Urethral Catheterization

Male, Female and

Pediatric

unpad
Catheter
from Greek kathetēr, from kathienai to send down

medical : a thin tube that is put into

the body to remove or inject a liquid or
to keep a passage open
CATHETERIZATION..
The process of inserting a catheter
 Catheterisation
Is it a new procedure?
• N0
• 3000BC river reeds and onion stems were
used to drain the bladder
• Gold, tin, lead and silver tubes were then
developed and used
• 1920’s first vulcanised rubber tubes were
produced
Urethral catheter
Catheterization Indication

Diagnostic Therapy
Acute urinary retention

To collect Chronic obstruction

uncontaminated urine causing hydronephrosis
specimen
Intermittent bladder
Study anatomy of the decompression for
urinary tract neurogenic bladder
Chronically bed-ridden
Urine output monitoring patients for hygiene
Instillation of
chemotherapeutic agents
 Contraindications
Absolute
• Priapism
• Suspected complete or partial urethral injury
• Urethral tumour.

Relative
• Recent urethral or bladder surgery
• Uncooperative patients
 Catheter Selection
The size and type of urinary catheter used depends on the
indication for catheter insertion, age of the patient, and type
of fluid expected to be drained
 t h et
Material, number of channel, coating, and tip of

ca
Material
er
Modern urinary catheters are most frequently made of latex, rubber, silicone,
and polyvinylchloride (PVC)

Coating
Various coatings on urethral catheters have been applied in an attempt to
reduce urethral trauma and infection risks

Number of Channels Tip Shape

 What does the Evidence say about
Catheter Materials?
• Antimicrobial catheter materials (versus standard
materials) for short-term catheterization:
– reduce catheter-associated bacteriuria
– unproven for reduction of symptomatic CAUTI
– do not substitute for a comprehensive CAUTI prevention
program.
• No clear benefit among standard materials on CAUTI rates
including:
– latex, hydrogel-coated latex, silicone-coated latex, or all-
silicone catheter
 Important prior knowledge

• Anatomy and physiology of urinary system

• Rationale for procedure
• Necessary equipment
• Competence in performing skill
Male Anatomy
Female Anatomy
Problems with catheter insertion in a male
patient
• Phimosis, meatal stenosis, urethral stone
• The catheter does not pass the prostate
🡪 Try a catheter with a larger diameter
🡪 Try a silicone catheter
🡪 Try a mandrain + catheter

This is potentially even so you better leave this to a urologist. More

hazardous , you really have to be experience with this technique.
 What can go wrong?

• A 'Fausse Route' (again French, meaning 'false

passage'
• The balloon of a Foley catheter is filled while
inside the urethra or prostate.
• Too small .
 Catheter complications
• Catheter Associated Urinary Tract Infection
(CAUTI)
• Catheter blockage (Catheter encrustation)
• Iatrogenic trauma
• Bladder pain
• Haematuria
• Inability to remove catheter
 List to be noted after catheterization
• The time and date of catheterization
procedure
• The type and number of catheter
• The ballon volume
• The initial volume of urine
• The color of urine
 Removing the Catheter
• Try wiggling and turning the catheter while
gently pulling the plunger.
 If the balloon won't empty :

• Try filling the balloon with 1-2 cc's of water to

open up a possibly clogged channel.
• Try to inflate the balloon past its maximum, so
it will burst.

• Try cutting the catheter a few cm from the

urethra to bypass a possible clogged up
channel in the distal end
 If the balloon won't empty :
• Using ultrasound, locate the balloon inside the
bladder and puncture it suprapubically.
Thank YOU