Trail Without Catheter (TWOC)

Patient Information

Urology

• Author ID: LC 
• Leaflet Ref: Urol 021 
• Version: 4 
• Leaflet title: Trial Without Catheter (TWOC)
• Date Produced: May 2024 
• Expiry Date: May 2026 

Trial Without Catheter (TWOC)

You will be invited to The Richmond Urology Unit situated on the first floor of The Hanover Diagnostic and Treatment Centre at Leigh Infirmary.  Here you will be greeted by a health care professional and shown to the area where you will be seated for the duration of the trial without catheter (TWOC).  It is expected that you will be here for about of 4 hours. 

Trial without catheter is the planned removal of your urinary catheter (the tube in your bladder).  The catheter needs to be removed to see if you can pass urine and empty your bladder without it.  Removing the catheter is the only way to find out if you can pass urine normally. Before removing your catheter, the nurse will put a small amount of water through the catheter into your bladder, so that your bladder is not completely empty when your catheter comes out. 

After having your catheter removed you will be asked to drink water throughout the morning, about 1 cup every 30 to 45 minutes.  You will be asked to pass urine into a bottle / bed pan so that it can be measured.  You will have a scan of your bladder after you have passed urine to see if your bladder is emptying properly.

Is there anything I can do before my TWOC appointment?

Yes, you can: 

• Make sure you have continued to take any medication prescribed by the Doctor for your prostate (men only).
• Make sure you are not constipated: ask your GP to prescribe medication to help you go to the toilet.
• Make sure you are drinking enough fluids, about 2 litres in 24 hours (8 cups). 

What will happen if I do not pass urine after the catheter has been taken out?

• A new catheter may be inserted, or you may be shown how to pass a catheter yourself to drain your bladder, this is called clean intermittent self-catheterisation (CISC).
• Appropriate follow up will be arranged with your Consultant.
• There is a risk of developing a UTI (water infection) when you have a catheter, so it is important to continue to drink 2 to 3 litres of fluid a day.  If you develop symptoms such as a high temperature, shivering and shaking, feeling unwell or flu like, or cloudy/smelly urine you may have a UTI (water infection) and you will need to take a sample of urine to your GP for analysis.

What will happen if I do pass urine after the catheter has been taken out?

• You may not need to see the Consultant again if you manage to pass urine but if necessary, appropriate follow up will be arranged.
• Drink about 2 litres of fluid a day following the TWOC and ensure you pass urine at least every 4 hours (even if you do not feel the need to go) to help strengthen the bladder muscle.
• You may still be at risk of needing another catheter for 1 to 2 weeks, if you feel you are not emptying your bladder properly, you are unable to pass urine, have abdominal pain (pain in your tummy), start to pass urine more frequently or start dribbling urine.

Contact

If you have any queries, please contact the Urology Nurses at the Richmond Urology Unit on: 

01942 264491 or 01942 264956.