Urinary Catheterization
Steps in male catheterization
- Place the
patient in the supine position with legs extended and flat on the bed.
- Prepare the
catheterization tray and catheter and drape the patient appropriately using the
sterile drapes provided. Place a sterile drape under the patient’s buttocks and
the fenestrated (drape with hole) drape over the penis.
- Apply
water-soluble lubricant to the catheter tip.
- With your
non-dominant hand, grasp the penis just below the glans and hold upright.
- If the
patient is uncircumcised, retract the foreskin. Replace the foreskin at the end
of the procedure.
- With your
dominant hand, cleanse the glans using chlorhexidine soaked cotton balls. Use
each cotton ball for a single circular motion.
- Place the
drainage basin containing the catheter on or next to the thighs.
- With you
non-dominant hand, gently straighten and stretch the penis. Lift it to an angle
of 60-90 degrees. At this time you may use the urojet to anesthetize the
urinary canal, which will minimize the discomfort.
- With your
dominant hand, insert the lubricated tip of the catheter into the urinary
meatus.
- Continue to
advance the catheter completely to the bifurcation i.e. until only the
inflation and drainage ports are exposed and urine flows (this is to ensure
proper placement of the catheter in the bladder and prevent urethral injuries
and hematuria that result when the foley catheter balloon is inflated in the
urethra).
- Note: If resistance is met during advancement of
the catheter: Pause for 10-20 seconds. Instruct the patient to breathe deeply
and evenly. Apply gentle pressure as the patient exhales
- If you still
meet resistance, stop the procedure and repeat above steps.
- Attach the
syringe with the sterile water and inflate the balloon. It is recommended to
inflate the 5cc balloon with 7-10cc of sterile water, and to inflate the 30cc
balloon with 35cc of sterile water. Improperly inflated balloons can cause
drainage and leakage difficulties.
- Gently pull
back on the catheter until the balloon engages the bladder neck.
- Attach the
urinary drainage bag and position it below the bladder level. Secure the
catheter to the thigh. Avoid applying
tension to the catheter.
- Remove
drapes and cover patient. Ensure drainage bag is attached to bed frame. Remove
your gloves and wash hands.
- Note: Never inflate a balloon before establishing
that the catheter is in the bladder and not just in the urethra. If the patient reports discomfort, withdraw
the fluid from the balloon and advance the catheter a little further, then
re-inflate the balloon.