URINARY CATHETER

Question 1

WHAT IS A URINARY CATHETER?

Answer 1

Are hollow tubes used to relieve urinary retention, obtain urine for analysis, irrigate bladder and to instill drugs into bladder

Question 2

WHAT ARE THE YPES OF URINARY CATHETERS?

Answer 2

a. Nonself-retaining catheter: Simple red rubber catheter.
b. Self-retaining catheter: Foley’s catheter, Malecot’s catheter, Gibbon’s catheter, De-Pezzer catheter.

Question 3

DESCRIBE THE TYPES OF CATHETERISATION

Answer 3

a) Indwelling catheterisation: When a catheter is left behind in bladder & remains, so it is called an indwelling catheter
 It is achieved by: Balloon tip of catheter-Foley’s catheter, Flower tip of catheter-Malecot’s catheter, De Pezzers or Straping catheter externally-Gibbon’s catheter.
b) Intermittent catheterization: A sterile catheter is introduced intermittently by pt or by care provider

Question 4

OUTLINE THE INDICATIONS FOR CATHETERISATION

Answer 4

(i) Therapeutic
 Urine retention
 Urine incontinence
(ii) Diagnostic
 Bladder rupture
 Renal failure
(iii)Pre- operative
 For monitoring urine output before operation
(iv)Unconsciousness
(v) Monitoring purposes
 Spinal injury
 Urine output
 Abdominal pressures

Question 5

WHAT ARE THE EARLY COMPLICATIONS OF CATHETERISATION?

Answer 5

(i) Early
 Traumatic injury to urethra
 Bleeding
 By – pass

Question 6

WHAT ARE THE LATE COMPLICATIONS OF CATHETERISATION?

Answer 6

(ii) Late
 Infections- UTI
 Urethral strictures
 Incontinence (urine)
 Paraphimosis
 Blockage of the catheter
i. Length - 38cm -M, 22cm - F
ii. Size 10-25cm French
 Excursion of catheter if suprapubic.
 Stone formation
 Failure of the ballon to deflate, Balloon size - 3-5mls
 Difficulty in removal of the catheter due to blockage of the balloon channel. Here bulb of Foley’s can be punctured either from above under US guidance or injecting ether into the balloon so as to burst it but may cause chemical cystitis or passing a stilette into the channe

Question 7

DESCRIBE FOLEY’S CATHETER

Answer 7

Foley’s catheter (named after Fredrick Eugene Basil Foley - American Urologist)
It is a self-retaining urinary catheter made of latex. It has a balloon near the tip into which distilled water is infused to make it self-retainable. Usually, Foley’s catheter is kept for 7 days. Sterilized by γ-radiation.
 Size: Adults- ≥16 F & Children-8 F or 10 F. (F-French unit, Charriere unit, where each unit =0.33 mm). 16 F means circumference of the catheter is 16 mm. Diameter is one-third of circumference)

Question 8

WHAT ARE THE USES OF FOLEY’S CATHETER?

Answer 8

a. To drain urine in retention of urine of any cause (BPH, stricture, trauma).
b. To measure urine output in renal failure, postoperative pts, and terminally ill pts.
c. Percutaneous cystostomy.
d. Cholecystostomy.
e. To drain fistulas.

Question 9

WHAT ARE THE TYPES OF FOLEY’S CATHETERS?

Answer 9

i. Two-way Foley’s catheter.
ii. Three-way Foley’s catheter - for bladder irrigation, e.g. following TURP.
 Silicone coated Foley’s—to reduce reaction and so as to keep for longer period (3 months)

Question 10

OUTLINE THE PROCEDURE FOR CATHETERIZATION

Answer 10

 Greet the pt, and introduce your self
 Explain procedure and its purpose. Then obtain verbal consent
 Insure privacy and assemble all the equipment
 Wash/sanitise your hands and wear sterile gloves
 Clean with chlorhexidine under strict asepsis,
 To minimize any discomfort, lignocaine gel is introduced in urethra using a syringe for lubrication of urethral meatus and urethra.
 Then pass the catheter is into the urethra with your right hand and while holding the penis with gentle upward pull with the left hand.
 Sometimes Maryfield introducer is used to pass Foley’s catheter where there is resistance.
 Once catheter is in the bladder, urine flows out. It is now connected to a urine bag.
 Balloon is inflated with 20–30 ml (amount is written on the catheter) of distilled water to make it self retainable.
 During removal of the catheter, same amount of water should be removed from the balloon before pulling out the catheter

Question 11

DESCRIBE MALECOT’S CATHETER

Answer 11

 Self-retaining urinary catheter with an umbrella or flower at the tip. It is made of red rubber, contains sulphur and so it is radio-opaque. Ideal for suprapubic use
 It is never introduced per urethrally.
 It is sterilised by boiling

Question 12

WHAT IS THE RED RUBBER CATHETER?

Answer 12

 A non-self-retaining urinary catheter.
 Its tip is blunt & has got only side opening

Question 13

WHAT ARE THE USES OF THE RED RUBBER CATHETER?

Answer 13

 Used to drain urine from the bladder temporarily.
 To find out residual urine. After passing urine, catheter is introduced into the bladder. The amount of retained urine is measured