers very firmly against your pubic bone. This holds
the lips open (pins them open?) Only then you can squeeze them
around your middle finger too.
So altogether it goes like this (don’t worry, actually doing it is 10 times
easier than writing about how to do it.)
The left middle fingertip is in the vagina. Then the left index finger and
ring finger hold open the outer lips and at the same time push
in very firmly against the pubic bone. Now at the same time while
you are still pushing in you can squeeze the index finger and
the ring finger together against the middle finger enough so that
now you gently pull DOWN with the middle finger the vagina wall
stretches down and the bottom of the urinary opening is pulled
down open. That’s all in one combination movement, spread out,
push in, squeeze together, pull down. Your middle finger in the
vagina makes sure there is enough space to get to the urinary
opening and is lined up as a guide to find the opening by sliding
the catheter over the middle finger tip.
I wish there were a way to just show you because it’s really very easy but
two whole pages of directions would scare me away from anything!
One more thing I forgot also, you can do this anyway just the same even if
you have a tampon in place.
Please just read the directions over, until it seems simple, because it really
is simple. I just can’t explain it well. Then with a little practice
it will change your life too. That’s what this is really about,
is taking back control of your life and becoming a whole person