Health Education | 6 Common Misconceptions About Intermittent Catheterization

For many patients suffering from neurogenic bladder, intermittent catheterization is a key method for scientifically managing urination and protecting kidney function. However, many patients and their families often fall into misconceptions that not only affect recovery outcomes but may also introduce unnecessary risks.

Today, we address the 6 most common misconceptions about intermittent catheterization to help you catheterize safely and live with confidence.

Misconception 1: Urinary Leakage Is Better Than Catheterization

Many patients believe that urinary leakage represents "natural urination" and is therefore preferable to catheterization. In fact, leakage is typically caused by overactive detrusor muscle activity, which leads to bladder fatigue, increased residual urine, and a higher risk of urinary tract infection. Long-term leakage can also reduce bladder capacity, cause skin maceration and breakdown, and may even result in urinary reflux and hydronephrosis. Intermittent catheterization, by contrast, allows the bladder to fill and empty in a regular, physiological manner, which supports the recovery of bladder function.

Misconception 2: Fewer Catheterizations Are Better

Catheterization frequency should be individualized based on the safe bladder capacity and urodynamic evaluation results. Arbitrarily reducing catheterization frequency leads to increased residual urine, raising the risk of infection and kidney damage.

Misconception 3: A Larger Bladder Capacity Is Better

When bladder volume exceeds 500 mL, the bladder becomes overdistended and intravesical pressure rises, reducing blood supply to the bladder wall and diminishing its ability to resist infection—thereby increasing the risk of urinary tract infection. Chronic overdistension can lead to fibrosis of the detrusor muscle, damage to pelvic nerves, and further impairment of bladder function, making recovery very difficult.

Misconception 4: Drinking More Water Prevents Urinary Tract Infections

Drinking a large amount of water in a short period of time can cause bladder overdistension. If the bladder is not emptied in time, the elevated pressure reduces blood circulation in the bladder wall, lowers the bladder's resistance to bacteria, and paradoxically increases the risk of urinary tract infection.

Misconception 5: "I Can Already Urinate On My Own — Why Do I Still Need to Catheterize?"

(1) The way patients believe they are urinating on their own is often neither safe nor correct. Long-term incorrect voiding patterns can lead to impaired kidney function. Catheterization recommended by the physician is therefore the scientifically sound choice.

(2) The goal of catheterization is to correct improper voiding patterns, preserve normal kidney function, protect the upper urinary tract, and ultimately safeguard the patient's long-term health and life expectancy—not to impose an unnecessary burden.

Misconception 6: "Catheterization Is Painful or Causes Bleeding — Why Continue?"

Occasional pain or mild bleeding during catheterization is usually a temporary phenomenon that can be managed by using anesthetic gel, switching to a hydrophilic-coated catheter, or improving technique. The core purpose of catheterization is to protect the upper urinary tract, and this essential rehabilitation method should not be abandoned due to temporary discomfort. If persistent discomfort occurs, consult a physician promptly for evaluation and adjustment of the treatment plan.

Intermittent catheterization is a scientifically validated and effective method of bladder management. Understanding and avoiding these common misconceptions is key to protecting kidney function and improving quality of life.

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The medical information provided here is for reference only and should not be used as a basis for clinical diagnosis or treatment.