What is a Foley catheter. How to insert a male Foley catheter. What supplies are needed for catheter insertion. How to maintain proper hygiene during catheterization. What are common issues with catheters. How often should a catheter be changed. What to do if complications arise during insertion.

Understanding Foley Catheters: Purpose and Function

A Foley catheter, also known as an indwelling catheter, is a crucial medical device used for continuous bladder drainage in both male and female patients. This flexible tube is inserted through the urethra into the bladder, allowing urine to flow out continuously. But what exactly makes a Foley catheter unique?

The key feature of a Foley catheter is its small balloon at the tip, which is inflated with sterile water once the catheter is properly positioned in the bladder. This balloon serves two important purposes:

• It anchors the catheter in place, preventing accidental removal
• It ensures a secure seal at the bladder neck, minimizing the risk of urine leakage around the catheter

Foley catheters are typically used in situations where a patient is unable to empty their bladder naturally, such as:

• After certain surgical procedures
• In cases of urinary retention
• For patients with neurological conditions affecting bladder control
• To accurately measure urine output in critically ill patients

While Foley catheters can be a lifesaving intervention, it’s important to note that they should only be used when medically necessary and for the shortest duration possible to minimize the risk of urinary tract infections and other complications.

Essential Supplies for Male Foley Catheter Insertion

Proper preparation is crucial for a successful and hygienic catheter insertion. Here’s a comprehensive list of supplies you’ll need:

1. Indwelling Foley Catheter Tray (typically containing a 16 Fr catheter with a 10 cc balloon for adults)
2. Sterile gloves
3. Antiseptic solution (e.g., Betadine)
4. Cotton balls or swabs
5. Lubricating jelly
6. Sterile water-filled syringe for balloon inflation
7. Empty syringe for balloon deflation (if removing an existing catheter)
8. Drainage bag
9. Soapy washcloth and wet washcloth for cleaning
10. Paper pad to place under the patient
11. Leg strap for catheter securement

By ensuring you have all these supplies ready before beginning the procedure, you can maintain a sterile environment and reduce the risk of complications.

Step-by-Step Guide to Male Foley Catheter Insertion

Inserting a Foley catheter requires careful attention to hygiene and technique. Follow these steps for a safe and effective procedure:

1. Preparation

Begin by thoroughly washing your hands with soap and water. Arrange all supplies within easy reach. Position the patient lying flat on their back with legs extended.

2. Removal of Existing Catheter (if applicable)

If there’s an existing catheter, deflate its balloon by attaching an empty syringe to the inflation port and withdrawing all the water. Gently remove the catheter once the balloon is fully deflated.

3. Cleansing

Clean the penis thoroughly with a soapy washcloth, followed by rinsing with a wet washcloth. Dry the area completely. Wash your hands again after this step.

4. Setting Up the Sterile Field

Open the catheter tray carefully, maintaining sterility. Pour the antiseptic solution over the cotton balls. Remove the plastic cover from the catheter without touching the tube itself. Apply lubricating jelly to the catheter. Connect the drainage bag to the catheter.

5. Maintaining Sterility

Designate one hand as “clean” (for handling sterile supplies) and one as “dirty” (for touching the patient’s body). Never allow these roles to mix during the procedure.

6. Cleansing the Urethral Opening

Hold the penis with your “dirty” hand. Use your “clean” hand to cleanse the urethral opening with antiseptic-soaked cotton balls, always wiping from the tip towards the shaft. Use a new cotton ball for each wipe.

7. Catheter Insertion

Slowly and gently insert the lubricated catheter into the urethral opening. Continue insertion until urine begins to flow and the catheter’s Y-junction is close to the penis tip.

8. Balloon Inflation

Once urine flow is observed, inflate the balloon using the pre-filled syringe. Inject all the sterile water into the inflation port.

9. Finalizing the Procedure

Clean off any remaining antiseptic solution from the penis. Secure the catheter with a leg strap if desired. Ensure the drainage bag is positioned below the level of the bladder to promote proper drainage.

By following these steps meticulously, you can minimize the risk of infection and ensure proper catheter placement.

Maintaining Catheter Hygiene and Preventing Complications

Proper care of an indwelling catheter is crucial for preventing infections and ensuring patient comfort. Here are some essential tips for catheter maintenance:

• Clean the urethral opening and surrounding area at least twice daily with mild soap and water
• Always keep the drainage bag below the level of the bladder to prevent urine backflow
• Empty the drainage bag regularly, at least every 8 hours or when it’s 2/3 full
• Avoid kinking or twisting the catheter tubing
• Maintain good hand hygiene before and after handling the catheter or drainage system
• Stay well-hydrated to promote regular urine flow and prevent blockages
• Watch for signs of infection such as fever, cloudy or bloody urine, or pain around the catheter insertion site

Is it necessary to use antiseptic solutions for daily cleaning? While antiseptic solutions are crucial during insertion, daily cleaning can typically be done with mild soap and water. Using harsh antiseptics regularly may irritate the skin and disrupt the natural bacterial balance.

Troubleshooting Common Catheter Issues

Even with proper care, catheter-related problems can occur. Here’s how to address some common issues:

Catheter Blockage

If urine flow stops or becomes very slow, the catheter may be blocked. Ensure the tubing isn’t kinked and try gently flushing the catheter with sterile saline if instructed by a healthcare provider. If this doesn’t resolve the issue, the catheter may need to be replaced.

Leakage Around the Catheter

Small amounts of leakage can be normal, especially during bowel movements or with bladder spasms. However, persistent leakage may indicate that the catheter is too small or positioned incorrectly. Consult a healthcare provider if this occurs.

Catheter Dislodgement

If the catheter comes out partially or completely, do not attempt to reinsert it. Cover the urethral opening with a clean cloth and seek medical attention promptly.

Pain or Discomfort

Some initial discomfort is normal, but persistent pain, especially during urination, could indicate an infection or improper catheter placement. Report any ongoing pain to your healthcare provider.

By being aware of these potential issues and knowing how to respond, you can help ensure the catheter functions properly and minimize discomfort for the patient.

Catheter Replacement Schedule and Considerations

Understanding when and how to replace a Foley catheter is crucial for maintaining urinary health and preventing complications. But how often should a catheter be changed?

The general guideline is to replace indwelling catheters every 2-4 weeks, but this can vary based on individual circumstances. Some factors that influence replacement frequency include:

• The patient’s overall health and immune status
• The reason for catheterization
• The type of catheter material used
• The presence of any urinary tract infections or other complications

Always follow your healthcare provider’s specific instructions regarding catheter replacement schedules. They may recommend more frequent changes if there are recurring infections or other issues.

Are there signs that a catheter needs to be changed sooner than scheduled? Yes, watch for these indicators:

• Blockage or decreased urine output
• Persistent leakage around the catheter
• Signs of infection (fever, cloudy or foul-smelling urine, pain)
• Visible damage to the catheter
• Buildup of sediment or debris in the catheter

If any of these issues occur, contact your healthcare provider promptly. They may recommend an earlier catheter change or other interventions to address the problem.

Special Considerations for Long-Term Catheter Users

While Foley catheters are often used for short-term purposes, some individuals require long-term or even lifelong catheterization. These patients face unique challenges and considerations:

Infection Prevention

Long-term catheter users are at higher risk for urinary tract infections. Strict adherence to hygiene protocols and regular monitoring for signs of infection are crucial. Some patients may benefit from periodic use of antibiotic-coated catheters or bladder irrigation with antiseptic solutions, as prescribed by their healthcare provider.

Bladder Health

Continuous drainage can lead to bladder shrinkage over time. To maintain bladder capacity, some patients may be advised to do periodic catheter clamping, allowing the bladder to fill partially before draining. This should only be done under medical supervision.

Psychosocial Impact

Living with a long-term catheter can affect self-image and quality of life. It’s important to address these concerns and explore strategies for maintaining an active lifestyle. Support groups and counseling can be beneficial for many patients.

Alternative Catheterization Methods

For some long-term users, intermittent catheterization or suprapubic catheters may be preferable alternatives to indwelling urethral catheters. Discuss these options with your healthcare provider to determine the best approach for your situation.

Nutrition and Hydration

Proper nutrition and adequate hydration play a crucial role in maintaining urinary health for catheter users. A diet rich in vitamin C can help acidify the urine, potentially reducing the risk of certain types of urinary tract infections. Staying well-hydrated helps flush the bladder and prevents the formation of sediment that could block the catheter.

By addressing these special considerations, long-term catheter users can maintain better health outcomes and quality of life. Regular follow-ups with healthcare providers and staying informed about the latest catheter care techniques are essential for managing long-term catheterization effectively.

Advancements in Catheter Technology and Future Prospects

The field of urinary catheterization is continuously evolving, with new technologies and materials being developed to improve patient comfort and reduce complications. Some recent advancements include:

Antimicrobial Catheters

These catheters are coated with substances that inhibit bacterial growth, potentially reducing the risk of catheter-associated urinary tract infections (CAUTIs). While promising, it’s important to note that they don’t eliminate the need for proper catheter care and hygiene practices.

Hydrogel-Coated Catheters

Catheters coated with hydrogel materials become extremely slippery when exposed to water, making insertion easier and potentially reducing urethral trauma. These coatings may also help prevent bacterial adherence to the catheter surface.

Silver Alloy-Coated Catheters

Silver has natural antimicrobial properties. Catheters coated with silver alloy have shown some promise in reducing bacterial colonization, although more research is needed to fully establish their long-term efficacy.

Smart Catheters

Researchers are developing catheters with built-in sensors that can detect early signs of infection or blockage. These “smart” catheters could potentially alert healthcare providers to problems before they become serious.

Biodegradable Catheters

Still in the experimental stage, biodegradable catheters could potentially eliminate the need for catheter removal procedures, reducing the risk of trauma and infection associated with these procedures.

What does the future hold for catheter technology? While it’s difficult to predict with certainty, some areas of ongoing research include:

• Development of materials that more closely mimic natural tissue properties
• Integration of drug-delivery systems into catheter designs for localized treatment of infections or other conditions
• Improvement of drainage systems to reduce the risk of reflux and contamination
• Exploration of alternatives to traditional catheterization, such as external collection devices or minimally invasive surgical techniques

As these technologies continue to develop, it’s important for healthcare providers and patients to stay informed about new options that may improve catheter care and patient outcomes. However, it’s equally crucial to remember that even the most advanced technology cannot replace proper catheter insertion techniques, meticulous hygiene practices, and regular monitoring for complications.

In conclusion, while Foley catheter insertion and management can seem daunting, understanding the process, maintaining proper hygiene, and staying informed about advancements in catheter technology can significantly improve patient comfort and reduce the risk of complications. Always consult with healthcare professionals for personalized advice and follow their instructions carefully to ensure the best possible outcomes in urinary catheter care.

Male Foley Catheter – My Shepherd Connection

An indwelling catheter is also called a foley catheter or “Foley.” It can be used in males or females. A Foley is usually left in the bladder and drains the bladder continuously.

Foley Catheter: Step by Step Process

1. Gather the Supplies

• Indwelling Foley Catheter Tray with a 10 cc balloon (size 16fr is a common size used for adults.) The tray comes with all the needed supplies
• Syringe to deflate the balloon of the existing catheter (if there is one already in the bladder)
• Soapy wash cloth and wet wash cloth

2. Wash hands with soap and water

3. Prepare all needed supplies

4. Lie flat on back with legs flat

5. If there is already a catheter in place, remove it by deflating the balloon.

• Attach the syringe to the end of the “Y” pigtail (side port).
• Withdraw the plunger of the syringe. This will deflate the balloon on the catheter inside the bladder.
• You will know it is completely deflated when you are unable to pull anymore water into the syringe.

6. Gently pull the catheter out from the bladder. 

 7. Wash penis

Wash with the soapy cloth and rinse with the wet cloth. Dry well.

8. Wash hands again.

9. Open the Indwelling Catheter Tray carefully. Set up the supplies.

• Place paper pad under hips.
• Put on the gloves if this is not a self catheterization.
• Pour the Betadine onto the cotton balls
• Remove the plastic cover from the catheter (be careful not to touch the catheter tube) & squirt the lubricating jelly onto the catheter.
• Remove the rubber cap from the syringe with the water in it.
• Connect the end of the catheter to the drainage bag

10. Choose your “clean” and “dirty” hand.

Whatever hand comes in contact with the body, the one that holds the penis, is dirty. The one that touches the catheter supplies is clean. Never mix clean and dirty hands in regard to the catheter supplies. It is important that this procedure stay “super clean” so as not to allow germs to enter the bladder.

11. Hold the penis.

Remember, the hand touching the body will now be the dirty hand.

12. Clean urinary opening on penis

• Use clean hand to touch items in the kit
• Clean penis with the cotton balls soaked in Betadine.
• Use 1 cotton ball per wipe.
• Always wipe from the tip of the penis toward the shaft of the penis.
• Never re-use a cotton ball.

13. Insert the catheter slowly and gently into the urinary opening on the penis. 

14. See the urine flow into the catheter

Continue to insert the catheter until the “Y” pigtail section of the catheter becomes very close to the end of the penis.

15. Blow up the balloon

While holding the catheter in place, attach the pre-filled syringe in the kit to the “Y” pigtail port and insert all of the water from the syringe. 

If it is easier, you can attach the syringe before you insert the catheter so it is ready when you need it. Do not blow up the balloon until the catheter is in and you see urine flowing.

Below is a picture of a catheter with an inflated balloon…this is what it would look like inside the bladder

16. Wash off the extra Betadine from the penis.

17. Always hang/attach the drainage bag to chair/bed frame below the level of the penis.

This will allow for the best drainage.

18. Consider wearing a leg strap.

The leg strap attaches the catheter to the inner thigh. It helps to keep the catheter secure.

19. If wearing a leg bag, always wear it below the knee.

Real Questions from Real People

1. How often does the catheter need to be changed?

Catheters can stay in for about a month as long as it is not leaking or having crusty areas around it near the urethral opening. You should wash the urinary opening at least twice a day while the catheter is in place. Change the catheter by the schedule given to you by your doctor.

2. Should I save anything from the catheter kit incase problems arise with the catheter?

Yes. Save the syringe so you can deflate the balloon when the catheter needs to be removed.

3. What if touch the catheter with my dirty hand or I drop the catheter on the floor before I have it safely inserted?

Stop and get another catheter or kit. It is important that germs do not enter the bladder during this procedure.

4. What if I have spasms while the catheter is being inserted?

Stop and wait for the spasm to pass; then continue with the insertion.

5. What if the catheter will not go in easily or I feel like I meet resistance when inserting it?

Do not force the catheter in. Call the doctor for further advice.

How To Do Urethral Catheterization in a Male – Genitourinary Disorders

By

Paul H. Chung

, MD, Sidney Kimmel Medical College, Thomas Jefferson University

Reviewed/Revised May 2023

View Patient Education

Topic Resources

Urethral catheterization is the standard method of accessing the urinary bladder. A flexible catheter is passed retrograde through the urethra into the bladder. Several types of catheters are available. Sometimes the urethra is impassable, requiring suprapubic catheterization of the bladder.

(See also Bladder Catheterization Bladder Catheterization Bladder catheterization is used to do the following: Obtain urine for examination Measure residual urine volume Relieve urinary retention or incontinence Deliver radiopaque contrast agents or. .. read more .)

• Relief of acute or chronic urinary retention, such as due to urethral or prostatic obstruction (obstructive uropathy Obstructive Uropathy Obstructive uropathy is structural or functional hindrance of normal urine flow, sometimes leading to renal dysfunction (obstructive nephropathy). Symptoms, less likely in chronic obstruction… read more ) or neurogenic bladder Neurogenic Bladder Neurogenic bladder is bladder dysfunction (flaccid or spastic) caused by neurologic damage. Symptoms can include overflow incontinence, frequency, urgency, urge incontinence, and retention…. read more

• Treatment of urinary incontinence

• Monitoring of urine output

• Measurement of postvoid residual urine volume

• Collection of sterile urine for culture (usually for infants and women only)

• Diagnostic studies of the lower genitourinary tract Genitourinary Imaging Tests Imaging tests are often used to evaluate patients with renal and urologic disorders. Abdominal x-rays without radiopaque contrast agents may be done to check for positioning of ureteral stents… read more

• Bladder irrigation or instillation of medication

Absolute contraindications

Relative contraindications

• History of urethral strictures Urethral Stricture Urethral stricture is scarring that obstructs the anterior urethral lumen. Urethral stricture can be Congenital Acquired Anything that damages the urethral epithelium or corpus spongiosum can… read more

• Current urinary tract infection Introduction to Urinary Tract Infections (UTIs) Urinary tract infections (UTIs) can be divided into upper tract infections, which involve the kidneys ( pyelonephritis), and lower tract infections, which involve the bladder ( cystitis), urethra… read more (UTI)

• Prior urethral reconstruction

• Recent urologic surgery

• History of difficult catheter placement

*Urethral injury may be suspected following blunt trauma if patients have blood at the urethral meatus (most important sign), inability to void, or perineal, scrotal, or penile ecchymosis, and/or edema. In such cases, urethral disruption should be ruled out with imaging (eg, by retrograde urethrography Genitourinary Imaging Tests Imaging tests are often used to evaluate patients with renal and urologic disorders. Abdominal x-rays without radiopaque contrast agents may be done to check for positioning of ureteral stents… read more ) before attempting urethral catheterization.

Complications include

• Injury to the urethra, prostate, or bladder with bleeding (common)

• UTI Introduction to Urinary Tract Infections (UTIs) Urinary tract infections (UTIs) can be divided into upper tract infections, which involve the kidneys ( pyelonephritis), and lower tract infections, which involve the bladder ( cystitis), urethra… read more (common)

• Creation of false passages

• Scarring and urethral strictures Urethral Stricture Urethral stricture is scarring that obstructs the anterior urethral lumen. Urethral stricture can be Congenital Acquired Anything that damages the urethral epithelium or corpus spongiosum can… read more

• Paraphimosis Paraphimosis Phimosis is inability to retract the foreskin. Paraphimosis is entrapment of the foreskin in the retracted position; it is a medical emergency. Phimosis is normal in children and typically resolves… read more , if the foreskin is not reduced after the procedure

Prepackaged kits are typically used but the individual items needed include

• Sterile drapes and gloves

• Povidone iodine with application swabs, cotton balls, or gauze

• Water-soluble lubricant

• Urethral catheter* (size 16 French Foley catheter is appropriate for most men; in the setting of prostatic hypertrophy Benign Prostatic Hyperplasia (BPH) Benign prostatic hyperplasia (BPH) is nonmalignant adenomatous overgrowth of the periurethral prostate gland. Symptoms are those of bladder outlet obstruction—weak stream, hesitancy, urinary… read more or urethral stricture Urethral Stricture Urethral stricture is scarring that obstructs the anterior urethral lumen. Urethral stricture can be Congenital Acquired Anything that damages the urethral epithelium or corpus spongiosum can… read more , an alternate size or style of catheter may be required†)

• 10-mL syringe with sterile water (for catheter balloon inflation)

• Local anesthetic (eg, 5 to 10 mL of 2% lidocaine jelly in a syringe [with no needle]) for distention and anesthesia of the male urethra

• Sterile collection device with tubing

*A closed-catheter system minimizes catheter-associated UTI Catheter-Associated Urinary Tract Infections A catheter-associated urinary tract infection (CAUTI) is a urinary tract infection (UTI) in which the positive culture was taken when an indwelling urinary catheter had been in place for &gt. .. read more .

†A coudé catheter is curved at the end and may facilitate passage in a male with significant prostatic hypertrophy.

• Sterile technique is necessary to prevent a lower urinary tract infection Introduction to Urinary Tract Infections (UTIs) Urinary tract infections (UTIs) can be divided into upper tract infections, which involve the kidneys ( pyelonephritis), and lower tract infections, which involve the bladder ( cystitis), urethra… read more .

• Place all equipment within easy reach on an uncontaminated sterile field on a bedside tray. You may put the box containing the catheter and the drainage system between the patient’s legs, so that it is easily accessible during the procedure.

• If not done already, attach the catheter to the collecting system and do not break the seal unless a different type or size of catheter or irrigation of the catheter is required.

• Test the retention balloon for integrity by inflating it with water, and apply lubricant to the catheter tip.

• Saturate the applicator swabs, cotton balls, or gauze with povidone iodine.

• Place the sterile fenestrated drape over the pelvis so that the penis remains exposed.

• Grasp the shaft of the penis using your nondominant hand, and retract the foreskin if the patient is uncircumcised. This hand is now nonsterile and must not be removed from the penis or touch any of the equipment during the rest of the procedure.

• Cleanse the glans penis with applicator swabs, gauze, or cotton balls saturated in povidone iodine. Use a circular motion, beginning at the meatus, and work your way outward. Discard or set aside the newly contaminated items.

• Inject viscous lidocaine into the urethra. Insert the hub of the lidocaine-containing syringe into the penile meatus and inject about 5 mL. Pinch the meatus closed, to retain the lidocaine within the urethra, for at least 1 minute. The lidocaine distends the urethra, as well as provides some anesthesia, thereby easing catheter passage.

• Hold the catheter in your free hand. If a coudé catheter is being used, the tip should point upward, so as to track the superior urethral wall during insertion.

• Advance the catheter slowly through the urethra and into the urinary bladder. Patient discomfort is common. Ask the patient to relax and take slow deep breaths as you continue to apply steady pressure on the catheter until it is fully advanced to the level of the side port. Urine should flow freely into the collection tubing.

• Slowly inflate the balloon with 5 to 10 mL of water. Obvious resistance or patient discomfort suggests incorrect placement. If this happens, deflate the balloon, withdraw the catheter slightly, and then reinsert the catheter all the way before trying to reinflate the balloon.

• Position the balloon at the bladder neck, after successful balloon inflation, by slowly withdrawing the catheter until you feel resistance.

• To prevent paraphimosis Paraphimosis Phimosis is inability to retract the foreskin. Paraphimosis is entrapment of the foreskin in the retracted position; it is a medical emergency. Phimosis is normal in children and typically resolves… read more , reduce the foreskin after the procedure.

VIDEO

• Remove the drapes.

• Secure the catheter to the thigh with an adhesive bandage, tape, or strap. Some advocate taping the catheter to the lower abdominal wall to minimize pressure on the posterior urethra.

• Place the bag below the level of the patient to ensure that urine can drain via gravity.

• Be sure to maintain strict sterile technique during the procedure to avoid urinary tract infection Introduction to Urinary Tract Infections (UTIs) Urinary tract infections (UTIs) can be divided into upper tract infections, which involve the kidneys ( pyelonephritis), and lower tract infections, which involve the bladder ( cystitis), urethra. .. read more .

• Be sure to reduce the foreskin after the procedure.

• Be careful not to use excessive force during insertion, which could potentially cause urethral injury.

• Do not continue attempts at catheter placement if significant resistance is met or if the catheter feels to be buckling inside the urethra and not advancing.

• Urine will appear in the catheter before the balloon has advanced beyond the prostate. Continue advancing the catheter completely to the end of the catheter before inflating the balloon, to avoid inflating the balloon in the prostate or urethral lumen, which will cause significant bleeding.

• If the catheter appears to be in the correct position, but urine does not return, lubricant may be obstructing drainage of urine. Flush the catheter with normal saline to dislodge the lubricant and see if urine returns.

• If the balloon is difficult to inflate or the balloon port distends during inflation, the proximal end of the catheter is probably not in the correct position. Deflate the balloon and advance the catheter further into the bladder.

• If correct positioning is questioned, flush the catheter with 30 to 60 mL of normal saline. If the fluid can be flushed and aspirated easily, then the catheter is in the correct position. A catheter that will not irrigate is not in proper position.

• Consult a urologist for any questions regarding catheter size and style or difficulty placing a catheter.

NOTE:


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Bladder catheterization in case of pathological obstruction of the outflow of urine, as well as for diagnostic purposes, involves the use of a catheter in the form of a thin tube into the urethra.

Indications for catheterization

For therapeutic purposes, the placement of a urinary catheter is carried out in the following conditions:

• acute urinary retention;
• presence of blood clots, mucus and pus in the bladder;
• administration of chemotherapeutic agents;
• after operations to restore the patency of the urethra.

Catheterization is also used for diagnostic purposes.

1. Urine sampling for analysis can be done with a Nelaton urological catheter (it is a thin plastic tube).
2. Ultrasound diagnosis of the pelvic organs should be performed on a full bladder. Catheterization is used if, due to voluntary urination or other pathological conditions, the patient cannot fill it on his own.
3. In case of severe poisoning or comatose conditions of the patient, when it is necessary to control the daily volume of urine (diuresis).

The insertion of soft catheters is carried out by paramedical staff: a nurse and a paramedic – catheterization with a rigid catheter is carried out by a doctor.

Contraindications

These conditions are considered an absolute contraindication for elective catheterizations:

• acute bacterial infections of the prostate;
• damage to the urethral canal;
• narrowing of the urethra.

In urgent cases, insertion of the catheter with extreme caution is possible.

Features of the catheterization procedure in men

It is more difficult to place a urinary catheter in a man due to the peculiarities of physiology (long curved urethra).

To place a Nelaton or Foley catheter, the health worker must work under aseptic conditions, using sterile gloves and dressings.

After treatment with an antiseptic, the catheter is inserted into the glans penis to a depth of 20 cm or until urine appears. To relieve pain, the catheter is pre-lubricated with vaseline oil or glycerin.

A 2% solution of lidocaine can be used as an anesthetic (administered before the procedure in a volume of 2-3 ml).

Possible complications

In case of violation of the rules for installing a catheter, the following conditions may appear:

• violation of the integrity of the walls of the urethra, prostate gland;
• bleeding;
• damage or rupture of part of the catheter;
• development of an infectious process.

Bladder catheterization in Kyiv is carried out in our clinic by qualified specialists, so that patients can be confident in the correct insertion and the absence of possible complications.

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Installation, replacement and removal of the Foley catheter in Kiev at home and in the Yurinmed clinic

at home by prior arrangement

In case of problems with urination, the installation of the urinary Foley catheter helps to gently and quickly solve the problem. The miniature device is recommended for long-term use in women and men, controls the outflow of urine during injuries, after surgery, reducing the risk of complications. But there are a number of features during the introduction and removal that require professional help from doctors.

Foley Catheter Purpose

A small medical device or appliance comes in the form of a tube with a balloon that is carefully inserted into the bladder cavity. It is designed for forced emptying in the event of a malfunction of the genitourinary system. Depending on the type, the placement of a Foley urinary catheter is possible for a period of 5 to 30 days.

Bladder catheterization is a medical way to restore the function of urine excretion. With some diseases and injuries, the process is disrupted, which threatens the patient’s health with severe complications, severe pain. It can also be used to administer medications, flush, and take fluid for laboratory testing.

The main indications for the installation of a urinary catheter:

• the presence of stones in the bladder;
• tumors;
• prostate adenoma;
• postoperative period;
• finding the patient in an unconscious or comatose state;
• exacerbation of cystitis in women;
• injection of drugs into the bladder;
• lavage of the organ cavity in certain diseases;
• diagnostics and sampling of biomaterial for analysis.

Insertion of a catheter in a woman is recommended for natural induction of labor. It accelerates the opening of the uterus without drugs and painful procedures, while simultaneously removing excess urine before delivery. The technique is safe for the woman in labor and the fetus.

A bladder catheter is also inserted into women for the following diagnoses and conditions of patients:

• diabetes mellitus;
• preeclampsia;
• polyhydramnios;
• multiple pregnancy;
• high blood pressure;
• diseases and heart defects.

Insertion of a urethral catheter is indicated for injuries of the spinal cord and spine: loss of sensation often leads to impaired urination. It is recommended for abnormal structure of the urethra, severe swelling with allergies, side effects of drugs, some rare pathologies and diseases.

Types of catheter

Several types of urinary catheter are used in medical practice. They have an identical principle of operation, but differ in materials, shape and some details. It depends on the purpose and gender of the patient, so the selection of the size should be performed by a specialist after examining the patient.

There are several types of urinary Foley catheter:

• Silicone . The most popular and demanded model that can be used for a long time and repeatedly. High-quality material does not provoke an allergic reaction, inflammation, does not stimulate the development of pathogenic microflora. After the introduction, discomfort quickly disappears, so it is recommended for patients who are on home treatment.
• Latex . More flexible and secure design with easy insertion into the urethra. It can be subjected to heat treatment, therefore it is used repeatedly, it is distinguished by an affordable price and quality. It has a high degree of strength, so it can be used up to 1 month, but in rare cases it provokes allergies.
• Silver plated . The cost of the material affects the price of the urine catheter. But silver effectively destroys bacteria, speeds up recovery, and reduces the risk of secondary infection. Used to stimulate labor in women, for diagnostic procedures, treatment of cystitis and urethritis.

Depending on the severity of the patient’s condition and the proposed diagnosis, the doctor chooses different types of bladder catheter. The most effective in medical manipulations:

• 2-way . The product has one channel, which is inserted into the bladder. It is fixed with a balloon, which inflates and eliminates congestion or swelling. At the first stage, urine is excreted, at the second stage, washing or administration of a medicinal solution is carried out. Easily sterilized, but inconvenient if necessary for daily medical procedures.
• 3 way . A more perfect fixture with an additional channel. It allows you to administer drugs directly at the time of emptying the bladder, to do washing. Such a “female” urinary catheter is recommended for diseases of the uterus, it is prescribed after abdominal operations.

Depending on the size and sex of the patient, doctors select different types of catheters:

• Male urinary catheter . Given the structure of the genital organs and the duration of the urethral canal, it can reach a length of 40 cm. Silicone or latex is more often used, softer and more elastic, with minimal discomfort during insertion.
• Female urinary catheter . It does not exceed 26 cm in length. In patients of the weaker sex, the urethra is located in close proximity to the vagina, so many doctors recommend silver-plated models. They prevent the development of a bacterial infection, are safer during pregnancy.
• Child . Complemented with a special stylet for simplified and painless insertion, made of soft and light material.

For children, it is recommended to choose medical devices from 1. 1 to 3.3 mm in diameter. For adult men, more massive catheters up to 8 mm thick are selected. When choosing, doctors take into account the age and purpose of use, the period for which the balloon is supposed to be inserted.

Catheter placement – basic rules

The procedure must be entrusted to an experienced doctor to avoid complications or infection. All manipulations are performed with sterile gloves with the utmost care. The specialist additionally treats the genitals, the skin around the penis with an antiseptic.

A specific algorithm for insertion of the urinary Foley catheter has been developed:

• For ease of insertion, the tip is liberally lubricated with Vaseline. Women are recommended a high-quality lubricant with a moisturizing effect.
• The external genital organs are thoroughly washed, wiped with a solution based on furacilin, chlorhexidine.
• The patient is placed on his back, legs are bent and spread apart.
• Gently and slowly insert the soft tip into the urethral canal, turning slightly around the axis. A man needs to further move the foreskin to expand the channel.
• Insertion of a catheter into a man is carried out until urine appears in a transparent tube. Spotting in the first portion of urine is not considered an abnormality. Often a complication is associated with the presence of blood in the bladder during an inflammatory process or injury.

When a catheter is placed on a man by a specialist, there should be no acute pain or spasms. Before starting, the doctor carefully examines the history, pictures, to exclude injuries and ruptures. To reduce discomfort, apply a few drops of an anesthetic with lidocaine.

In women, the process of placing a catheter has certain nuances associated with the anatomical features of the body. Before preparing for surgery or labor, after inserting the tube into the urethra, the doctor further expands the channel with a balloon. Up to 10 ml of water is injected into it using a syringe. This ensures uninterrupted excretion of urine.

Women often have a catheter for severe cystitis. In addition to removing urine, an antiseptic solution is injected through thin soft tubes. It removes pathogenic bacteria, normalizes microflora, accelerates recovery.

The most difficult process is placing a urinary catheter in a child. The doctor needs to calm the baby, lay him on his back, carefully treat the external genitalia with a disinfectant. During the introduction, the specialist acts without pressure, in order to exclude rupture of the canal, injuries and pain, he always applies anesthesia. The maximum depth for catheterization of a boy is up to 15 cm, depending on age.

Features for changing and flushing the urinary catheter

The Foley catheter can be used multiple times. But the narrow tube often becomes clogged and requires regular cleaning and rinsing. On average, it can be used for up to 5 days, after which treatment is carried out:

• The doctor carefully treats the hands with an antiseptic, wipes the outer parts and tubes with a solution. A little chlorhexidine is applied to the injection site into the urethral canal.
• Carefully remove the catheter from the tubing and inject saline with a large syringe.
• The liquid after washing is drained, repeated until plaque is completely removed and the tubes are cleaned.

During cleansing, the urinary catheter is only removed from the outside. In this case, the patient does not remove the elements introduced into the urethra. This eliminates pain. If long-term catheterization is necessary, only silicone products are used: they do not deform during heat treatment.

Removing the urinary catheter

Despite the simplicity of the design, an experienced specialist must remove the tube according to a certain algorithm of actions:

• Be sure to treat your hands with a disinfectant solution and wear sterile gloves.
• Carefully remove the retaining clip that prevents the catheter from moving.
• Empty the bladder and tube completely.
• Ask the patient to take a supine position with legs spread apart, to relax as much as possible.
• Carefully remove the assembly slowly without jerks, making sure that there is no damage.

After removal of the Foley catheter, the genitals and urethra are carefully cleaned with an antiseptic solution. For several days, unpleasant sensations may persist during self-urination, which does not require additional treatment or anesthesia.

Urinary Catheter Contraindications

Before using the construct, the clinician must ensure easy and unhindered insertion. The procedure is contraindicated in the following diagnoses and pathologies:

• severe pelvic injuries;
• malignant and benign tumors of the prostate;
• ruptured urethra;
• spasms;
• acute inflammation of unknown etiology.

Do not insert a urinary catheter in men if there is damage to the external genitalia. In such a situation, a more complex system is used, in which the structure is installed in the area above the pubis.

Possible complications

Insertion and removal of a urinary catheter In Kyiv, at home, only an experienced doctor who takes precautions should be entrusted. Otherwise, you may face serious complications:

• infection of the genitourinary system, uterus in women;
• rupture or trauma of the urinary canal with sudden insertion;
• exacerbation of cystitis, urethritis, urolithiasis;
• microtrauma of the cervix.

In parturients, misuse of a Foley catheter can lead to abnormal labor that requires an emergency caesarean section. In some patients, with prolonged wear, irritation of the mucous membranes is observed at the point of contact with silicone or latex tubes.

It is imperative to consult a doctor if the patient’s condition worsens, an admixture of pus or blood appears in the urine. With a secondary infection introduced during the installation of the construct, the patient quickly develops signs of intoxication with fever, chills.