Male Catheter

Question 1

What are the indications for catheterisation?

Answer 1

Monitor urine output
Retention
Patients who have low GCS/anesthetised
To administer intravesicle drugs
Incontinence
Urological investigations

Question 2

What are the contraindications to catheterisation?

Answer 2

Patient refusal
Allergy to catheter
Urethral stricture
do not catheterise in notes
Urethral injury e.g. trauma
Surface burns

Question 3

What is in intillergel and what volume is it?

Answer 3

It is 11 mls

contains anesthetic, antibacterial and lubricant

Question 4

What equipment do you need for a catheter?

Answer 4

Catheter pack - sterile gloves, kidney bowl, cotton balls, sterile towel
Foley catheter
Saline
11mL 1% lidocaine instillergel
Water for baloon inflation 10mls
Gauze
Catheter bag

Question 5

How long is a male catheter?

Answer 5

40cm

Question 6

What size diameter catheter should be used?

Answer 6

Smallest possible to reduce uretheral trauma

Measured in Charriere and diameter determines what fluid can be drained

Question 7

How long can mid term catheters stay in?

Answer 7

4 weeks

Question 8

How long can long term catheters stay in?

Answer 8

12 weeks

Question 9

What is the procedure of catheter insertion?

Answer 9

• Consent + chaperone.
• CHECKS: patient identity (3 ways), and check this against wrist band..
o Allergies?
o Clean? Check that patient has had a wash with soap and water prior to insertion to remove any debris prior to catheterisation.
o Healthy? Assess genitalia for swelling, trauma, blood, foreskin or any signs of infection. Trouble inserting a catheter before?
• POSITION: patient in a supine position, and ensure comfort.
• PREP BENCH AND EQUIPMENT:
o Clean tray and stool. Put on a pair of non-sterile gloves. Don apron. Expose patient.
o Get equipment and place on the tray, open tray, don sterile gloves. Pour cleaning fluid into galipot after washing with alcohol wipe, prep your tray.
o Put on a pair of sterile gloves.
• CLEAN PENIS:
o Hold penis using gauze, retract foreskin and wash with 0.9% NaCl. Wipe away from the meatus. Use a single wipe per gauze ball.
o Protect cleansed area with new gauze (i.e. remove first gauze and put another one there), and put sheet over patient’s penis.
• INSTAGEL PENIS:
o Remove gloves, don new gloves, connect catheter bag to catheter, and drape penis, and prep instagel.
o Administer instagel. Hold behind glans for 1.5 minutes. Allow 5 minutes to fully anaesthetise.
• CATHETERISE PENIS:
o Insert the catheter.
o Observe for urinary flow.
o Inflate balloon with 10mLs sterile water.
o Replace foreskin if uncircumcised.
• FINISH UP:
o Remove all equipment and dispose.
o Attach catheter bag to stand.
o Secure catheter band to G strap.
o Wash hands.
o Document!
 Review patient post insertion.
 Educate on catheter care.

Question 10

WHat education must you give the patient about the catheter?

Answer 10

Importance of good hygiene
Do not pull catheter and keep below bladder
Tell nurse if get signs of infection e.g. pain, redness, swelling, exudate
How to prevent paraphimosis

Question 11

How do you remove the catheter?

Answer 11

Use non sterile gloves
deflate baloon
Get patient to breathe out as remove to relax pelvic floor muscles