Catheters Flashcards
when to insert a catheter
for acute retention if bladder volume >500mL (or lower volume if symptomatic)
types of urinary catheters
indwelling (IDC)
suprapubic (SPC)
intermittent self-catheter (IMC)
short term IDCs are used when
for hospital management of acute urinary retention (AUR), bladder irrigations, peri-operative setting
trial of void
individuals with AUR may require an indwelling IDC to remain in situ for several days before attempting trial of void
when specialist referral is needed
multiple failed appropriately times trail of voids
IDC morbidity
prolong hospital stay and add to healthcare costs
complications include infection and traumatic insertion
patients with permanent catheters are at an increased risk of
bladder stones and bladder cancer
requires surveillance
catheter associated UTI
CA-UTI
common nosocomial infection
what are external catheters
devices adhering to the external genitalia, commonly referred to as ‘urodome’ or ‘condom catheters’
advantages of external catheters
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
disadvantages of external catheters
tissue damage to the penile shaft with incorrect placement
inadequate bladder drainage capacity
only male products commercially available
what are intermittent catheters
a straight, hollow PVC tuber inserted via the urethra and removed post void
advantages of intermittent catheters
less impact on mobility, independence and body image
reduced incidence of CA UTI
disadvantages of intermittent catheters
only used in competent patients
increase incidence of urethral trauma with multiple insertions
compared to IDCs, reduced efficacy for treating urinary retention
what are indwelling catheters
double or triple lumen catheter, held in situ via inflation of a balloon with sterile water, commonly referred to as a Foley catheter
advantages of indwelling catheter
able to remain in situ for 1-12 weeks
generally efficient and accepted treatment of urinary retention
disadvantages of indwelling catheter
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
what is a suprapubic catheter
a double lumen catheter enter the bladder through a surgically formed tract through abdominal wall
advantages of the suprapubic catheter
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
disadvantages of suprapubic catheter
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
asymptomatic bacteruria
common in elderly
elderly patients with signs and symptoms of sepsis require antibiotic treatment
when to investigate for bactururia
cloudy or malodorous urine does not require further investigation or treatment unless there are associated symptoms or signs of sepsis
culture results from IDCs
are often unreliable
