Medical Procedures And Devices
Your health care professional may recommend a medical procedure or device to treat your urinary retention, depending on the cause of the retention. Examples of these procedures and devices include
- cystoscopyusing a cystoscope to look inside the urethra and bladder to find and remove blockages such as urinary tract stones
- laser therapytherapy that uses a strong beam of light to treat an area of enlarged prostate tissue by breaking up the blockage and reducing the obstruction
- prostatic urethral lift, or UroLiftusing tiny implants to lift and hold the prostate away from the urethra so urine can flow more freely
- transurethral electrovaporizationa procedure that uses heat to vaporize an area of enlarged prostate tissue
- transurethral water vapor therapy, or Rezumtherapy that uses water vapor, or steam, to shrink an enlarged prostate
- urethral dilationgradually increasing the size of the urethral opening by stretching the scar tissue, to help treat urethral stricture
- vaginal pessarya stiff ring that is inserted into the to help stop urine leakage, such as with cases of a cystocele or rectocele
Why Choose New York Urology Specialists For Treatment Of Bladder Problems
- All treatment is performed by a Board-certified urologist experienced in treating men with symptoms of frequent urination, urinary urgency, urinary incontinence and bladder pain using medical therapy, minimally invasive therapies, lasers and open surgery.
- We are one of the few practices in the region to offer a full range of options for treatment of urinary problems in men and women
- We offer treatment options for overactive bladder, UTI, and urinary incontinence in our office which avoids the risks, costs, and recovery from general anesthesia.
- Extensive Experience: Hundreds of men and women have treated successfully using medical therapy, Botox for overactive bladder, Interstim for frequent urination and tibial neuromodulation.
When it comes to experience and innovation New York Urology Specialists are a step ahead. Better Science Means Better Care. We specialize in minimally invasive highly effective treatment for symptoms of bladder pain, urethral burning, pelvic discomfort, incomplete bladder emptying, urinary frequency, and urgency. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.
Medicare and major insurances accepted. We offer .
How Should I Prepare For Self
Your healthcare provider will show you how to perform self-catheterization. The process gets easier with practice. Before performing self-catheterization, you should:
- Try to urinate the regular way.
- Wash your hands with soap and water.
- Wash your genitals with soap and water or an antiseptic towelette. This step lowers infection risk.
- Remove the catheter from its package being careful to keep it very clean.
- Apply a water-based lubricant on the tip and top two inches of the insertion end of the catheter if needed. Some catheters come pre-lubricated.
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Deterrence And Patient Education
The patient with acute urinary retention needs to be educated about catheter care and monitoring urinary output. If the patient is performing clean intermittent catheterization, they need to be taught proper techniques to avoid complications. Those with suprapubic catheters need to be shown proper care of these catheters and keeping the suprapubic site clean and free of the urinary leak to prevent dermatitis. Patients may need followup home care and education if they have complications. The patient with benign prostatic hyperplasia requires education about the trial without catheterization and follow-up care. The surgical options and the risk and complications of surgical treatment should be shared with the patient. If the etiology of the acute urinary retention is medication-based, the patient should understand the side effects of the medication and the need to find an alternative.
What Causes Urinary Retention After Catheter Removal In Females
Urinary retention is when you do not drain your bladder often enough or when something blocks your bladder from draining completely.
Normally, the urine flows freely from the bladder to the outside of your body.
However, if something blocks this flow of urine or keeps your bladder from draining completely, urine can get trapped inside the bladder. The longer this happens, the more likely it will lead to infection.
If you do not urinate frequently enough or when you are supposed to , there is a risk of developing urinary retention.
This can be caused by nervous system problems or it may happen after surgery. If you do not urinate after surgery, this should be reported to your surgeon immediately.
Having an overactive bladder which leads to urine leakage can increase the risk of urinary retention.
Urinary retention can be a result of bladder or bowel problems, including neurogenic bladder and fecal incontinence.
Bladder or bowel problems can be caused by nerve or brain damage, infections, medications that relax the bladder, stroke, uncontrolled diabetes, and other medical conditions.
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Urinary Retention After Catheter Removal Female: What You Need To Know
Urinary retention is a common complication that occurs after catheter removal. If this is not treated promptly, it can lead to infection.
The bladder must be drained 3-4 times a day after the catheter has been removed.
Drainage should not be done through the urethra because of potential damage to the sensitive tissue at the site where the catheter was inserted.
- To avoid urinary retention, the patient should take frequent walks around the ward.
- If symptoms persist, paracetamol should be administered orally or rectally to reduce pain and spasm in the bladder neck.
- On follow-up, a pelvic floor physiotherapy session would help strengthen the pelvic floor muscles which could help prevent future episodes of urinary retention.
- If there is still no improvement, an indwelling catheter should be reinserted and the patient should be reassessed by a urologist.
- In rare cases, an obstructive stone might need to be removed surgically.
What Is A Foley Catheter And What Is It Used For
People have used urinary catheters for centuries. They are tubes that help drain urine from the bladder quickly. The Foley catheter is a special type of catheter that researchers invented in the 1930s. It was the first of its kind because it was designed to be indwelling. This means that it can stay in place to continuously drain urine over time.
The design of the Foley catheter is unique because it has a small balloon at its end that sits in the bladder and holds it in place. Foley catheters come in different sizes and can be used in men, women, and children.
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How Do I Perform Self
Regardless of gender, the steps for performing self-catheterization are generally the same. Females may find it helpful at first to use a mirror to find the urethral opening where urine comes out. To perform self-catheterization:
- Sit on the toilet .
- Use firm, gentle pressure to insert the lubricated end of the catheter into the urethra.
- Hold the other end of the catheter over the toilet bowl or container.
- Slowly slide the catheter until it reaches the bladder and urine starts to flow out of the tube.
- Continue inserting the catheter another inch or two.
- Hold the catheter in place until the bladder empties.
- Slowly and gently slide out the catheter.
How Do You Care For A Urinary Catheter
One-time use catheters and reusable catheters are available. For reusable catheters, be sure to clean both the catheter and the area where it enters the body with soap and water to reduce the risk of a UTI. One-time use catheters come in sterile packaging, so only your body needs cleaning before inserting the catheter.
You should also drink plenty of water to keep your urine clear or only slightly yellow. This will help prevent infection.
Empty the drainage bag used to collect the urine at least every 8 hours and whenever the bag is full. Use a plastic squirt bottle containing a mixture of vinegar and water or bleach and water to clean the drainage bag. Read more on clean intermittent self-catheterization.
While UTIs are the most common side effects associated with urinary catheters, there are other potential side effects that you may discuss with your doctor. These include:
- bladder spasms and pain, which may feel like stomach cramps
- blood or other debris getting trapped inside the catheter tube, which may stem from blockage in the catheters drainage system
- catheter leakage, which may happen from a blockage in the system, or from pushing during toileting if youre constipated
- urethra or bladder injuries
While not all side effects from urinary catheter use are completely avoidable, you may help reduce your risk with certain dietary and hygiene steps, as well as preventing blockages in the catheters drainage system.
Discuss the following risk factors with your doctor:
Transurethral Microwave Thermotherapy Of The Prostate
Because of the risks associated with transurethral prostatectomy, minimally invasive therapies have been developed as alternative strategies to ablate prostatic tissue.25 Of these strategies, radiofrequency and microwave energy have been the most extensively investigated. In general, these minimally invasive techniques are less effective than transurethral prostatectomy but are associated with fewer significant complications. However, a troublesome consequence of these minimally invasive therapies is postprocedure AUR.
The incidence of AUR following TUMT is related to the amount of energy delivered to the prostate. In a prospective randomized study reported by DAncona and colleagues,26 the length of catheterization was 4.1 days following transurethral prostatectomy versus 12.7 days with TUMT. Blute and colleagues27 reported that, following TUMT, 36% of men required catheterization for urinary retention. The rate of AUR following TUNA ranges from 13.3% to 41.6%.25
Clinical Need And Target Population
Chronic urinary retention can occur in a broad set of medical conditions with neurological and non-neurological causes.3 As a result, it is difficult to accurately estimate the affected population. The most common conditions, described below, are not a comprehensive list, but from these we can roughly estimate that about 33,000 people in Ontario live with chronic urinary retention.
Neurogenic bladder typically results from spinal cord injury, spina bifida , multiple sclerosis, stroke, and Parkinson disease. In Ontario, an estimated 33,140 people live with spinal cord injury and around 600 new spinal cord injuries occur every year,4 and approximately 70% to 84% of individuals with spinal cord injury have some degree of bladder dysfunction.5 As of 2010, about 3,500 Ontarians live with spina bifida.6 Approximately 95% of children with spina bifida have some aspects of bladder and bowel dysfunction, and it is estimated that 65% require intermittent catheterization.7,8 Multiple sclerosis affects close to 23,000 Ontarians,6 and 50% to 80% of people with multiple sclerosis report symptoms of bladder dysfunction or urinary incontinence.9 As of 2010, about 94,000 Ontarians live with stroke, and about 15% have urinary tract dysfunction.5,6,10 An estimated 28,200 Ontarians live with Parkinsonism, and 37% to 72% may have bladder symptoms.5,6,10 However, only a small proportion of those with urinary symptoms require intermittent catheterization.
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Iii Proper Techniques For Urinary Catheter Maintenance
Health Technology Under Review
Types of Intermittent Catheters by Coating
Several materials and methods are available for intermittent catheters. To reduce friction and discomfort during insertion and removal, catheters can be coated with a hydrophilic polymer or prelubricated with a gel , or they can be noncoated, which requires the user to apply additional lubricant.
Because of their coated nature, hydrophilic and gel reservoir catheters must be discarded after each use.11 Hydrophilic catheters, the most common type of coated intermittent catheter, have an outer layer of a polymer called polyvinylpyrrolidone bound to the surface of the catheter.12 Upon exposure to water, the catheter surface becomes slippery, which replaces the need for an additional water-soluble lubricant. The lubrication remains throughout the entire length of the urethra.1 The hydrophilic coating can be either pre-activated or activated by adding water at the time of use.24 Prelubricated gel reservoir catheters are nonhydrophilic in nature but are packaged with a gel lubricant. The user does not apply additional lubricant, thus minimizing contact with the catheter itself during catheterization.
With noncoated intermittent catheters, users typically apply a separate lubricant before insertion. Noncoated catheters are made of a variety of materials including polyvinyl chloride , PVC-free material, silicone, rubber latex, and Teflon.12
Other Variations of Intermittent Catheters
Single Use and Reuse of Intermittent Catheters
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Will Urinary Retention Go Away
It is common for urinary retention to happen after a catheter has been removed. Usually, it goes away with time.
In most cases, a patient will urinate normally a few days after their catheter is removed. If you still have trouble going to the bathroom, it could be a sign of another medical condition.
You need to contact your doctor if urinary retention lasts for longer than three days or if you keep having difficulty going to the bathroom.
Urinary Retention After Vaginal Delivery With Epidural Anesthesia
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government.Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.|
|First Posted : August 12, 2016Last Update Posted : April 20, 2022|
|Device: Foley catheterDevice: Short term catheterDrug: Epidural anesthesia||Not Applicable|
An explanation about the study will be delivered to each participant and each participant will sign a confirmed consent. Patients will be randomized between 2 groups of treatment: 1. intermittent catheterization applied every 4 hours during labor. 2. foley catheter inserted adjacent to epidural anesthesia.
In patients with a foley catheter, the catheter will be removed soon after delivery. Participants will be followed by a clinician post labor. An abdominal US will be performed either 4 hours after delivery or after the participant urinates to check the bladder volume.
Patient information including demographic information, information regarding the patient’s pregnancy and delivery will be collected from the patient’s electronic record.
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What Are The Benefits Of Urinary Catheterization For Treatment Of Urinary Retention Or Incomplete Bladder Emptying
Urinary catheterization allows the bladder to be emptied completely. This can prevent urinary tract infections and kidney damage in patients with urinary retention. Typically, patients experience significant relief and improvement in the quality of life after they start clean intermittent catheterization. Because the bladder is emptied completely with the catheter, patients typically do not have bladder discomfort and pain, do not have a constant urgency to urinate and are able to go and lead a fairly normal life.
Early Catheter Removal Following Radical Retropubic Prostatectomy
An indwelling urinary catheter is required following radical prostatectomy. Until recently, urinary catheters were typically left indwelling for up to 3 weeks. Lepor and colleagues23 reported that the urinary catheter is a source of significant bother and limits recovery following radical prostatectomy. In a survey of men who had undergone radical prostatectomy, more than 90% of patients expressed a willingness to undergo cystography in order to facilitate earlier removal of the catheter. Over the past several years, these investigators have attempted to identify the optimal timing for removal of the urinary catheter. In their initial study, gravity cystography was performed in 179 men 7 days following radical prostatectomy.23 Urinary catheters were removed in all patients who had no evidence of extravasation, unless a large pelvic hematoma was observed. AUR developed in 15% of the patients following removal of the urinary catheter on postoperative day 7.
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How Does A Provider Insert A Foley Catheter
Foley catheter insertion is usually quick, but it may be uncomfortable. After cleansing the area, your provider will typically use some numbing gel and lubricant so youre comfortable.
Then theyll insert the catheter through the urethra into the bladder. Once urine starts draining, it confirms the catheter is in the right place. To keep the catheter from sliding out, theres a very small balloon at the end of the Foley they inflate with water. This balloon tip of the catheter rests inside the bladder.
Finally, theyll secure the catheter tubing to your thigh with a strap to keep it safely out of the way. The urine will drain through the tubing into an attached bag.