Urine Drainage Bag and Leg Bag Care

The Foley catheter is a tube that helps drain urine from the bladder. It is used by some patients who have had urological or gynecological surgery, or who have a condition that makes urination difficult.

The urinary (Foley) catheter is placed into the bladder through the urethra, the opening through which urine passes. The catheter is held in place in the bladder by a small, water-filled balloon. In order to collect the urine that drains through the catheter, the catheter is connected to a bag. It is either a regular (large bag) drainage bag or a small leg bag.

If you have a urinary (Foley) catheter, you will use the larger drainage bag at night while you are sleeping. You can use the leg bag during the day.

Attaching or removing a leg bag

The leg bag is attached to your leg and allows you to move around more easily. Because the bag is hidden under your clothes, it may also make you feel more comfortable about the catheter.

To attach or remove a leg bag, you will need the following materials:

• Clean leg bag(s).
• Leg straps or tape.
• Cotton balls and alcohol pads.
• White vinegar.
• Water and a towel.
• Regular (large) drainage bag.

To attach or remove the leg bag:

• Wash your hands with soap and water for 15 seconds.
• Empty the large drainage bag. The different types of drainage bags open in different ways: a drain spout that you remove from its sleeve, a clamp that you open to the side, or an opening that you twist. Whichever method you use, be sure to not touch the tip when you let the urine flow out of the large drainage bag into the container or toilet.
• Place a towel under the connection between the catheter and the bag.
• Pinch off the soft rubber tube (the catheter tube) so that urine doesn't leak out.
• Disconnect the urinary (Foley) catheter tube from the current large drainage bag with a twisting motion. Keep pinching the soft rubber tube (the catheter tube) so that urine does not leak out.
• Be careful not to pull on the catheter. Place the old large drainage bag on the towel.
• Prepare to place the leg bag in the catheter tube from which you just disconnected the large drainage bag. Remove the protective coating from the tip of the leg bag drainage tube. (Save this tip to use later when you change back). Clean the tip with an alcohol pad, wiping away from the opening to avoid getting the tube dirty. Insert the tip in the catheter tube.
• Fasten the straps of the leg bag to your thigh. Secure the catheter itself to your leg with tape. Be sure to leave some slack in the catheter so that you don't put too much pressure on the bladder, urethra, and other parts of the body. Don't fasten the straps on the leg bag too tightly to your leg, as that may interfere with your circulation. If the leg strap gets dirty, wash it with soap and water.

Emptying the leg bag

Please note that because a leg bag is smaller than a regular drainage bag, it will have to be emptied more frequently.

• Empty the leg bag when it is half-full, or at least twice a day.
• Place a large plastic or metal container on the floor next to you. You may also empty the urine into the toilet. The nurse may give you a container to use at home.
• Wash your hands with soap and water.
• The different types of drainage bags open in different ways: a drain spout that you remove from its sleeve, a clamp that you open to the side, or an opening that you twist. Whichever method you use, be sure to not touch the tip when you let the urine flow out of the urine bag into the container or toilet.
• When the bag is empty, close the clamp or twist on the cap on the leg bag.
• Wash your hands with soap and water.
• Write down how much urine was in your bag, if your caregivers have asked you to keep a record.

It is a good idea to occasionally change your leg bag from one leg to the other. The best time to do this is right after you shower.

Cleaning the bag

• When you are ready to go to sleep, change out the leg bag and put on the drainage bag. Rinse out the leg bag with 1 part vinegar and 3 parts water. Soak the bag for 20 minutes. Rinse the bag out with warm water and hang it up to dry.
• In the morning, take off the drainage bag, put on the leg bag, and clean out the drainage bag the same way.
• Clean your leg bag every day and replace it whenever your doctor tells you to. This is usually once a month.

Other care tips

• Drink plenty of liquids. You should drink at least 8 cups of healthy liquids a day, if your health care provider approves.
• Do not pull or tug on the tubing. This can cause bleeding and hurt the area in which the water-filled balloon is located.
• Do not step on the tubing when you are walking. Hold the tubing curled in your hand, with the urine bag below your bladder when you are walking. You may also want to clip or pin the tubing to your clothing.
• Arrange the catheter tubing so that it does not twist or loop. When you are getting into bed, hang the urine bag beside the bed. You can sleep in any position as long as the bedside bag is below your bladder. Do not place the urine bag on the floor.
• Always keep your urine bag below your bladder, which is at the level of your waist. This will prevent urine from flowing back into your bladder from the tubing and urine bag, which could cause an infection. Also, do not go to bed or take a long nap while wearing the leg bag.
• When you take a shower, you can keep the larger drainage bag in place and hang it on the rail in the shower area. You can also use a plug that is inserted in the place where the catheter connects to the drainage bag. Lay the drainage bag aside with a cover over the connection piece while you shower, and reconnect when you are done. It is important to put a cap on the end of the drainage bag tubing so it does not become contaminated.
• If you dislodge the catheter, it will stop draining or it will leak. Call your doctor if this happens. Leakage can happen from many things: dislodgement, bladder spasms, or blockage. In all cases, notify your doctor.
• Check the catheter and drainage tube on a regular basis to make sure the tube isn't squeezed or tangled.

When should you contact your healthcare provider about your urine drainage bag?

Contact your healthcare provider if you have:

• Cloudy, foul-smelling urine.
• Red or pink urine, mean that there is blood in the urine.
• A fever greater than 101 degrees Fahrenheit.
• Pain or burning in your urethra, bladder or lower back.
• Swelling, draining, or redness in your urethra (the area where the Foley catheter leaves the body).

You should also contact your healthcare provider if no urine has drained from your catheter in six to eight hours or if your catheter is leaking.

Symptoms of a urinary tract infection may include:

• A need to urinate often.
• A painful, burning feeling in the area of the bladder or urethra while you are urinating.
• Nausea or vomiting.

You may also feel bad all over — tired, shaky, washed out —and feel pain even when you are not urinating. The urine itself may look milky or cloudy or even reddish if blood is present.