Appendix 6

Procedure Guidelines - Male Catheterisation

Equipment

1. Sterile pack for catheterisation 6. 11mls antiseptic lubricant gel

containing lignocaine 2%
2. Sterile gloves
7. Syringe and sterile water for non-
3. Disposable plastic apron
filled catheters
4. 0.9% normal saline for cleansing
8. Drainage bag
fluid
9. Alcohol hand rub
5. Selected catheter type and size
appropriate for individual 10. Drainage bag and stand or holder
NB must be standard length for
males 40 -44 cm

Considerations prior to catheterisation

Check for allergies including latex and local

anaesthetic

Cultural and religious beliefs need to be

considered before performing the
catheterisation

Procedure
Rationale
Action
To ensure that the patient understands the
1. Explain procedure to patient and gain procedure and gives his valid consent
consent

2. Place protective cover onto bed To protect bed linen

3.
a) Screen the bed if patient in shared area
or To ensure patients’ privacy
(b) Ensure do not disturb sign on bedroom
door

4. Position the patient in bed, in supine To enable appropriate positioning for

position with legs extended. catheterisation to take place.

Do not uncover patient at this stage. Maintain patient dignity whilst preparing
oneself for procedure

Northumberland, Tyne and Wear NHS Foundation Trust 1

Appendix 6 – Male Catheterisation – V02 – Issue 1 – May 14
Part of AMPH-PGN-04 – Urethral Catheterisation (NTW(C)29 - Trust Std for Physical Assessment & Examination)
3. Wash hands using soap and water or To reduce risk of infection
bactericidal alcohol hand rub.

4. Put on a disposable plastic apron. To reduce risk of cross-infection from

micro-organisms on uniform

5. Prepare the clean trolley, placing all The top shelf acts as a clean working
equipment required on the bottom shelf. surface

6. Take the trolley to the patient’s bedside, To allow dust and airborne organisms to
disturbing screens as little as possible. settle before the field is exposed

7. Remove cover that is maintaining the To allow procedure to take place

patient’s privacy

8. Clean hands with anti bacterial alcohol To reduce risk of cross-infection

hand rub.

9. Put on sterile gloves. To reduce risk of cross-infection

10. Open the outer cover of the

catheterisation pack and slide contents
onto the clean and dry top shelf of the
trolley

11. Using a sterile technique open up the To reduce risk of cross-infection

pack to create a sterile field and open
supplementary equipment, place
contents onto sterile field.

12. Hold the penis with a sterile swab. To allow procedure to take place

13. In non-circumcised patients, retract the

foreskin slightly to enlarge the glans
penis to be cleansed and the urethral To prevent injury
opening to be visible. NB Do not fully
retract a tight foreskin

14. Clean the glans penis with 0.9% To reduce risk of cross-infection
sodium chloride

Northumberland, Tyne and Wear NHS Foundation Trust 2

Appendix 6 – Male Catheterisation – V02 – Issue 1 – May 14
Part of AMPH-PGN-04 – Urethral Catheterisation (NTW(C)29 - Trust Std for Physical Assessment & Examination)
15. Break the seal on the local anaesthetic To minimise discomfort
gel according to the manufacturer’s
instructions
 Gently insert the nozzle of the local
anaesthetic gel into the urethral. Instill
the gel into the urethral until no more
can be inserted
 Gently remove the nozzle after
instillation. Massage the gel along the
urethra. Discard the tube
 Squeeze the penis and wait
approximately 5 minutes
 Grasp the penis behind the glans,
raising it until it is almost totally
extended. Maintain grasp of penis until
procedure is complete
 When the anesthetic gel has taken
effect, wipe away any excess gel,
dispose of gloves, wash and dry hands,
then put on a new pair of sterile gloves

16. Place sterile drape across patients To reduce risk of cross-infection

thighs, exposing penis

17. Place collecting bowl on the pad under To prevent spillage

penis to collect urine

18. The catheter tip only should be To ensure a no-touch technique.

exposed from the inner bag and this
will be withdrawn gradually as the
catheter is inserted
Continue slowly and smoothly to pass
the catheter through the urethra and
into the bladder
To aid catheter insertion.
If resistance is felt at the external
sphincter, change position of penis,
increase the traction on the penis
slightly and apply steady, gentle
pressure on the catheter. Ask the
patient to cough or to strain gently as if
passing urine
 If at any further stage there is difficulty
passing the catheter, or the patient
complains of undue pain, stop and seek
medical help

Northumberland, Tyne and Wear NHS Foundation Trust 3

Appendix 6 – Male Catheterisation – V02 – Issue 1 – May 14
Part of AMPH-PGN-04 – Urethral Catheterisation (NTW(C)29 - Trust Std for Physical Assessment & Examination)
19. Insert the catheter for 15 – 25 cms until To ensure correct position of catheter and
urine flows. The male urethra is prevent urethral damage.
approximately 18cms long
Catheter may only be required to obtain a
 Either remove the catheter when urine residual urine measurement.
flow stops (and record residual urine
amount) or when urine begins to flow, To ensure correct positioning if catheter to
advance the catheter to its bifurcation. be left in situ
Giving assurance that the catheter is in
Balloon must not be inflated until urine the bladder.
flows.
 Slowly inflate the balloon with 10ml To secure the catheter if being left in situ.
sterile water, according to manufacturer’s
instructions. For pre-filled balloons,
remove clip and gently squeeze reservoir
of sterile water. Balloon inflation should
be pain-free. If the patient is
experiencing any pain or discomfort
during the pain inflation, the balloon may
be positioned in the urethra. Deflate the
balloon and advance the catheter a few
more centimeters before trying again.
 NB Patients with spinal damage may
have reduced, or no sensation, and
pain would not be an indicator for
balloon inflation, low arousal patients
may show little or no sign of
discomfort, extreme caution should
be used

20. Withdraw the catheter slightly and To ensure balloon in situ and catheter is
attach the catheter to a previously secure
selected appropriate drainage
system. Ensure that the glans penis
is clean, and reposition the foreskin.
Wash hands

21. Support the catheter, if the patient To prevent pulling

desires, by using a specially designed
support, e.g. Simpla G-strap. Ensure
that the catheter does not become
taut when the patient is mobilising.
Ensure that the lumen is not occluded
by the fixation device

22. Ensure that the area is clean and dry.

23. Make the patient comfortable.

24. Take urine specimen if necessary.

Northumberland, Tyne and Wear NHS Foundation Trust 4

Appendix 6 – Male Catheterisation – V02 – Issue 1 – May 14
Part of AMPH-PGN-04 – Urethral Catheterisation (NTW(C)29 - Trust Std for Physical Assessment & Examination)
25. Dispose of equipment in an orange To prevent environmental contamination.
plastic clinical waste bag and seal the Orange is the recognised colour for clinical
bag before moving the trolley. waste (DH 2005b: C)

26. Wash hands again

27. Document procedure appropriately; To provide a point of reference or

Record amount of urine drained comparison in the event of later queries
(NMC 2005b: C)

Northumberland, Tyne and Wear NHS Foundation Trust 5

Appendix 6 – Male Catheterisation – V02 – Issue 1 – May 14
Part of AMPH-PGN-04 – Urethral Catheterisation (NTW(C)29 - Trust Std for Physical Assessment & Examination)