11 July 2025

An estimated 90 000 people living in the community have long-term indwelling urinary catheters (Gage et al, 2017). Most urinary catheters are initially inserted in hospital (Shackley et al, 2017). In some cases, there are plans to carry out a trial without catheter (TWOC) but in other cases the indication for urinary catheterisation is unclear and/or there are no plans to remove the catheter. Around 50–70% of people with long-term catheters experience problems such as bladder pain, catheter leakage, blockage and urinary tract infection (Youssef et al, 2023). In the past TWOC was routinely carried out in dedicated hospital clinics (Tay et al, 2016), but in recent years increasing numbers of TWOCs have been carried out in the community (Logan and Coghlan, 2022). Suprapubic catheters are often inserted when it is difficult to catheterise urethrally and there can be the sense that suprapubic catheters are permanent (British Association of Urological Surgeons (2025). This article explores suprapubic TWOC in community settings.

07 October 2022

Indwelling urinary catheters are one of the most commonly used devices in health care. When they are left in situ for longer than necessary, the person is put at risk of complications while waiting for an appointment to have it removed. This article discusses the transition from hospital to a community-based nurse-led TWOC service and its benefits. 

25 June 2021

Indwelling urinary catheters are still one of the most commonly used invasive devices in health care, with recognised significant risk factors, including catheter-associated urinary tract infection (CaUTI) and sepsis. Timely and successful removal of the catheter often falls to the responsibility of community nurses. There has been much debate about the optimum timing and circumstances for a successful trial without catheter (TWOC). This article looks at best practice guidelines and relevant clinical evidence to support healthcare professionals in making choices around TWOC procedures.