Urethral Catheterization: Females

Question 1

What are the indications for urinary catheterization in females?

Answer 1

1. Acute or chronic urinary retention
2. Monitoring urine output
3. Collection of sterile urine specimen
4. Diagnostic studies of lower urinary tract

Question 2

What are the contraindications for urinary catheterization in females?

Answer 2

1. Known urinary tract obstruction (urethral stricture)
2. Recent reconstructive surgery of urethra or bladder neck
3. Known or suspected urethral disruption due to pelvic trauma

Question 3

What equipment is needed for urinary catheterization in females?

Answer 3

1. Foley catheter
2. Lubricant
   A. Water soluble or local anesthetic
3. 5 ml syringe of sterile water for foley balloon
4. Closed urinary drainage system
5. Sterile drapes
6. Sterile gloves
7. Providone- iodine
8. Sterile gauze
9. Sterile specimen cup
10. Tape
11. Forceps

Question 4

What is the procedure for urinary catheterization in females?

Answer 4

1. Place patient in lithotomy position with legs abducted
2. Use sterile technique
3. Isolate genitalia with sterile drape
4. Cleanse the exposed meatus and surrounding tissues with iodine soaked gauze
5. Pass an appropriately sized catheter (10 Fr small children, 14-16 Fr in adults) that has been well lubricated
6. Slowly direct catheter into urethra and upward towards the bladder
   A. A catheter that inadvertently enters vagina should be discarded
7. Pass catheter approx 3 inches into bladder
   A. Obvious resistance or patient discomfort signals potential abnormal placement
8. Once urine is obtained, slowly inflate balloon with 5-10ml sterile water (balloon size 5 ml)
9. If you suspect abnormal placement, deflate the balloon immediately and reposition the catheter
10. When catheter properly placed, re-inflate balloon
11. Slowly withdraw catheter until the balloon is resting against the bladder neck
12. Connect the catheter to thigh with adhesive tape or simply place it under knee to drain dependently into bedside drainage bag

Question 5

What complications can arise from urinary catheterization in females?

Answer 5

1. Urinary tract infection
2. Urethral stricture
3. Transient hematuria
4. Recurring bladder spasm
5. Bladder perforation
6. Periurethral abscess
7. False passages rarely created from cath in females, compared to males
8. Rarely are urethral strictures caused by traumatic catheterization in females