What to do when a catheter is bleeding?

September 28, 2025 •

5 min read

Millions of people worldwide use urinary catheters, and experiencing some form of bleeding, medically known as hematuria, is a relatively common concern. Knowing what to do when a catheter is bleeding is crucial for managing the situation safely and preventing further complications, always in consultation with a healthcare provider.

Quick Summary

When a catheter is bleeding, immediately assess the severity: mild spotting can be monitored, while heavy, bright red bleeding or large clots require emergency medical attention. Ensure the catheter is secure, check for kinks, increase fluid intake, and promptly notify your healthcare provider for guidance on the underlying cause and next steps.

Key Points

Assess Severity: Mild pinkish tinge can often be managed with observation and increased fluids, while bright red blood or clots demand immediate medical attention.
Call a Professional: Persistent bleeding, or any bleeding accompanied by pain, fever, or signs of infection, should be reported to a healthcare provider immediately.
Secure the Catheter: Improperly secured or accidentally pulled catheters are a common cause of trauma and bleeding. Always ensure it is properly fastened.
Do Not Force It: If you encounter resistance during self-catheterization, do not force the catheter. Stop and contact your doctor, as this can cause urethral damage.
Check for Obstructions: A kink in the catheter tubing or an improperly placed drainage bag can cause blockages and lead to bleeding. Always ensure a clear path for drainage.
Increase Fluid Intake: Adequate hydration can help flush the bladder and reduce the concentration of blood, which is beneficial for managing mild bleeding.
Prioritize Hygiene: Proper handwashing and cleaning of the catheter insertion site are crucial for preventing infections, which can lead to or worsen bleeding.

Understanding the Types and Severity of Catheter Bleeding

Bleeding from or around a catheter can range from a minor, temporary issue to a sign of a more serious problem. It’s important to understand the different types of bleeding you might see and how to react accordingly. Minor bleeding might appear as a slight pink or reddish tinge in the urine, while more severe bleeding presents as bright red urine or visible blood clots.

Mild vs. Severe Bleeding: When to Seek Help

Recognizing the difference between mild and severe bleeding is the first and most critical step. Mild bleeding can often be managed with careful monitoring and home care, but severe bleeding requires immediate medical attention. Never hesitate to contact your healthcare provider or emergency services if you are unsure.

Mild Bleeding: This may appear as pink-tinged urine or occasional, small spots of blood. It often occurs after insertion or during catheter movement.
Severe Bleeding: This is indicated by bright red, persistent bleeding, large blood clots, or blood leaking profusely from the catheter site. If accompanied by pain, fever, or signs of shock, it is a medical emergency.

Immediate Actions for Catheter Bleeding

Regardless of the severity, there are a few immediate actions you should take to stabilize the situation before seeking professional medical advice. These steps can help prevent further injury and manage the immediate symptoms.

Stay Calm and Assess: Panic can cloud your judgment. Take a moment to calm down and carefully observe the color, consistency, and amount of the bleeding. Note any other symptoms, such as pain or fever.
Check for Kinks and Obstructions: A common cause of minor bleeding is improper drainage due to a kink in the tubing. Ensure the catheter tubing is straight and that the drainage bag is always positioned below the bladder to prevent backflow.
Increase Fluid Intake: Drinking plenty of fluids, if medically permitted, helps flush the bladder and can reduce the concentration of blood in the urine. This is particularly helpful for mild, minor bleeding.
Secure the Catheter: Confirm that the catheter is properly secured to your leg or abdomen, depending on the type. A loose or accidentally pulled catheter can cause significant trauma and bleeding. If the catheter has been completely pulled out, do not attempt to reinsert it.

Step-by-Step Management for Different Scenarios

What you do next depends on the type and severity of the bleeding. Follow these guidelines while preparing to contact your healthcare provider.

If Bleeding is Mild and Not Getting Worse:

Monitor Your Urine: Keep a log of your urine's color, clarity, and volume. Note any changes over time. Your provider will need this information.
Stay Hydrated: Continue to drink plenty of fluids to help clear the bladder.
Maintain Hygiene: Gently clean the catheter entry point with a mild soap and water to prevent infection, which can worsen bleeding.
Contact Your Provider: Even mild bleeding should be reported to your healthcare provider, as it can sometimes be a precursor to a more serious issue.

If Bleeding is Severe or Accompanied by Other Symptoms:

Apply Pressure (if appropriate): For bleeding at the insertion site of a suprapubic catheter, apply firm but gentle pressure with a clean cloth or sterile gauze.
Call Emergency Services: If the bleeding is heavy, bright red, or accompanied by large clots, call 911 or your local emergency number immediately.
Do Not Manipulate the Catheter: Never try to adjust or re-insert the catheter yourself during a severe bleeding event. This could cause further damage.
Monitor for Shock: Watch for signs of shock, including dizziness, weakness, rapid heart rate, or feeling faint.

Potential Causes of Catheter Bleeding

Bleeding can be caused by several factors, including:

Catheter Trauma: Rough handling during insertion or removal, or accidental pulling, can cause injury to the urethra or bladder.
Urinary Tract Infection (UTI): Infections are a leading cause of catheter-related issues and can cause inflammation that leads to bloody urine.
Bladder or Kidney Stones: These can irritate the bladder lining, causing bleeding.
Improper Catheter Size: A catheter that is too large or too small can cause irritation and friction, leading to micro-tears in the delicate tissues.
Incorrect Balloon Inflation/Deflation: The retention balloon on an indwelling catheter can cause trauma if not properly inflated or deflated.

Comparison Table: Catheter Bleeding Scenario Actions


Scenario	Severity	Initial Action	When to Call a Doctor	When to Call Emergency Services
Slight Pink Tinge	Mild	Monitor urine color, increase fluids, check for kinks.	If persistent beyond 24 hours or if other symptoms appear.	Not typically required unless other severe symptoms develop.
Small Spots of Blood	Mild	Ensure catheter is secure, maintain hygiene, drink fluids.	If bleeding increases, or pain/fever starts.	If bleeding becomes profuse or clots appear.
Bright Red Blood / Clots	Severe	Stay calm, apply pressure if from suprapubic site.	Call immediately.	Immediately, especially with pain, fever, or dizziness.
Catheter Pulled Out	Severe	Apply pressure to site with sterile gauze. Do NOT reinsert.	Call immediately.	Immediately, as this can cause significant trauma.

Preventing Future Bleeding

Proper catheter care is the best defense against bleeding and other complications. Regular communication with your healthcare team is essential.

Use Proper Technique: If you self-catheterize, ensure you are using the correct technique. Seek refresher training if needed.
Adequate Lubrication: Always use plenty of lubricant during intermittent catheterization to minimize friction. Consider hydrophilic catheters for their pre-lubricated surfaces.
Secure Catheter Appropriately: Use a leg strap or other securement device to prevent accidental pulling and movement.
Maintain Hydration and Hygiene: Drink enough fluids to keep urine flowing and practice meticulous hand hygiene and insertion site care.
Choose the Right Catheter: Ensure you are using the correct size and type of catheter for your needs, as recommended by your doctor. The Centers for Disease Control and Prevention (CDC) provides guidelines on catheter use and infection prevention that are helpful for patients and caregivers.

Conclusion

Seeing a catheter bleed can be a frightening experience, but understanding the steps to take can help you respond effectively. While mild bleeding can sometimes resolve on its own with monitoring and proper care, persistent or severe bleeding should never be ignored. The most important action is to communicate with your healthcare provider and, in cases of severe bleeding, to seek emergency care. Following proper care techniques and prevention strategies, and trusting professional medical advice, is key to managing your condition safely.

Frequently Asked Questions

It is not uncommon to see a slight pinkish tinge or a few drops of blood in the urine shortly after a catheter is inserted. This is usually caused by minor trauma to the urethra. However, if it persists beyond a few days or worsens, you should contact your healthcare provider.

You should call your doctor if the bleeding is new or persistent, if you notice an increase in the amount of blood, or if the bleeding is accompanied by symptoms like fever, abdominal pain, or a change in the color or smell of your urine. They can determine if further evaluation is needed.

A blood clot in the catheter tubing is a sign of potentially significant bleeding. If you notice a clot, do not attempt to clear it yourself. Contact your doctor immediately, as this could indicate a blockage and requires professional assessment.

If your catheter is pulled out, do not try to reinsert it. Apply firm pressure to the site with a clean cloth or sterile gauze to control any bleeding and seek immediate medical attention by contacting your doctor or heading to the nearest emergency room.

Preventative measures include ensuring the catheter is properly secured to avoid accidental pulling, using adequate lubrication during self-catheterization, and practicing good hygiene. Your doctor can also confirm if you are using the correct catheter size and type for your body.

Yes, a catheter-associated urinary tract infection (CAUTI) is a common cause of bleeding. The infection causes inflammation of the urinary tract, which can lead to blood in the urine. Other symptoms of a CAUTI include fever and cloudy, foul-smelling urine.

Increasing your fluid intake can help flush your bladder and may reduce the blood's concentration in your urine, especially for mild bleeding. However, this should only be done if not restricted by a healthcare provider for a different medical condition.