Catheters

Question 1

when to insert a catheter

Answer 1

for acute retention if bladder volume >500mL (or lower volume if symptomatic)

Question 2

types of urinary catheters

Answer 2

indwelling (IDC)
suprapubic (SPC)
intermittent self-catheter (IMC)

Question 3

short term IDCs are used when

Answer 3

for hospital management of acute urinary retention (AUR), bladder irrigations, peri-operative setting

Question 4

trial of void

Answer 4

individuals with AUR may require an indwelling IDC to remain in situ for several days before attempting trial of void

Question 5

when specialist referral is needed

Answer 5

multiple failed appropriately times trail of voids

Question 6

IDC morbidity

Answer 6

prolong hospital stay and add to healthcare costs
complications include infection and traumatic insertion

Question 7

patients with permanent catheters are at an increased risk of

Answer 7

bladder stones and bladder cancer
requires surveillance

Question 8

catheter associated UTI

Answer 8

CA-UTI
common nosocomial infection

Question 9

what are external catheters

Answer 9

devices adhering to the external genitalia, commonly referred to as ‘urodome’ or ‘condom catheters’

Question 10

advantages of external catheters

Answer 10

reduced incidence of bacteriuria, UTI, pain, or death compared to IDCs
increased safety and comfort, especially in delirious and demented patients
practical option for incontinent elderly males where IDC not appropriate

Question 11

disadvantages of external catheters

Answer 11

tissue damage to the penile shaft with incorrect placement
inadequate bladder drainage capacity
only male products commercially available

Question 12

what are intermittent catheters

Answer 12

a straight, hollow PVC tuber inserted via the urethra and removed post void

Question 13

advantages of intermittent catheters

Answer 13

less impact on mobility, independence and body image
reduced incidence of CA UTI

Question 14

disadvantages of intermittent catheters

Answer 14

only used in competent patients
increase incidence of urethral trauma with multiple insertions
compared to IDCs, reduced efficacy for treating urinary retention

Question 15

what are indwelling catheters

Answer 15

double or triple lumen catheter, held in situ via inflation of a balloon with sterile water, commonly referred to as a Foley catheter

Question 16

advantages of indwelling catheter

Answer 16

able to remain in situ for 1-12 weeks
generally efficient and accepted treatment of urinary retention

Question 17

disadvantages of indwelling catheter

Answer 17

highest incidence of CA UTI compared to other methods of catheterisation
risk of urethras and bladder neck injury in insertion and removal, due to balloon
self extraction risk in demented and delirious patients

Question 18

what is a suprapubic catheter

Answer 18

a double lumen catheter enter the bladder through a surgically formed tract through abdominal wall

Question 19

advantages of the suprapubic catheter

Answer 19

can remain in place for 2-3 months at a time
ability to use a catheter valve as an alternative to free drainage when urine storage within bladder is acceptable
easier to clean and change
do not cause urethral erosion
maintain sexual function
reduce enteric microorganism contamination

Question 20

disadvantages of suprapubic catheter

Answer 20

contraindications to insertion include coagulopathy and abdominal wall infection
potential risk of abdominal organ injury and peritonism
requires prompt access to a urology service in case of complications
difficult insertion and maintenance in obese individuals
patients may continue to leak urine via urethra

Question 21

asymptomatic bacteruria

Answer 21

common in elderly
elderly patients with signs and symptoms of sepsis require antibiotic treatment

Question 22

when to investigate for bactururia

Answer 22

cloudy or malodorous urine does not require further investigation or treatment unless there are associated symptoms or signs of sepsis

Question 23

culture results from IDCs

Answer 23

are often unreliable