Catheterisation

Question 1

Name some clinical indications for catheterisation

Answer 1

Urinary retention
critically unwell e.g. sepsis
monitoring fluid balance post op
empty bladder prior to labour or surgery
to instil fluid e.g. irrigation, cytotoxic drugs or contrast medium
to perform urodynamic bladder function tests
comfort purposes in EOL patients

Question 2

What size of catheter should be used?

Answer 2

Size 12 = clear urine
Size 12 – 14 = cloudy / infection
Size 16 + = haematuria / clots / debris
Plastic / PVC – 7 days
PTFE – 28 days
Silicone – 12 weeks - latex allergy
Hydrogel – 12 weeks 
Standard length catheters (43 cm) for males and females 
unless gynaecology ward or going home from hospital

Question 3

Explain female anatomy relevant to catheterisation

Answer 3

meatus – external urethral orifice – internal urethral orifice - bladder

Female urethra is approx 3-5cms in length

Question 4

Explain male anatomy relevant to catheterisation

Answer 4

Meatus – cavernous urethra – membranous urethra – prostatic urethra – bladder

male urethra = approximately 18-20cms in length.

Question 5

Explain 3 contraindications to catheterisation

Answer 5

urethral stricture,

meatal stenosis,

Urethral/Pelvic trauma.
Patients receiving anticoagulant therapy

Women:
possible scarring/damage from female genital mutilation (reportable to safeguarding),

previous traumatic catheterisation

Men:
enlarged prostate

Recent TURP <12 wks (risk of creating false passage)

Recent radical prostatectomy surgery <6mos (risk of damage to anastomosis)

Question 6

Talk through how you would gain consent for catheterisation

Answer 6

Introduce self
identify patient

Ask about medications (anticoags/anti-arrhythmics)

check for allergies + CIs

Explain procedure incl risks plus benefits

encourage pt to ask questions