How to Reduce the Risk of UTIs When Self-Catheterising

Urinary tract infections (UTIs) are one of the potential complications people may encounter when performing intermittent self-catheterisation. Because a catheter passes through the urethra and into the bladder, there is an opportunity for bacteria to enter the urinary tract during the process, which is why good hygiene and careful catheter technique are so important.

However, reducing your risk of a UTI isn't simply about keeping the catheter clean. How you handle and insert your catheter, how effectively your bladder empties, your catheterisation schedule and other aspects of your bladder and general health can all play a role.

This also means that developing a UTI doesn't necessarily mean you've done something incorrectly. Even people who follow their catheterisation routine carefully can experience UTIs, and individual risk can be influenced by the underlying reason for catheterisation and other health factors.

Why can self-catheterisation increase the risk of a UTI?

Your urinary system has natural mechanisms that help protect it from infection. Regular urine flow helps flush microorganisms from the urinary tract, while the urinary tract itself has several natural defences that make it more difficult for potentially harmful bacteria to establish an infection.

Intermittent self-catheterisation temporarily bypasses some of these natural protections. Each time a catheter is passed through the urethra and into the bladder, bacteria from the hands, skin around the urethral opening or surrounding environment may potentially be carried into the urinary tract.

One way to think about the possible route is:

Hands or surrounding surfaces → catheter → urethra → bladder

This is why hand hygiene and keeping the catheter clean during handling are such important parts of the process.

However, UTI risk isn't only about bacteria getting onto the catheter. Several other factors associated with bladder management may also contribute, including:

• Incomplete bladder emptying: Urine remaining in the bladder can provide an environment in which bacteria may multiply.

• Urethral irritation or trauma: Forceful or difficult catheterisation can damage the delicate tissues of the urethra.

• Catheterisation frequency: Catheterising too infrequently may allow the bladder to become overly full, while unnecessary catheterisation increases the number of times the urinary tract is instrumented. This is why your schedule should be individually determined by your healthcare professional.

• Catheter handling and technique: Touching the insertion portion of the catheter or allowing it to contact potentially contaminated surfaces can introduce additional microorganisms.

• The catheter being used: An inappropriate size, insufficient lubrication or other catheter-related difficulties may contribute to irritation or make catheterisation more difficult.

• Individual health factors: The reason you need catheterisation, your bladder function and other medical conditions can also influence your individual risk of infection.

It's also important to understand that bacteria in the urine don't always mean you have a UTI. People who regularly use urinary catheters may sometimes have bacteria present in their urine without experiencing symptoms of infection. This is known as asymptomatic bacteriuria and is different from a symptomatic UTI.

For this reason, changes such as cloudy or stronger-smelling urine shouldn't automatically be assumed to mean an infection is present. Your symptoms and individual circumstances need to be considered, and suspected UTIs should be assessed by a healthcare professional. 

So, what can you do in your everyday catheterisation routine to help reduce UTI risks? Let's look at some of the most important steps.

1. Wash your hands before and after catheterisation

Good hand hygiene is one of the simplest ways to help reduce the opportunity for bacteria to be introduced during self-catheterisation. Wash and dry your hands thoroughly before handling your catheter and again once you've finished.

After washing, try to avoid touching unnecessary surfaces—such as your phone, toilet controls or door handles—before handling the catheter. If you use disposable gloves as part of your routine, remember that gloves don't replace hand hygiene and should be changed between catheterisations.

2. Keep your catheter clean during handling

Even with freshly washed hands, how you handle the catheter matters. Avoid unnecessarily touching the section that will enter the urethra, and don't allow it to come into contact with potentially contaminated surfaces such as the toilet, sink, floor or clothing.

Open the catheter only when you're ready to use it and follow the manufacturer's instructions for preparation and handling. If a single-use catheter becomes contaminated before insertion, use a new one rather than attempting to wipe or rinse it clean.

If your catheter includes a no-touch sleeve or handling grip, use it as directed to help minimise contact with the insertion portion.

3. Clean the urethral area as you've been taught

Good hygiene isn't limited to your hands and catheter. Keeping the area around the urethral opening clean can also help minimise the transfer of bacteria during catheterisation.

Follow the cleaning technique recommended by your healthcare professional, including any guidance you've been given about what products to use. This is particularly important because the appropriate approach can differ depending on your individual circumstances.

More cleaning isn't necessarily better. Avoid introducing strong antiseptics, fragranced products or other cleansing products around sensitive genital tissue unless they've been specifically recommended for you, as these may cause irritation.

4. Don't reuse a single-use catheter

If your intermittent catheter is labelled single-use, it should be used once and then disposed of according to the manufacturer's instructions.

It can be tempting to think that rinsing or wiping a catheter makes it suitable to use again, particularly if it still looks clean. However, a catheter can carry microorganisms that aren't visible, and cleaning a single-use product at home doesn't convert it into a reusable device.

Not all catheter products are designed or approved for use in exactly the same way, so always check the manufacturer's instructions and follow the advice provided by your healthcare professional.

5. Use the correct catheter and lubrication

Using a catheter that's appropriate for your anatomy and bladder-management needs can help make catheterisation smoother and minimise unnecessary irritation to the urethra.

Intermittent catheters vary in diameter, length, tip design and coating, and some require separate lubrication while others are supplied pre-lubricated or with a hydrophilic coating.

Adequate lubrication, where required, helps reduce friction as the catheter passes through the urethra. This matters because repeated irritation or trauma to the urethral lining is something you want to minimise when catheterising regularly.

Your catheter size and type should be selected with your healthcare professional. If your usual catheter suddenly becomes uncomfortable or increasingly difficult to insert, don't simply move to a smaller, larger or differently shaped catheter yourself.

Instead, speak with your healthcare professional so they can determine whether your catheter or technique needs reviewing.

6. Don't force the catheter

If your catheter doesn't pass as expected, pushing harder isn't the answer.

Forceful catheterisation can irritate or injure the urethra and may cause pain or bleeding. Maintaining a gentle technique therefore isn't only about comfort—it's an important part of avoiding unnecessary urinary tract trauma.

7. Follow your recommended catheterisation schedule

UTI prevention isn't only about keeping bacteria away from the catheter. How regularly and effectively your bladder is emptied can matter too.

As a general guide, when intermittent clean self-catheterisation (ICSC) is the primary way a person empties their bladder, catheterisation may be performed approximately every four hours during the day and every six hours overnight.

However, this is only a general guide. The appropriate frequency can differ considerably from one person to another depending on factors such as bladder capacity and function, urine volumes, fluid intake, medications, the underlying reason for catheterisation and whether you can also pass urine naturally.

Your healthcare professional should therefore determine a catheterisation schedule specifically for you. Following that schedule can help prevent the bladder from becoming excessively full and reduce the amount of urine remaining in the bladder between catheterisations.

If you're regularly producing much larger or smaller catheterised volumes than expected, frequently feeling overly full between catheterisations, or finding that your usual schedule no longer seems appropriate, discuss it with your healthcare professional rather than changing the frequency yourself.

8. Make sure your bladder has finished draining

When urine begins flowing through the catheter, give your bladder sufficient time to empty according to the technique you've been taught.

Removing the catheter before drainage has finished may leave more urine behind in the bladder. Residual urine can be relevant to UTI risk because stagnant urine may provide an environment in which bacteria can multiply.

Don't rush simply because the initial stream has slowed. Follow your healthcare professional's instructions for determining when your bladder has finished draining and for removing the catheter correctly.

9. Stay appropriately hydrated

Adequate fluid intake supports normal urine production and helps urine move through the urinary system. Not drinking enough can result in more concentrated urine and may contribute to other bladder-management difficulties. 

As a general reference, the Australian and New Zealand Nutrient Reference Values set an Adequate Intake (AI) from fluids—including plain water, milk and other drinks—of around 2.6 litres (about 10 cups) per day for adult men and 2.1 litres (about 8 cups) per day for adult women. When water contained in food is included, total daily water intake is approximately 3.4 litres for men and 2.8 litres for women.

However, these figures are intended as general guidance for healthy adults rather than a target that everyone needs to meet. Your individual fluid requirements can vary depending on your body size, activity levels, climate, medications, bladder management and medical conditions.

10. Maintain healthy bowel habits

Bowel health might not be the first thing that comes to mind when thinking about catheterisation, but the bowel and bladder sit close together and can influence one another.

When the bowel becomes very full due to constipation, it can place additional pressure on the bladder and surrounding structures. For some people, constipation may contribute to difficulties with bladder emptying or make catheterisation more challenging.

If constipation is frequent, severe or becoming a recurring problem alongside difficulties with catheterisation, speak with your healthcare professional. Avoid starting laxatives or significantly changing your bowel-management routine without appropriate advice if you have underlying medical conditions or an established bladder and bowel management plan.

11. Store your catheters properly

Good catheter hygiene continues even when you're not actively catheterising. 

A few things to remember:

• Keep unopened catheters in their original packaging.

• Store them somewhere clean and dry, away from obvious sources of contamination.

• Check the manufacturer's recommended storage conditions, including any temperature requirements.

• Don't use a catheter if its sterile packaging is torn, punctured, wet or otherwise compromised.

• Check expiry dates when rotating through your supplies.

• Avoid storing catheters where the packaging could easily become damaged, crushed or contaminated.

Temperature is another consideration, particularly in Australia. Avoid leaving catheter supplies in very hot locations, such as inside a parked car, unless the manufacturer confirms that those conditions fall within the product's permitted storage range.

Know the signs of a possible UTI

Even when you follow good catheterisation practices, UTIs can still occur, so it's important to recognise when something may have changed.

Possible signs and symptoms can include:

• Burning, stinging or discomfort in the urinary tract

• New lower abdominal or bladder discomfort

• Blood in the urine

• Needing to urinate more frequently or urgently, if you also urinate naturally

• Fever or chills

• Feeling unusually tired or generally unwell

• Pain in your back or side

If you develop symptoms that could indicate a UTI, contact your healthcare professional for advice rather than trying to diagnose the infection yourself. They may recommend urine testing or further assessment to determine whether treatment is needed. 

Can you test for a UTI at home? 

If you notice possible UTI symptoms, an at-home UTI test may provide useful preliminary information before you speak with a healthcare professional.

Home UTI tests typically use a urine test strip to check for certain markers that may be associated with a urinary tract infection. Depending on the test, these may include leukocytes (white blood cells) and nitrites, which can be present when an infection is occurring.

They're generally simple to use: a urine sample is tested according to the product instructions and the resulting colour changes on the strip are compared with the supplied reference chart.

However, a home UTI test can't confirm or rule out every urinary tract infection. A negative result doesn't necessarily mean you don't have a UTI, particularly if you're experiencing symptoms, and a positive result may still require further assessment or laboratory testing.

Conclusion: Reducing UTI risk starts with good everyday habits

While urinary tract infections are a recognised risk of intermittent self-catheterisation, there are practical steps you can take to help reduce that risk as part of your everyday routine. 

Just as importantly, get to know what's normal for you. Changes in how catheterisation feels, difficulty emptying your bladder or symptoms that could indicate a UTI are worth paying attention to. At-home UTI tests may provide useful preliminary information, but they shouldn't replace professional assessment when symptoms are present.

If you experience recurrent UTIs, don't assume it's simply something you have to put up with—or that you necessarily need to clean more. Speak with your healthcare professional, who can review your catheterisation technique, catheter choice, schedule and other factors that may be contributing.

Disclaimer: This article is provided for general educational and informational purposes only and is not intended to replace medical advice, diagnosis, treatment or individual catheterisation training. Always follow the catheterisation technique, schedule and bladder-management advice provided by your healthcare professional.

If you experience symptoms of a UTI, recurrent infections, difficulty catheterising or other changes in your urinary health, seek advice from an appropriately qualified healthcare professional.

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