Urinary catheters can have adverse effects on body image and sexual function, a qualitative study has revealed.

A total of 36 individuals, aged 22 to 96, who had used an indwelling urinary catheter for three months or longer were interviewed. Two thirds of the participants were men. All were of white ethnicity apart from one who was South Asian.

Most (22) of the patients had catheters because of a neurological condition; the second most common reason was cancer (prostate, bowel and uterus).

Half of the interviewees spoke about feelings related to masculinity, femininity, sex and body image.

The main themes were:

• Importance of sex in everyday life

• Self-esteem and body image

• How catheters physically affect sex

• Lack of information

Sex was important for some individuals, but for others less so. Some respondents commented on negative body image and low sexual self-esteem while others appeared to have a positive self-image in spite of the catheter

For some, the catheter impeded the physical act of sex. One man tried to tape his urethral catheter back along the penis but it made him sore because of the constant pulling during sex; this was better when he opted for a suprapubic catheter.

Many respondents complained about a lack of information. A couple of female respondents said that both doctors and nurses were reluctant to discuss sex or sexuality. One participant who had helped a group of healthcare professionals develop a questionnaire for a study was surprised that no one suggested including a question about sex.

This study highlights the importance of sex and sexuality for patients with indwelling catheters. The article also suggested some guidance from useful websites to help clinicians such as GPs to discuss these matters with patients, see the Useful information box, below.

Dr Richard Ma