Urethral Catheterization: Males

Question 1

What are the indications for urinary catheterization in males?

Answer 1

1. Acute or chronic urinary retention
2. Urethral or prostatic obstruction
3. Monitoring urine output
4. Collection of sterile urine specimen
5. To act as a traction device for the purpose of hemostasis after prostate surgery

Question 2

What are the contraindications for urinary catheterization in males?

Answer 2

1. Trauma with suspected urethral injury
2. Blood @ meatus in pelvic trauma pt
3. Penile, scrotal, or perineal hematoma
4. Acute prostatitis or urethritis

Question 3

What is a Robinson catheter?

Answer 3

One-time, straight, rubber catheter

Question 4

What is a Foley catheter?

Answer 4

1. Silicone or silicone-coated to resist encrustation when left in the bladder for prolonged periods
2. Latex allergic pts

Question 5

What is a Coude catheter?

Answer 5

1. Bend at the distal tip to follow anterior surface of the male urethra (false passages that may occur on posterior surface of urethra)

Question 6

How is a catheter sized?

Answer 6

1. French scale: 0.33 mm = 1 French

2. 3 Fr = 1 mm (in diameter)

Question 7

What sized catheter is used in children?

Answer 7

5-12 Fr

Question 8

What sized catheter is used in adults?

Answer 8

14 Fr, 16 Fr or 18 Fr

Question 9

What equipment is used for urinary catheterization in males?

Answer 9

1. Foley catheter
2. Lubricant
   A. Water soluble
   B. Local anesthetic
3. 5 ml syringe with sterile water for foley balloon
4. Closed drainage system
5. Sterile drape
6. Sterile gloves
7. Povidone-iodine sol’n
8. Sterile gauze pads
9. Sterile specimen cup
10. Tape
11. Forceps

Question 10

What is the procedure for urinary catheterization?

Answer 10

1. Obtain consent
2. Wash your hands
3. Use sterile technique for procedure
4. Place patient in supine position with legs slightly abducted
5. Make patient aware that he may feel some discomfort/urge to urinate
6. Retract the foreskin
7. Wrap sterile gauze around retracted foreskin at coronal sulcus
8. Cleanse urethral meatus with antiseptic solution
9. Hold penis upright while slowly passing well lubricated catheter
10. Obtain proper cath size, then pass the total length of catheter, slowly inflate balloon with 5 ml water
11. Obvious resistance or patient discomfort signals possible abnormal positioning
    A. If this occurs, deflate balloon and attempt to pass catheter again
12. After placement of catheter & balloon inflation, slowly withdraw catheter until balloon is resting against bladder neck
13. Connect catheter to sterile leg bag or closed system bedside drainage bag
14. Tape catheter to thigh or place it under knee to drain into bedside drainage bag
15. Replace foreskin if uncircumcised pt!

Question 11

What complications can arise from urinary catheterization?

Answer 11

1. Urinary tract inflammation or infection
2. Transient hematuria
3. Urinary structural trauma
   A. Bladder perforation
4. Urethral stricture
5. Recurring bladder spasms
6. Periurethral abscess
7. Patient-caused trauma
   A. Confused pt