Female Urinary Catheterisation

Question 1

Indications

Answer 1

Strict monitoring of urine output
Acute urinary retention
Chronic obstruction
Neurogenic bladder - iatrogenic causes like epidural use in childbirth
Patient is unable to move, get to the bathroom on time without SOBOE
Bladder irrigation for frank hematuria
Investigations - micturating cystourethrography
Chemotherapy directly into the bladder
Last resort for urinary incontinence

Question 2

Contraindications

Answer 2

Suspected urethral injury after pelvic trauma

Past history of urethral strictures/fistulae

Question 3

Complications

Answer 3

Pain
Urethral bleeding
UTI
Urethral strictures

Question 4

Preparing your equipment

Answer 4

Clean trolley

Catheterisation pack

• drapes
• sterile water pot
• sterile gauze
• foreceps for cleaning
• yellow sterile waste bag
• sterile gloves

12-14 Foley catheter for female catheterisation

Catheter bag
Kidney dish
Sterile gloves
2 x10ml syringe
2% lignocaine gel
Sterile water

Question 5

Preparation - patients

Answer 5

Introduce yourself
ID DOB
Explain procedure, obtain consent
-there may be some discomfort but we will use local gel anaesthetic

Ask patient to lie frog legged
Introduce chaperone

Question 6

Preparation of equipment

Answer 6

Open catheter pack aseptically onto clean trolley
Pour saline solution into container provided

Draw up 10ml sterile water into a syringe
Draw up 10ml of 2% lignocaine gel into syringe

Question 7

Cleaning of external genitalia

Answer 7

Wash and dry hands
Put on sterile gloves
Place sterile sheet under patient’s bottom
Place kidney dish in front of ext genitalia
Hold labia apart with sterile swabs with nondom hand
Clean urethral meatus with saline soaked swabs with dominant hand towards perineum

Question 8

Preparation of catheter insertion

Answer 8

Release small amount of lignocaine into sterile field
Inject lignocaine gel into urethra with syringe
-warn patient that it may sting and feel cold
Leave it for 2-5mins to allow gel to work

Remove gloves, clean hands with alcogel
Put on new pair of sterile gloves

Remove catheter tip from bag
Hold catheter by sleeve with dominant hand

Question 9

Insertion of urinary catheter

Answer 9

Gently and progressively insert into urethra
Once stream of urine flows out, advance 6-8cm
Inflate balloon with 10ml sterile water
-ask patient for any pain
Gently retract catheter until you feel resistance

Question 10

Post insertion

Answer 10

Attach catheter end to collection bag
Discard rubbish
Thank patient
Document procudure in patient notes
-volume of urine in catheter bag
-type of bag
-size of catheter
-volume of water used to inflate balloon - info found on catheter packaging sticker