How to put a urinary catheter in a man. Urine catheter

In the practice of a urological doctor, one often encounters such a device as a urinary catheter. It is a rubber tube or a system consisting of several tubes that is necessary for insertion into the lumen of the bladder if the patient does not pass urine for one reason or another or for other diagnostic purposes.

Most often, catheterization is needed by men who have diseases such as prostate adenoma or its malignant degeneration (prostate cancer). Against their background, there is a violation of the patency of the urethra, which leads to urinary retention.

What is bladder catheterization?

The main goal of catheterization is to restore the normal outflow of urine from the lumen of the bladder, which normalizes all urodynamic processes and prevents a number of the most dangerous complications for the patient's life.

The catheter is inserted into the external opening of the urethra, after which it gradually moves along the urethra and reaches the lumen of the bladder. The appearance of urine in the catheter is evidence that the procedure was performed correctly and successfully.

Catheterization should only be performed by a qualified medical professional (doctor or paramedic).

Although the catheterization technique is quite simple to perform, some skill is required to perform it correctly.

When performing bladder catheterization, it is important to observe a number of the following basic conditions:

the introduction of a catheter into the urinary canal (urethra) should be done carefully, without the use of rudeness and violence;
the procedure begins with the use of elastic devices (Tieman or Mercier type catheter);
in order to minimize possible damage to the walls of the urethra, it is necessary to use a large diameter catheter;
a metal catheter is inserted into the patient only if the doctor who performs the manipulation is fluent in this skill;
if any pain occurs during catheterization, it must be stopped, and the patient should be immediately hospitalized in a hospital;
if the patient has acute urinary retention, but the introduction of a catheter into the bladder is impossible (there are contraindications), then resort to percutaneous cystostomy.

Types of catheters and their classification

Previously, only metal (rigid) catheters were used for catheterization, which led to frequent complications (mucosal injuries, ruptures, etc.). Currently, silicone (soft) and rubber (elastic) devices of different diameters have become widespread.

There are catheters for men (their length is about 30 cm) and for women (its length is 15-17 cm).

The following types of devices are used:

Nelaton's catheter(used for catheterization for a short period of time, for the purpose of one-time drainage);
Foley catheter (introduced for a long period of time, has several passages through which drugs are simultaneously administered and urine is excreted);
Timan stent (a device used by urologists for diseases of the prostate gland, well accepts the bends of the urethra).

The catheter is chosen depending on the purpose of its use.

Procedure technique

In order to carry out the catheterization procedure, in accordance with all the rules of asepsis and antisepsis, it is necessary to carry it out in a specialized hospital, using modern antiseptics, sterile devices, medical disposable gloves, etc.

Bladder catheterization in a woman

The manipulation algorithm is as follows:

The woman is laid on her back, asked to bend her knees and spread them apart.
The female genital organs are carefully treated using antiseptic solutions, after which the vaginal inlet is lined with sterile wipes.
A well-lubricated urine catheter is inserted with the right hand until it appears (about 4-5 cm).
If urine suddenly stops flowing, this may indicate that the device has rested against the wall of the bladder, so you need to pull the catheter back a little.
After the end of the manipulation, and the complete outflow of urine, it is necessary to carefully bring the catheter out, and again treat the lumen of the urethra with an antiseptic solution.
The patient is required to be in a horizontal position for an hour.

The procedure is carried out only by qualified specialists

During pregnancy, there are situations when a woman needs catheterization, for example, when a calculus is advanced, and blockage of the lumen of the urinary tract, which leads to acute urinary retention, as well as before the upcoming caesarean section.

The condition requires immediate hospitalization and observation of the woman only in a specialized hospital.

In men, catheterization complicates the anatomical structure of the urethra, namely its small diameter, significant length, tortuosity, and the presence of physiological narrowing.

The algorithm for the procedure is as follows:

The man is laid on his back (legs do not need to be bent at the knees).
The penis and inguinal region are lined with sterile wipes around the entire perimeter.
With the left hand, the doctor pulls back the foreskin, exposing the lumen of the urethra, and at the same time pulls the penis perpendicular to the surface of the patient's torso. The head of the penis and other male genital organs are carefully treated with antiseptic solutions.
The pre-lubricated catheter is inserted with the right hand, all movements should be smooth and uniform, while the doctor should apply only a small effort in places of anatomical narrowing (the patient is asked to relax as much as possible).
Periodic palpation of the tip of the catheter is recommended, especially if there are obstacles in its path, until urine passes through it (an indication that it has reached the lumen of the bladder).
When the procedure is completed, the catheter is removed, and the lumen of the urethra is re-treated with an antiseptic solution. The patient needs to be in a horizontal position for an hour.

Abduction of the penis perpendicular to the male body allows for maximum straightening of the anterior urethra

Bladder catheterization in a child

In general, the technique of catheterization in children does not differ significantly from the procedure performed in adults. It is carried out in order to restore the normal outflow of urine, and eliminate all signs of acute urinary retention.

The introduction of a catheter to a child requires special care and accuracy, since they have a high risk of damage to the mucous membranes, up to a complete rupture of the wall of the urethra or bladder. That is why a smaller diameter device is used for catheterization of children, and if such a possibility exists, then the procedure is carried out under ultrasound or X-ray control.

Indications and contraindications for the procedure

Main indications for bladder catheterization:

development of acute urinary retention in various pathological conditions;
chronic retention of urine in the lumen of the bladder;
the state of shock of the patient, in which there is no possibility of independent discharge of urine;
the need to determine the exact volume of daily urine in patients in the intensive care unit or intensive care unit;
determination of the volume of urine that remains in the patient after the act of urination;
the introduction of substances-contrasts (required for cystourethrographic examination);
washing the lumen of the bladder with solutions of antiseptics or antibiotics;
to remove blood clots from the bladder;
carrying out a number of diagnostic procedures (for example, taking a urine test for its further sowing on nutrient media, when natural delivery is impossible or difficult).

The most common cause of urinary retention in men is prostate adenoma.

The following pathological processes can serve as a contraindication for catheterization in men and women:

inflammatory process in the tissues of the prostate gland (acute prostatitis or exacerbation of its chronic form);
inflammatory process in the testicles or their appendages;
abscesses of the prostate or other volumetric formations in it, leading to a sharp narrowing of the lumen of the urethra, when the introduction of a catheter is impossible;
infection of the urethra (acute urethritis or exacerbation of a chronic process, when the edematous component is pronounced);
traumatic damage to the urethra or its sharp deformation against the background of strictures (the introduction of a catheter may lead to a rupture of the urethral wall);
severe spasm of the external sphincter of the bladder (for example, against the background of impaired innervation in case of damage to the lumbar spine);
contracture of the cervical part of the bladder.

Complications after manipulation

As a rule, if catheterization is performed by an experienced specialist, and the patient does not have any pathological processes that make it difficult to move the catheter along the urethra, then complications are quite rare.

The most common adverse outcomes from the procedure are:

damage to the walls of the urethra or bladder, resulting in blood in the urine (hematuria);
accidental rupture of the wall of the urethra or perforation of the bladder (this occurs with a rough introduction of the catheter);
infection of the urethra or bladder (cystitis or urethritis develops);
a sharp decrease in blood pressure numbers (hypotension against the background of manipulation).

The male urethra has several anatomical curves, so rough and incorrect manipulation can cause a number of complications.

Catheter replacement or removal

If catheterization of the bladder is performed for a long period of time, then it often becomes necessary to replace the device. This happens in the following situations:

initially incorrectly selected size of the catheter, as a result of which there is a gradual "leakage" of urine;
blockage of the lumen of the device;
the appearance of severe spasms in the patient or other unpleasant sensations that require temporary removal of the catheter.

Removal of the device, as well as its insertion, should only be carried out by a specialist with a medical background in order to prevent any complications. The doctor disconnects the urine reservoir from the main tube. Using a large syringe attached to the outer opening of the tube, the residual volume of urine is withdrawn, then the catheter is removed completely. All movements should be smooth and cautious, any "jerks" should be avoided.

After removing the catheter, you need to leave the patient in a horizontal position for 20-30 minutes. At the same time, it is important to ask him for any discomfort, pain, etc.

If, after catheterization, the patient has bloating, blood from the urethra or other pathological symptoms appear, then it is necessary to find out their cause

Conclusion

Bladder catheterization is a manipulation that requires the intervention of only a specialist with a medical education.

Each patient who has a catheter requires constant monitoring. If any unpleasant symptoms appear, a diagnosis of this condition is necessary, and the question of its removal is decided only by a doctor.

In the article, we will consider how to put a urinary catheter in a woman.

People very often have to get acquainted with a wide arsenal of various medical instruments. And one of them is a urinary catheter for women and men. What is it and why is it generally used?

Main purpose

Why is a urinary catheter required for women and men? In urology, catheters of various shapes and sizes are used to perform certain activities. For each patient, the device is selected individually. At the outlet, such a probe, as a rule, is connected to a drainage bag, that is, directly to a collector designed to collect urine.

The bag is fixed on the patient's leg so that he can move freely and the collector can be used throughout the day. At night, larger containers are used, hanging from the bed.

The indications for the procedure are:

The need to obtain bladder urine for analysis.
The presence of inflammatory diseases of the bladder in women.
The appearance of acute or chronic urinary retention.

Description

The catheter is a tube designed to create a kind of passage between the internal cavities of the body and the external environment. An instrument is used to inject therapeutic solutions, and, in addition, to wash the organ, perform surgical procedures.

A urinary catheter for women and men is required to achieve forced emptying of the organ. For example, catheterization may be required immediately after childbirth, when a woman in labor is unable to urinate on her own for the first time. Sometimes the procedure is performed against the background of damage to the bladder. For example, due to injury, the lumen often closes, and urine is not naturally excreted from the human body. In a number of situations, the use of female urological catheters is required in the process of conducting an examination to make a diagnosis. It is often necessary:

Determination of the amount of urine present in the bladder.
Obtaining a sterile portion of urine for analysis.
Performing radiography of the urethra and bladder by introducing a contrast component into the organs.

Types of catheters

There are many types of urinary catheters available today. The type of medical instrument chosen directly depends on the specific case, for example:

A device called the "Foley catheter" is applicable for long-term catheterization (when patients are in a coma). It is also suitable for short-term manipulation. It is used for the purpose of washing, eliminating blood clots, diverting urine, and so on.
"Nelaton's catheter" is designed for periodic catheterization in situations where the patient cannot independently carry out the process of urination. Until the invention of the Foley catheter, this device was intended for permanent use.
A device called the "Pezzera catheter" is well suited for maintaining continuous catheterization and drainage of urine through a cystostomy. This tool, unfortunately, has quite a few shortcomings, in connection with this, they work with it only in the absence of other possibilities.

Which ones are used more often?

Urinary catheters are currently predominantly flexible. Metal models are rarely used. The fact is that they are less comfortable for the patient and not very convenient to use. Catheters are necessarily fixed after insertion, the doctor chooses the technique for this and is guided by the characteristics of a particular situation.

The difference between female and male models

The difference between the female and male urological catheter is determined by the anatomical feature of the body. Although the purpose of the devices can be said to be the same, they still differ in structure:

Male models are intended for insertion into narrow and curved urethra, because the tube is made thin and long.
The urinary catheter for women is made with the expectation of a short, wide and straight urethra, so that such an instrument is endowed with the appropriate characteristics, that is, a relatively large diameter, small length and the complete absence of any bends.

Today, urological catheters are available in most medical stores. Usually, in the description for each such product, it is indicated for which gender of the patient this or that instrument is designed. The approximate cost of the product is from nine to two and a half thousand rubles. The price largely depends on the type of catheter, and at the same time on the place of purchase and the material of manufacture.

How is a urinary catheter placed in a woman?

Installation Features

By itself, such a procedure is not at all difficult, since the female body is very convenient for inserting a tube. For example, in a man, in order to be able to get to the bladder, it will be necessary to overcome the genital organ. But in women, the urethra is located directly behind the labia.

Let's take a closer look at how a catheter is placed in the bladder of a woman.

Before the catheterization procedure, the patient should take a shower, wash thoroughly and come to the room for manipulation. In the event that the procedure is carried out to collect urine, then at first the doctor or nurse may try to do without inserting an instrument into the urethra. For this:

The patient needs to lie down on the couch, on which a diaper or oilcloth is preliminarily spread.
Next, the bent legs must be spread apart so that a vessel can be placed between them in order to accumulate urine.
A warm heating pad is placed on the lower abdomen of the patients. It helps stimulate reflex urination. For similar purposes, the genitals can be watered with slightly heated water.

Stages of catheterization

How to insert a urinary catheter in a woman, what are the steps of the procedure? In cases where urination could not be provoked, doctors proceed to the catheterization procedure. It includes the following main steps:

Disinfection of the urethra.
Careful insertion of the catheter into the urethra at a distance of five to seven centimeters. In this case, the doctor will need to keep the patient's labia divorced.
Collection of urine that flows through the tube into a container prepared for this.
Then, if necessary, the following procedure is performed (that is, the bladder is washed, drugs are administered, etc.).

How to put a catheter in the bladder of a woman, every specialist with the appropriate qualifications knows.

What are the inconveniences?

Despite the fact that catheterization is much less unpleasant for women than for men, nevertheless, manipulation of this kind is quite stressful. Many patients do not experience much pain or any other physical discomfort, but they absolutely always have to experience obvious psychological discomfort. A good doctor manages to create a trusting, but at the same time calm atmosphere in which women feel relaxed. It is very important that the patient is not afraid and not shy, then the procedure will be very easy, painless and fast enough.

In simple situations, catheterization can be performed by a nurse, for example, when a diagnosis needs to be confirmed. In the event that the manipulation is performed for medicinal purposes, then only a qualified doctor should work. Catheterization is important to do very carefully, as a sharp or too fast movement can damage the urethra, provoking an inflammatory process (like cystitis or urethritis).

The female urinary catheter is one of the achievements of medicine, whose importance is very great, and it is difficult to overestimate it. Thanks to this simple device, diseases of the urinary system simply cease to be difficult for people: they are easier to recognize and treat. It would be superfluous to remind about patients suffering from severe brain or back injuries, when the use of a catheter is one of the main conditions for providing full-fledged patient care. How to insert a catheter into the bladder of a woman is now clear.

What pathologies require catheterization?

So, catheterization of such an organ as the bladder in women is a procedure necessary in some cases with the development of pathologies of this organ. The procedure itself involves the introduction of a catheter in the form of a flexible latex tube, which can also be made of silicone or Teflon. Such a tube is able to pass through the urethra directly to the bladder.

Often, the need for the described event in women arises in the postoperative periods against the background of gynecological or diseases. Catheterization is performed to control the amount of urine produced. In addition, it can contribute to the healing of postoperative wounds.

In some situations, the procedure is required by patients for washing in case of bleeding, administration of medications, detection of general obstruction, urine output due to neurological pathologies (paralysis), incontinence or delay in a number of certain diseases.

For cancer

Bladder cancer, which is often diagnosed in women, often requires the insertion of a catheter. Typically, such a disease can develop against the background of papillomas. In this case, as a rule, in the urine of patients there is an excessive amount of blood, which is very easily detected in them even with the ordinary naked eye.

Often, cancer is diagnosed in smokers and those who work with aniline dyes. Often, such a pathology is also formed against the background of chronic inflammation of this organ, after irradiation, and in those who often do not urinate on demand. Various sweeteners and a number of medicines also have an effect.

We looked at how to put a urinary catheter in a woman. This procedure is very useful, necessary for carrying out in the presence of pathologies of the bladder.

urinary catheter is a system of tubes placed in the body to drain and collect urine from the bladder.

Urinary catheters are used to drain the bladder. Bladder catheterization is often a last resort due to possible complications from prolonged use of the catheter. Complications associated with the use of a catheter may include:

bubble stones
Blood infections (sepsis)
Blood in the urine (hematuria)
Skin damage
Urethral trauma
Urinary tract or kidney infections

There is a wide variety of urinary catheters. Urinary catheters differ in material they are made of (latex, silicone, Teflon) and type (Foley catheter, straight catheter, curved tip catheter). For example, a Foley catheter is a soft plastic or rubber tube that is inserted into the bladder to drain urine.

Urologists recommend using the smallest catheter size. Some people may need large catheters to prevent urine from leaking around the catheter or if the urine is concentrated and contains blood or a lot of sediment.

It must be remembered that large catheters can damage the urethra. Some people with long-term use of latex catheters may develop an allergy or sensitivity to latex. In these patients, Teflon or silicone catheters should be used.

Long-term (permanent) urinary catheters

A catheter, which is inserted into the bladder for a long time, is connected to a urinal to collect urine. There are two types of urinals.

The first type of urinal is a small bag that is attached to the leg with an elastic band. Such a urinal can be worn during the day, as it is easy to hide under trousers or a skirt. The bag is easily emptied in the toilet.

Another type of urinal is a large bag that is used at night. This urinal is usually hung on the bed or placed on the floor.

How to care for your urinary catheter

If the catheter becomes clogged, painful, or infected, the catheter must be replaced immediately.

To care for an indwelling catheter, it is necessary to wash the urethra (the exit site of the catheter) daily with soap and water. Also clean the genital area completely after each bowel movement to prevent infection of the catheter. Urologists no longer recommend the use of antibacterial ointments for cleaning catheters, as their effectiveness in preventing infection has not been proven.

Increase your fluid intake to reduce the risk of complications (if you can drink plenty of fluids for health reasons). Discuss this issue with your doctor.

The urinal should always be located below the bladder to prevent urine from flowing back into the bladder. Empty the bag either every 8 hours or as it fills up.

Make sure that the outlet valve of the urinal remains sterile. Wash your hands before and after handling the bag. Do not let the outlet valve touch anything. If the outlet valve is dirty, wash it with soap and water.

How to handle the urinal?

Clean and deodorize the bag by filling the bag with a solution of two parts vinegar to three parts water. You can replace the aqueous solution of vinegar with chlorine bleach. Soak the urinal in this solution for 20 minutes. Hang the bag with the outlet valve open to dry.

What to do if the catheter is leaking?

Some people may experience leakage of urine around the catheter. This phenomenon may be due to a small catheter, an inappropriate balloon size, or bladder spasm.

If bladder spasm occurs, check to see if the catheter is draining urine properly. If there is no urine in the urinal, then the catheter may be blocked by blood or coarse sediment. Or, the catheter or drainage tube has tucked up and formed a loop.

If you have been taught how to flush the catheter, then try to flush the catheter yourself. If you cannot flush the catheter, contact your doctor immediately. If you have not been instructed how to flush the catheter and urine does not enter the bag, then you need to contact your doctor immediately.

Other causes of urine leakage around the catheter include:

Constipation
Urinary tract infections

Potential Complications of Using Urinary Catheters

Contact your doctor if you develop any of these complications:

Bleeding in or around the catheter
The catheter is draining a small amount of urine, or there is no urine despite adequate fluid intake
Fever, chills
Large amounts of urine leaking around the catheter
Urine with a strong odor or urine that is cloudy or thick
Swelling of the urethra around the catheter

Suprapubic urinary catheters

Suprapubic urinary catheter is an indwelling catheter that is inserted directly into the bladder through the abdomen above the pubic bone. This catheter is inserted by a urologist in the conditions of either a clinic or a hospital. The catheter exit site (located on the abdomen) and the catheter should be cleaned daily with soap and water and covered with dry gauze.

Replacement of suprapubic catheters is carried out by qualified medical personnel. The suprapubic catheter can be connected to the standard urinals described above. The suprapubic catheter is recommended:

After some gynecological operations
For patients who need long-term catheterization
For patients with trauma or blockade of the urethra

Complications caused by the use of a suprapubic catheter may include:

Bladder stones
Blood infections (sepsis)
Blood in the urine (hematuria)
Skin damage
Urine leakage around the catheter
Urinary tract or kidney infections.

After prolonged use of the catheter, the development of bladder cancer is possible.

How to put a urinary catheter in a man?

Wash your hands. Use betadine or a similar antiseptic (unless specifically instructed) to clean the urethra.
Put on sterile gloves. Make sure you do not touch the outer surface of the gloves with your hands.
Lubricate the catheter.
Take the penis and hold it perpendicular to the body. Slightly pull the penis towards the navel.
Begin gently inserting and advancing the catheter.
You will meet resistance when you reach the external sphincter. Ask the patient to take a few deep breaths to relax the muscles blocking the urethra and continue advancing the catheter.
If urine appears, continue advancing the catheter to the "Y" level of the connector. Hold the catheter in one position while you inflate the balloon. Inflating the catheter balloon in the urethra causes severe pain and can lead to injury. Check if the catheter is in the bladder. You can try flushing the catheter with a few milliliters of sterile water. If the solution does not return easily, the catheter may not have been inserted far enough into the bladder.
Fix the catheter and attach the urinal to it.

How to put a urinary catheter in a woman?

Collect all equipment: catheter, moisturizing gel, sterile gloves, clean wipes, syringe with water to inflate the balloon, urinal.
Wash your hands. Use betadine or another antiseptic to treat the external opening of the urethra. In women, it is necessary to treat the labia and the opening of the urethra with gentle movements from top to bottom. Avoid the anal area.
Put on sterile gloves. Make sure that you do not touch the outer surface of the gloves with your hands.
Lubricate the catheter.
Part the labia and locate the opening of the urethra, which is located below the clitoris and above the vagina.
Slowly insert the catheter into the opening of the urethra.
Gently advance the catheter.
If urine appears, advance the catheter another 2 inches. Hold the catheter in one position while you inflate the balloon. Check if the catheter is in the bladder. If the patient feels pain when the balloon is inflated, it is necessary to stop. Deflate the balloon and advance the catheter another 2 inches and try to inflate the catheter balloon again.
Fix the catheter and attach the urinal.

How to remove a urinary catheter?

Indwelling catheters can be removed in two ways. The first method is to attach a small syringe to the opening of the catheter. Remove all liquid. Slowly withdraw the catheter.

Caution: Never remove your indwelling catheter unless your doctor has instructed you. Remove the catheter only after the permission of the doctor.

Some urologists instruct their patients to cut the catheter balloon inflation tube above the main tube. After all the water has drained out, slowly withdraw the catheter. Be careful not to cut the catheter elsewhere.

If you cannot remove the urinary catheter with little effort, inform your doctor immediately.

Tell your doctor if you don't pass urine within 8 hours after the catheter is removed, or if your stomach is swollen and hurts.

Short term (intermittent) catheters

Some patients require intermittent bladder catheterization. These people need to be taught how to insert a catheter on their own to drain the bladder when needed. They do not need to wear a urinal all the time.

People who may use intermittent catheterization include:

Any patient who is unable to properly empty their bladder
men with large prostates
People with damage to the nervous system (neurological diseases)
Women after certain gynecological surgeries

The process is similar to the procedures described above. However, the balloon does not need to be inflated and the catheter is removed immediately after the flow of urine has stopped.

The article is informational. For any health problems - do not self-diagnose and consult a doctor!

V.A. Shaderkina - urologist, oncologist, scientific editor

Carrying out diagnostics and a therapeutic course in some cases requires the installation of a catheter in the patient's bladder. Most often, the tube is inserted through the urethra, but placement through the abdominal wall, located in front, is also possible. The catheter performs such important functions:

removes urine;
flushes the bladder;
helps to administer the medicine.

Catheterization is used in such cases:

If urine does not pass or passes very weakly, not in full. This is observed with prostate adenoma, if the blockage of the urethra with stones is disturbing, the diagnosis is paralysis or paresis of the bladder, which appeared due to lesions in the spinal cord, after operations.
You need to examine the bladder urine.
The patient does not come out to urinate on his own, for example, if he is going through a coma.
If the patient is concerned about cystitis, it is more effective to prescribe a bladder lavage through a catheter.

Do not rush to put a catheter, even if there is evidence for this. First, check the contraindications when it is dangerous to place a catheter:

suffers from an acute inflammatory process affecting the urethra caused by gonorrhea;
There is an injury to the urinary sphincter.

That is why experts advise patients to be extremely frank with their doctor. Otherwise, you can invite big trouble.

How to choose a catheter for a particular patient

Catheters are sold in pharmacies of two types:

soft instrument - equipped with a flexible tube with thick walls, 25 to 30 cm long;
rigid, in which metal is present. The tube is curved, for women - 12-15 cm long, and for men - 30 cm. The instrument has a rod, a beak and a handle.

The use of a rigid catheter is gradually becoming a thing of the past. The soft catheter does not injure the urethra and performs the same functions. The one who inserts the tube puts a disinfectant on his hands, otherwise you can bring an infection into the genitals of a sick man or woman. The tube is inserted as carefully as possible, the task of the nurse is not to violate the integrity of the walls of the urethra. Make sure that the catheter packaging is sealed!

How to put a catheter in a woman

Due to the short length of the urethra, it is not difficult to place a catheter in a woman. The process consists of the following manipulations:

The nurse enters to the right of the patient.
She spreads the woman's labia with her hand.
Apply water to the vulva and then add an antiseptic.
Further, an instrument pre-treated at the inner end with vaseline oil is inserted into the opening of the urethra, located outside.
Fluid should flow from the tube, if the discharge does not go away, the procedure must be repeated. If the patient has pain, the nurse should take this into account.

The subtleties of installing a catheter in the bladder of a man

The male urethra is longer and narrower. It may not be possible for everyone to freely insert a tube from the first eye. Follow these instructions:

The nurse should stand up from the patient on the right side.
The health worker treats the head of the penis with an antiseptic, you need to smear the external opening of the urethra well.
Glycerin or liquid paraffin is applied to the tube, after which it is grasped with tweezers and distributed in the urethra. The penis is supported with the left hand.
Push the tool a little, you can resort to translational rotational movements. In the supposed site of narrowing of the urethra, the man is asked to take a deep breath, he will relax the muscles of the smooth muscles, and the catheter will pass more easily.
If the patient complains of soreness in the urethra, stop and wait until the urethra is relaxed. Use the deep breath technique. The appearance of highlights indicates that the object has reached its final destination.

If soft tubing is ineffective

This happens if a man suffers from urethral strictures or is worried about prostate adenoma. If it is impossible to do without a tube that will bring out the discharge, they resort to the use of a metal tool.

Movements must be careful, haste can harm the patient:

The nurse takes a position to the left of the patient.
After treating the head and opening of the urethra with an antiseptic agent, the penis is positioned vertically.
With the free hand, the tube is inserted so that it takes a horizontal direction, the beak should look at the floor.
Advance the catheter with your right hand, as if pulling the penis on the instrument, until the beak disappears into the urethra.
Point the penis towards the abdomen, lift the free end of the tube and, considering this position, insert to the base of the penis.
Next, the tube should be transferred to the vertical.
Slightly, with little effort, press down on the end of the tool, capturing the lower part of the penis.
When the anatomical narrowing of the urethra is behind, the catheter is tilted towards the perineum.
When it enters the bladder, the resistance goes to "no", urine flows out of the tube.

Leave the handset in this position. It is impossible to rotate and move the instrument even further, this will lead to injury to the patient's bladder.

A visual video instruction on bladder catheterization is presented below:

Insertion of a urinary catheter- a procedure performed in a hospital by a nurse and urological doctors. Bladder catheterization in women, men and children is different, as are the devices themselves.

The placement of a urinary catheter can only be done in a hospital.

Indications for a urinary catheter

The installation of a urinary catheter is indicated in the following conditions:

Urinary retention due to infection and surgery.
Unconscious state of the patient with uncontrolled outflow of urine.
Acute inflammatory diseases of the urinary organs, requiring lavage and administration of drugs into the bladder.
Injury to the urethra, swelling, scars.
General anesthesia and postoperative period.
Spinal injuries, paralysis, temporary incapacity.
Severe circulatory disorders of the brain.
Tumors and cysts of the urinary organs.

In inflammatory diseases of the urinary organs, the installation of a urinary catheter is indicated.

Also, catheterization is carried out if it is necessary to take urine from the urinary bladder.

Types of catheters

The main type of device used in urology is the Foley catheter. It is used for urination, washing the urinary bladder for infections, to stop bleeding and injecting drugs into the genitourinary organs.

What this catheter looks like can be seen in the photo below.

Foley catheter comes in different sizes

There are the following subspecies of the Foley device:

Two-way. It has 2 holes: through one, urination and washing is performed, through the other, liquid is injected and pumped out of the balloon.
Three-way: in addition to standard moves, it is equipped with a channel for the introduction of medicinal preparations into the patient's urinary organs.
Foley-Timman: has a curved end, is used for prostate catheterization in men with a benign tumor of the organ.

A Foley catheter can be used for procedures on any urinary tract. Duration of operation depends on the material: devices are available in latex, silicone and silver-plated.

The following devices can also be used in urology:

Nelaton: straight, with a rounded end, consists of a polymer or rubber. It is used for short-term bladder catheterization in cases where the patient is unable to urinate on his own.
Timman (Mercier): silicone, elastic and soft, with a curved end. Used to drain urine in male patients suffering from prostate adenoma.
Pizzera: A rubber appliance with a bowl-shaped tip. Designed for continuous drainage of urine from the bladder through a cystostomy.
Ureteral: a long PVC tube 70 cm long placed with a cystoscope. It is used for catheterization of the ureter and renal pelvis, both for the outflow of urine and for the administration of drugs.

Nelaton's catheter is used for short-term bladder catheterization

All types of catheters are divided into male, female and children:

female - shorter, wider in diameter, straight shape;
male - longer, thinner, curved;
children - have a smaller length and diameter than adults.

The type of device installed depends on the duration of catheterization, sex, age and physical condition of the patient.

Types of catheterization

According to the duration of the procedure, catheterization is divided into long-term and short-term. In the first case, the catheter is installed on a permanent basis, in the second - for several hours or days in a hospital.

Depending on the organ undergoing the procedure, the following types of catheterization are distinguished:

urethral;
ureteral;
renal pelvis;
bladder.

Urethral catheterization

Also, catheterization can be divided into male, female and children.

Preparation for bladder catheterization

The procedure does not require special preparation. Before catheterization, the patient should wash himself, if necessary, shave the hair in the intimate area.

The nurse or attending physician should sterilize and prepare the necessary instruments for use. The catheterization kit includes the following:

sterile tray for instruments;
diaper or oilcloth;
disposable rubber gloves;
rubber antiseptic;
gauze napkins;
vaseline or glycerin;
tweezers;
Janet's syringe;
furacilin solution;
2 new catheters.

Catheterization kit

You may also need a container to collect urine for analysis.

Before the procedure, the specialist washes his hands thoroughly, puts on disposable gloves and treats them with an antiseptic preparation. The tip of the selected device is lubricated with petroleum jelly or glycerin.

Algorithm of actions when installing a urinary catheter

In order for catheterization not to harm the body, you should read the instructions for its implementation. Procedures for inserting a catheter are different for men, women, and children.

Carrying out catheterization in women

The installation of a urological catheter in women is performed as follows:

The patient takes a horizontal position: lies on her back, bends her knees, spreads them apart. A diaper is placed under the buttocks of the patient.
The labia is washed away, treated with an antiseptic and pushed apart.
The entrance to the urethra is treated with a solution of furacilin.
A tube soaked in petroleum jelly is inserted into the urethra using tweezers.
When the device is inserted 7 cm deep, urine begins to flow through the tube. The second end of the catheter is fixed in the urinal.

Depending on the purpose of the procedure, it may end at this point, or continue with flushing, drug administration, and further removal of the device.

Due to physiological characteristics, women tolerate this procedure much easier than men.

Setting technique for men

The setting of a urethral catheter for men is carried out as follows:

The patient lies in a horizontal position, on his back. The legs are bent at the knees and spread apart. An oilcloth is placed under the buttocks.
The penis is wrapped with a napkin, the urethra is treated with a solution of furacilin and wiped.
The catheter is taken with tweezers, inserted into the urethral canal. The penis is slowly and gently pulled over the tube until it advances to the external sphincter.
The device is slowly lowered into the scrotum until the obstacle is overcome.
The second end of the catheter is fixed in the urinal. The specialist waits for the outflow of urine from the bladder to begin.

Urethral catheter in men

Further instructions depend on how long the catheter is placed. For short-term use, after the outflow of urine or the introduction of drugs, the device is removed. With prolonged use, catheterization ends after insertion.

If the procedure was carried out correctly, there is no pain.

How is a catheter placed in children?

The general algorithm for installing a catheter for children does not differ from the adult instructions.

There are important features when performing the procedure in children:

The urethral catheter for children should have a small diameter so as not to damage the genitourinary organs of the child.
The device is placed on a full bladder. You can check the fullness of the organ using ultrasound.
Treatment with medicines and strong antibacterial compounds is prohibited.
Pushing the labia in girls should be done carefully so as not to damage the frenulum.
The introduction of the tube should be soft, slow, without force.
It is necessary to remove the catheter as soon as possible so as not to provoke inflammation.

The procedure in children, especially in infants, should be handled by a urologist with a pediatric education.

Caring for your urinary catheter

An indwelling urinary catheter must be carefully cared for to avoid urinary tract infections. The processing algorithm looks like this:

Lay the patient on his back, place an oilcloth or vessel under the buttocks. Drain the drain fluid and carefully remove the device.
Drain the urine from the drainage bag, rinse it with water, treat with an antiseptic: Chlorhexidine, Miramistin, Dioxidine, boric acid solution.
Flush the catheter with a 50 or 100 mg syringe. Pour an antiseptic into it, and then rinse with running water.
In case of inflammatory processes of the urinary tract, treat the catheter with a solution of furacilin, diluting 1 tablet in a glass of hot water.

Miramistin - antiseptic for the treatment of the urinal

The urinal must be emptied 5-6 times a day, and washed with antiseptics at least 1 time per day. The catheter should be processed no more than 1-2 times a week.

In addition, it is necessary to thoroughly wash the patient's genitals.

How to change the catheter yourself at home?

Performing a catheter replacement at home is a dangerous procedure that can cause serious injury to the urinary organs. Self-administration of the procedure is only permissible for a soft urethral device, and with a serious need.

To replace the device, the old catheter must be removed:

Empty the urinal. Wash your hands with soap and put on gloves.
Lie in a horizontal position, bend and spread your legs to the sides.
Flush the tube of the device and genitals with an antiseptic or saline solution.
Locate the bottle opening of the device. This is the second hole not used for urine output and bladder lavage.
Empty the balloon with a 10 ml syringe. Insert it into the hole and pump out the water until the syringe is completely filled.
Gently pull the tube out of the urethra.

Correct position for catheter replacement

After removing the device, a new one is inserted into the urethra, according to the above instructions for representatives of different sexes.

The nurse should change the ureteral and renal pelvic catheters. The replacement and removal of the suprapubic (bladder) device is handled by the attending physician.

Possible complications after the procedure

Pathologies resulting from catheterization include:

damage and perforation of the urethral canal;
trauma to the urethral bladder;
urethral fever;
urinary tract infections.

Incorrect catheterization may cause inflammation of the urethra

You can avoid these complications if you use a soft catheter and carry out the procedure in medical institutions, with the help of a nurse or attending physician.

Bladder catheterization is used for stagnation of urine and infections of the genitourinary system. With a properly selected device and compliance with its setting, the procedure is unable to harm the patient and cause discomfort.