Conditions That May Require Urinary Catheterisation
Urinary catheterisation can be useful for people with bladder problems, such as:
- urinary retention inability to empty the bladder, for example due to neurological conditions such as stroke and multiple sclerosis, or other factors such as faecal impaction or enlarged prostate
- bladder obstruction for example, caused by bladder stones or narrowing of the urethra .
It can also be useful on a temporary basis, such as:
- to help people to retrain their bladder catheterisation can be discontinued as soon as bladder control is re-established
- after surgery to the genital area such as prostate gland or hip surgery or a hysterectomy
- for the first few days after major surgery or to monitor fluid output in patients receiving intravenous fluids.
Slide : Hygiene And Standard Precautionscatheter Insertion Procedure23
- Don sterile gloves.
- Cover resident’s lower abdomen and upper thighs with dignity cover.
- Organize contents of tray on sterile field
- Pour antiseptic solution over swabs in tray compartment.
- Squeeze sterile catheter lubricant onto tray.
2. Gould CV, Umscheid CA, Agarwal RK, et al. Centers for Disease Control and Prevention. Guidelines for prevention of catheter-associated urinary tract infections 2009. Atlanta, GA: US Department of Health and Human Services, CDC 2009. Accessed January 28, 2016.3. Willson M, Wilde M, Webb M, et al. Nursing interventions to reduce the risk of catheterassociated urinary tract infection: part 2: staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009 36:137-54. PMID: 19287262.
Different Types Of Urinary Catheterisation
The two main types of urinary catheter are:
- indwelling catheter inserted through the urethra, or through the wall of the stomach, into the bladder and left in place for a period of time
- intermittent catheter inserted through the urethra into the bladder to empty it, then removed, several times a day.
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Slide : Learning Objectives
Upon completion of this session, licensed staff who insert or assist in the insertion of urinary catheters will be able to
- Explain the similarities and differences between the four different types of urinary catheters
- Prepare for and insert an indwelling urinary catheter using aseptic technique and
- Summarize effective strategies in preventing CAUTIs.
What To Do Before Inserting A Male Catheter
Before we get to the step-by-step process of actually inserting the catheter into the male patient, its important to ensure that youve carried out all of the necessary preparation. By preparing the supplies and the patient, the process will be able to go much more smoothly. Here are some key things to do before you begin:
- Prepare the Supplies Catheter insertion requires not only the catheter itself, but also some additional supplies, such as a syringe, medical wipes, cleaning clothes, gloves, and so on. Ensure that you prepare all the essentials before starting the process.
- ID the Patient Its important to ensure that youre working with the correct patient for catheterization, so nurses and doctors should always verify the identification of their patient before they begin by asking for two pieces of information, like name and date of birth.
- Speak with the Patient As long as its possible to do so, its also a good idea to communicate with the patient before the process begins to explain to them what will happen and what the catheterization will involve.
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Who Can Insert A Catheter
There are many medical professionals who can be trained in catheter insertion and who will be capable of inserting a catheter into a patient. The likes of doctors, nurses, and EMTs, for example, may all be trained in catheter insertion, and its important for many members of the medical team to have this skill, as catheter insertion can be a crucial step in patient treatment. Its even possible for patients to be taught to insert their own catheters at home, if they are living with conditions that require long-term catheter usage.
Slide : Prepping For Catheter Insertion Procedure3
- Cleanse hands and don gloves
- Get your buddy to help at the bedside
- Place resident in the supine position
- For a femaleapply topical lidocaine jelly if needed for comfort
- Inspect catheter kit and remove it from its outer packaging to form a sterile field
- Remove gloves and wash hands!
3. Willson M, Wilde M, Webb M, et al. Nursing interventions to reduce the risk of catheterassociated urinary tract infection: part 2: staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009 36:137-54. PMID: 19287262.
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Tips On Foley Catheter Care
- Never have sexual intercourse with the catheter inserted.
- Alway make sure an indwelling foley catheter is secured with a securement device.
- Maintain the cleanliness of the catheter by cleaning the area around it twice daily with soap and water.
- Never tug or pull the catheter.
- Check the area directly around the catheter for signs of infection or inflammation.
- Never apply any type of lotion to the area around the catheter.
Latex Vs Silastic Catheters
Silastic catheters have been recommended for short-term catheterization after surgery. Compared with latex catheters, silastic catheters have a decreased incidence of urethritis and, possibly, urethral stricture.18 However, use in animal models for longer than six weeks showed no difference in inflammatory response between latex and silastic catheters.18 Because of its lower cost and similar long-term outcomes, latex is the catheter of choice for long-term catheterization. The cost differential becomes less significant in patients who do not require frequent catheter changes.6 Silastic catheters should be used in latex-allergic patients.
Catheters impregnated with various substances have not proved to be beneficial in patients with long-term catheterization. Silver-impregnated catheters, antibiotic-coated catheters and electrified catheters may diminish bacteriuria for a few days but are costly and have no role in long-term catheterization.4,19â21 In one study, silver-impregnated catheters were associated with more frequent bacteriuria and an increased risk of staphylococcal bacteriuria.21
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Cleaning Urine Drainage Bags
Foley Catheter: Step By Step Process
1. Gather the Supplies
- Indwelling Foley Catheter Tray with a 10 cc balloon The tray comes with all the needed supplies
- Syringe to deflate the balloon of the existing catheter
- Soapy wash cloth and wet wash cloth
2. Wash hands with soap and water
3. Prepare all needed supplies
4. Lie flat on back with legs flat
5. If there is already a catheter in place, remove it by deflating the balloon.
- Attach the syringe to the end of the “Y” pigtail .
- Withdraw the plunger of the syringe. This will deflate the balloon on the catheter inside the bladder.
- You will know it is completely deflated when you are unable to pull anymore water into the syringe.
6. Gently pull the catheter out from the bladder.
Wash with the soapy cloth and rinse with the wet cloth. Dry well.
8. Wash hands again.
9. Open the Indwelling Catheter Tray carefully. Set up the supplies.
- Place paper pad under hips.
- Put on the gloves if this is not a self catheterization.
- Pour the Betadine onto the cotton balls
- Remove the plastic cover from the catheter & squirt the lubricating jelly onto the catheter.
- Remove the rubber cap from the syringe with the water in it.
- Connect the end of the catheter to the drainage bag
10. Choose your “clean” and “dirty” hand.
Remember, the hand touching the body will now be the dirty hand.
- Use clean hand to touch items in the kit
- Use 1 cotton ball per wipe.
- Never re-use a cotton ball.
14. See the urine flow into the catheter
15. Blow up the balloon
This will allow for the best drainage.
Urinary Catheter Insertion For Male Patients
Hi there! Lets take a look at urinary catheters and catheter insertion for male patients.
A urinary catheter is a hollow, flexible tube inserted through the urethra into the bladder to drain urine into an external collection bag.
Once the catheter has been inserted, a small balloon on the internal end is inflated with sterile water to keep it in situ.
Catheters are used often in healthcare settings to assist with a variety of conditions, such as both urinary incontinence and urinary retention, or by patients who may be unable to go to the toilet without assistance.
The following demonstration is based on the Catheterisation Clinical Guidelines by the Australia and New Zealand Urological Nurses Society.
Remember to always refer first to your organisations internal policies and procedures when performing any procedure like this one.
Slide 1: Female Catheter Insertion Procedure
- Using gloved nondominant hand, identify urethra by spreading the labia
- Spread inner labia slightly with gentle traction and pull upwards toward resident’s head.
- Clean periurethral area and urethral opening using antiseptic soaked swabs using tongs, in expanding circular motion. Discard used swabs away from sterile field.
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When To Seek Medical Advice
You should contact a district nurse or nurse practitioner or your GP if:
- you develop severe or persistent bladder spasms
- your catheter is blocked, or urine is leaking around the edges
- you have persistent blood in your urine, or are passing large clots
- you have symptoms of a UTI, such as pain, a high temperature and chills
- your catheter falls out
If your catheter falls out and you cant contact a doctor or nurse immediately, go to your nearest accident and emergency department.
Slide : Indwelling Urinary Catheters1
Images: Figure l. Routes of entry of uropathogens to catheterized urinary tract.An image depicts the male and female lower urinary tract system, and the difference in placement of a catheter in the bladder.
Source: Maki DG, Tambyah PA. Engineering out the risk of infection with urinary catheters. Emerg Infect Dis. 2001 Mar-Apr 7:342-7.*CMS, State Operations Manual, 2014.
1. Maki DG, Tambyah PA. Engineering out the risk for infection with urinary catheters. Emerg Infect Dis. 2001 7:342-7. PMID: 11294737.
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Introduction On How To Insert Foley Catheters
Inserting catheters is a skill that is often used in the medical profession by nurses. Nurses are able to gain access to patients bladders and the contents using Foley catheters. Since the catheter can be placed inside the bladder for an extended period of time, it is known as an indwelling catheter. The patients urine drains into a bag that is later taken from an outlet device and subsequently drained. Nurses can send the urine samples to the laboratory for further testing for crystals, infections, blood, kidney function, muscle breakdown, and electrolytes. Catheters are also used to treat bladder outlet obstruction and urinary retention in patients.
Should You Use Sterile Gloves When Inserting A Male Catheter
Yes, it is recommended to use sterile gloves when carrying out any kind of catheterization. This will help to reduce the risk of any microbes being transferred from your hands onto the catheter tube and then inserted into the patients body. This is very important, as infection is one of the most common complications associated with catheter insertion.
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Urethral Vs Suprapubic Catheters
Suprapubic catheters are recommended by some physicians for short-term use when a catheter is needed for gynecologic, urologic and other surgeries.1 Theoretically, there are fewer microbes on the abdominal wall than on the perineum, creating less risk for infection. Another advantage is easier catheter changes. Suprapubic catheters can also be clamped to test for adequate voiding. Some patients might also prefer a suprapubic catheter to enhance self-image and sexual functioning. Other patients prefer its comfort and convenience.1 Disadvantages of suprapubic catheters include the risk of cellulitis, leakage, hematoma at the puncture site, prolapse through the urethra1 and the psychologic barrier of insertion through the abdominal wall.
Risks And Potential Problems
The main problems caused by urinary catheters are infections in the urethra, bladder or, less commonly, the kidneys. These types of infection are known as urinary tract infections and usually need to be treated with antibiotics.
You can get a UTI from using either a short-term or a long-term catheter. However, the longer a catheter is used, the greater the risk of infection. This is why it’s important that catheters are inserted correctly, maintained properly, and only used for as long as necessary.
Catheters can also sometimes lead to other problems, such as bladder spasms , leakages, blockages, and damage to the urethra.
Read more about the risks of urinary catheterisation.
Page last reviewed: 26 February 2020 Next review due: 26 February 2023
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How To Catheterize The Bladder In A Female Child
, MD, Nemours/Alfred I. duPont Hospital for Children
Bladder catheterization can be done for diagnosis and/or treatment.
The main reason to insert a bladder catheter in female children is to
Collect a sterile urine sample for testing in very young children who cannot void on command
Less common reasons include
Monitoring of urine output in certain hospitalized patients
Slide 1: Insertion Avoiding Common Mistakes4
- Wash hands BEFORE and AFTER procedure
- Put on your sterile gloves after opening catheter kit
- If sterile, gloved hand gets contaminated or glove rips, then remove glove, wash hands, and don NEW sterile gloves
4. Manojlovich M, Saint S, Meddings J, et al. Indwelling urinary catheter insertion practices in the emergency department: an observational study. Infect Control Hosp Epidemiol. 2016 37:117-9. PMID: 26434781.
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Slide : Alternative Catheter Types
- Inserted directly into the urethra and bladder.
- Removed after insertion and drainage of bladder.
- Used intermittently.
- Placed surgically directly through skin into the bladder.
- Connected by tubing to a bag used to collect and measure urine.
External “Condom” Catheters for Men
- Does not enter the bladder.
- Connected by tubing used to collect and measure urine output.
- Cannot be used to treat acute urinary retention.
Slide : Catheter Insertion Kit Contents3
- Drape with opening, sterile gloves.
- Antiseptic solution for periurethral cleaning before insertion, swabs and tongs to use for applying antiseptic solution.
- Single-use packet of lubricant.
- Single-use dose of topical lidocaine jelly.
- Sterile urinary catheter, of smallest size effective for patient connected to tubing and bag.
- Catheter securing device.
3. Willson M, Wilde M, Webb M, et al. Nursing interventions to reduce the risk of catheter-associated urinary tract infection: part 2: staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009 36:137-54. PMID: 19287262.
Also Check: Men’s Urinary Incontinence Pads
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.
How Can I Help Prevent An Infection
- Wash your hands: Always wash your hands with soap and water before you catheterize yourself.
- Clean and dry reusable catheters: Clean all reusable catheters with soap and warm water after every use. Sterilize all reusable catheters in a pan of boiling water for 20 minutes. Set the catheters on a clean paper towel to dry.
- Store catheters correctly: Store dry catheters in a clean plastic bag. Throw away torn, hardened, or cracked catheters.
- Wear cotton boxers or underwear: These allow airflow and keep your genital area dry.
- Drink plenty of liquids: Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. This helps to keep you from getting a urinary infection.
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What Are The Potential Risks Or Complications Of Self
Inserting a catheter can raise the risk of introducing infection-causing bacteria into the body, but having an indwelling Foley catheter presents even a higher risk. So if possible, CIC is a better option than an indwelling Foley. With any type of catheter, you have a higher chance of having a:
- Bladder infection, perforation or spasms.
- Signs of urinary tract infection .
- Skin rash or sores at the site of insertion.
A note from Cleveland Clinic
Some people need self-catheterization for a short time. Depending on the cause of the bladder problem, medications or surgery may correct the problem. If you have a chronic problem or a condition that is expected to get worse over time, you may always need to use a catheter to urinate. Everyoneâs situation is different. Talk to your healthcare provider about what you can expect.
Last reviewed by a Cleveland Clinic medical professional on 10/23/2020.