Male Urinary Catheterisation Flashcards
Indications for male urinary catheterisation
Strict monitoring of urine output -last resort measure, try penile sheath/commode pans/bottles Acute urinary retention Chronic obstruction If patient is unable to move Bladder irrigation for visible hematuria Investigations (micturating cystourethrography) Last resort for urinary incontinence
Contraindications for urinary catheterisation
Suspected urethral injury (after pelvic trauma)
Past history of urethral structure/fistulae
Severe phimosis
Complications
Paraphimosis - if unable to reposition foreskin Pain Urethral bleeding UTI Urethral stricture
Preparation beforehand
-equipment needed
Catheterisation pack -drapes -tray -sterile gauze -foreceps -yellow waste bag -sterile gloves 14-16 Foley catheter for men => EXP DATE
Catheter bag Kidney dish - catch first drops of urine before attaching bag Sterile gloves 2 x 10ml syringe Lidocaine gel 2% Sterile water
Preparation - patient
Introduce yourself
Patient ID check
Explain procedure, consent
-may be slightly uncomfortable but will be using local gel anaesthetic
Ask patient to lie flat with straight legs slightly apart
Ask chaperone to be present
Wash hands with alcogol
Preparation of sterile field
Set up sterile field on cleaned trolley
Put on sterile gloves
Draw up 10ml sterile water into syringe
Draw up 10ml 2% lidocaine gel into syringe
Cleaning of penis
Fenestrated sterile drape on patient with penis protruding through hole
Place kidney dish under penis
Hold penis with sterile swab with nondom hand
Retract foreskin with dominant hand
Wipe around meatus with saline soaked swabs towards the body
Preparation of penis for insertion
Leave a small amount of lignocaine gel on sterile field to later coat the end of the catheter
Inject 10ml lignocaine gel into urethra with syringe
-warn patient that it may sting and feel cold
Gently hold and press penile urethra to prevent oozing out of gel
Leave for 2-5mins to allow anaesthetic to work
Insertion of catheter into penis
Remove gloves, clean hands with alcogel Put on new pair of sterile gloves Remove catheter tip from bag, hold catheter by sleeve in dominant hand Dip catheter tip in lignocaine gel Hold penis vertically Gently insert catheter into urethra When resistance felt, hold penis down Ensure that any urine draining out of catheter drains into the kidney dish
Once stream of urine flows out, advance 6-8cm
Inflate balloon with 10ml of sterile water
Check that the patient isn’t in pain
Gently pull catheter until resistance felt
Post insertion
Attach catheter end to collection bag
Reposition foreskin to prevent paraphimosis
Discard waste
Thank patient Document procedure -volume of urine in bag -type of bag used -volume of water used to inflate balloon (info found on catheter packaging sticker)
