home Calculators Types of urological catheters and features of their use. What is the renal catheterization procedure and what are its goals? Placement of a urinary foley catheter

Types of urological catheters and features of their use. What is the renal catheterization procedure and what are its goals? Placement of a urinary foley catheter

A sick woman often has to “get acquainted” with a wide arsenal of medical instruments. And one of them is a urinary catheter. What is it and why is it used?

What is a urinary catheter

A catheter is a tube designed to create a kind of “channel” between the external environment and the internal cavities of the body. An instrument is used to administer medicinal solutions, wash the organ, and perform surgical operations.

A urinary catheter is necessary to forcefully empty the bladder. For example, catheterization may be required after childbirth, when a woman is initially unable to urinate on her own. Sometimes the procedure is performed when the bladder is damaged: due to injury, the lumen often closes, and urine is not excreted from the body naturally.

In some cases, the use of a female urological catheter is required during the examination to make an accurate diagnosis. It is often necessary:

determine the volume of urine present in the bladder;
obtain a sterile sample of urine for analysis;
take an x-ray of the urethra and bladder by injecting a contrast component into the organs.

There are many types of urinary catheters. The type of tool chosen depends on the specific case. Exist:

Foley catheter. Suitable for both long-term catheterization (for example, when the patient is in a coma) and for short-term manipulations. Used for washing, removing blood clots, and draining urine.
Nelaton catheter. Designed for periodic catheterization in cases where the patient cannot independently urinate. Before the invention of the Foley catheter, it was intended for continuous use.
Pezzer catheter. Suitable for permanent catheterization and urine drainage through a cystostomy. The tool has many disadvantages, so they only work with it if there are no other options.

Urinary catheters are now predominantly flexible. Metal models are used very rarely: they are less comfortable for the patient and not very convenient to use. Catheters must be fixed after insertion; the doctor chooses the method for this, guided by the characteristics of a particular situation.

Urinary catheter: female and male - what is the difference

The difference between male and female urological catheters is due to the anatomical features of the body. Although the purpose of the instruments is the same, they are somewhat different in structure:

male catheters are designed for insertion into a narrow and curved urethra, so the tube is made thin, slightly curved and long;
female catheters are made with a wide, short and straight urethra in mind, so the instrument is endowed with the appropriate characteristics - a relatively large diameter, short length, and no bends.

Urological catheters are widely available in medical stores. Usually in the description of each product it is indicated for which gender of the patient the instrument is designed. The approximate price of the product ranges from 9 to 2500 rubles. depending on the type of catheter, material of manufacture and place of purchase.

How to place a female urinary catheter

The catheterization procedure itself is not complicated, since the female body is very “convenient” for inserting a tube. If in men, in order to get to the bladder, it is necessary to “overcome” the penis, then in women, the urethra is hidden directly behind the labia.

Before catheterization, the patient takes a shower, washes herself thoroughly and comes to the office for manipulation. If the procedure is to collect urine, the doctor or nurse may initially try to avoid inserting an instrument into the urethra. For this:

A woman needs to lie down on a couch, on which a diaper or oilcloth is first laid out.
Bent legs should be spread apart so that a vessel can be placed between them to collect urine.
A warm heating pad is placed on the patient's lower abdomen to stimulate reflex urination. For a similar purpose, they can pour slightly heated water over the genitals.

In cases where urination cannot be provoked, they proceed to catheterization. It includes the following main steps:

Disinfection of the urethra.
Carefully insert the catheter into the urethra at a distance of 5-7 cm. In this case, the doctor needs to keep the patient’s labia apart.
Collecting urine, which flows through a tube into a container prepared for this purpose.

Although catheterization is much less unpleasant for a woman than for a man, the manipulation is still quite stressful. Many patients do not experience severe pain or other physical discomfort, but they have to endure obvious psychological inconvenience. A good doctor knows how to create a trusting and calm atmosphere in which a woman will feel relaxed. It is important that she is not shy or afraid, then the procedure will be easy, quick and painless.

In simple cases, catheterization can be performed by a nurse, for example when a diagnosis needs to be confirmed. If the manipulation is performed for medicinal purposes, only a qualified doctor should work. It is important to do catheterization carefully, since sudden or too fast movements can damage the urethra and provoke an inflammatory process (cystitis, urethritis).

The female urinary catheter is one of the achievements of medicine, the importance of which can hardly be overestimated. Thanks to this simple tool, diseases of the urinary system are no longer so difficult: they are easier to recognize and treat. It would be superfluous to mention patients with severe back or brain injuries, when the use of a catheter is one of the main conditions for providing comprehensive care for the patient.

Carrying out diagnostics and a therapeutic course in some cases requires installing a catheter in the patient’s bladder. Most often, the tube is inserted through the urethra, but it is also possible to place it through the abdominal wall, located in front. The catheter performs the following important functions:

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

Catheterization is used in the following cases:

If urine does not come out or comes out very weakly, not in full. This is observed with prostate adenoma, if there is a concern about blockage of the urethra with stones, paralysis or paresis of the bladder is diagnosed, which appears due to lesions in the spinal cord, after surgery.
It is necessary to examine the vesicular urine.
The patient is unable to urinate on his own, for example, if he is experiencing a coma.
If the patient is concerned about cystitis, it is more effective to prescribe lavage of the bladder using a catheter.

Do not rush to insert a catheter, even if there are indications for it. First, check the contraindications when inserting a catheter is dangerous:

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 specific patient

Catheters are sold in pharmacies in two types:

soft instrument - equipped with a flexible tube with thick walls, 25 to 30 cm long;
hard, containing metal. The tube is curved, for women it is 12-15 cm long, and for men it is 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. A soft catheter does not injure the urethra and performs the same functions. The one who inserts the tube applies a disinfectant to his hands, otherwise an infection can be introduced into the genitals of a sick man or woman. The tube is inserted as carefully as possible; the nurse’s task is not to disrupt the integrity of the walls of the urethra. Make sure that the catheter packaging is sealed!

How to correctly insert a catheter into a woman

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

The nurse comes in to the patient's right.
Spreads the woman's labia with his hand.
Apply water to the vulva and then add antiseptic.
Next, an instrument pre-treated at the inner end with petroleum jelly is inserted into the opening of the urethra, located externally.
Liquid should flow out of the tube; if the discharge does not drain, the procedure must be repeated. If the patient experiences pain, the nurse should take this into account.

Subtleties of installing a catheter in a man’s bladder

In men, the urethra is longer and narrower. Not everyone may be able to insert the tube freely from the first eye. Follow these instructions:

The nurse should stand on the right side of the patient.
The health worker treats the head of the penis with an antiseptic; the external opening of the urethra should be well smeared.
Glycerin or petroleum jelly is applied to the tube, then grabbed with tweezers and distributed in the urethra. The penis is supported with the left hand.
Push the tool a little at a time, you can resort to translational rotational movements. At the supposed site of narrowing of the urethra, the man is asked to take a deep breath, this will relax the smooth muscle muscles, and the catheter will pass longer easily.
If the patient complains of tenderness in the urethra, stop and wait for the urethra to relax. Use a deep breath technique. The fact that the object has reached its final destination is indicated by the appearance of discharge.

If the soft tube is ineffective

This happens if a man suffers from urethral strictures or is bothered by prostate adenoma. If it is impossible to do without a tube that will bring the discharge out, they resort to using a metal instrument.

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, the penis is positioned vertically.
With your free hand, insert the tube 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 onto the instrument, until the beak disappears into the urethra.
Point the penis towards the stomach, lift the free edge of the tube and, taking this position into account, insert it to the base of the penis.
Next, the tube should be placed vertically.
Lightly, with little force, press the end of the instrument, grasping the lower part of the genital organ.
When the anatomical narrowing of the urethra is behind, the catheter is tilted towards the perineum.
When it enters the bladder, the resistance disappears and urine flows out of the tube.

Leave the handset in this position. You cannot rotate or move the instrument further, as this will lead to injury to the patient’s bladder.

A visual video instruction for bladder catheterization is presented below:

Bladder catheterization is a manipulation performed using a catheter (a special rubber tube) inserted through the urethra.

The procedure is simple, but you must have special skills and carefully observe a number of requirements (including sterility).

The procedure is performed in medical institutions and can be prescribed for diagnosis or treatment.

The need for catheterization occurs when:

Conducting laboratory diagnostics using bladder urine.
Injecting medications into the bladder.
Determination of residual urine volume.
Carrying out surgery using anesthesia or epidural anesthesia.
Washing the bladder.
Carrying out an X-ray examination (special substances are injected into the bladder).
Inability to urinate naturally.
Retention (acute, chronic) of urine.

Tools used

To perform catheterization in women you will need:

2 soft sterile catheters;
2 sterile cotton balls;
2 sterile gauze wipes;
tray;
kortsang;
furacillin solution;
petroleum jelly or glycerin;
container for urine;
oilcloth;
latex gloves;
washing tools;
syringes (for installation of medications).

And here you will find out what diseases CT scans of the kidneys are used to diagnose. The essence of the procedure, indications and contraindications.

Execution technique and procedure algorithm

The female urethra is short, so the procedure is not difficult. Bladder catheterization is performed using a sterile catheter (rubber or metal).

The nurse may perform the catheterization procedure using only a soft catheter.

The nurse prepares for the procedure (washes her hands thoroughly, treats them with a disinfectant) and prepares the necessary instruments (tray with sterile catheters, tweezers, sterile napkins).

The procedure consists of several stages:

After the procedure is completed, the patient should be helped to stand up, and the used instruments should be placed in a disinfectant solution (the catheter is placed in a 3% chloramine solution for 1 hour, after which it is treated in accordance with the requirements).

Consequences and complications

The purpose of catheterization is to alleviate the patient's condition.

However, in some cases, damage to the urethra occurs, and in more severe cases, it is perforated.

The procedure is performed without anesthesia so that the patient can report any pain.

If the catheter is inserted deeply, its tip will rest against the wall of the bladder.

It is possible to damage the bladder during insertion of the catheter if it is not filled enough. To prevent this situation, before insertion you should perform percussion (tapping) of the bladder in the area above the pubis.

Frequent catheterization in women can cause urethral fever, which develops as a result of microbes entering the circulatory system through areas of the urethra that have been damaged by medical instruments. It is characterized by elevated temperature and intoxication of the body. To prevent such a complication, you should inject a disinfectant solution into the bladder before removing the catheter from the urethra.

Complications that may arise during catheterization are due to a number of reasons:

use of force when inserting a catheter;
improperly installed metal catheter;
violation of aseptic rules during manipulation;
conducting an incomplete survey.

The main possible complications are:

injury to the walls of the urethra (including its complete rupture);
infection of the urethra with subsequent progression of urethritis, and subsequently cystitis and pyelonephritis.

Catheterization of the bladder with a soft catheter in women can reduce the likelihood of complications. It is unacceptable to perform catheterization on patients suffering from infectious diseases of the urinary tract or with a damaged urethra.

Endoscopic methods are very effective in diagnosing diseases, since the doctor can evaluate the internal state of the organ with his own eyes. , indications, stages and possible consequences, read carefully.

You will find out in the block what the leukocyte norm should be based on the results of a urine test. As well as the reasons for deviations from the norm.

Video on the topic

Catheterization is a manipulation to access the bladder cavity without violating the integrity of the skin - inserting a tube (metal or rubber catheter) into the urethral canal under sterile conditions. This allows the bladder cavity to be emptied.

This method is diagnostic or therapeutic. It allows you to remove all urine from the cavity of the bladder, rinse it and deliver medications to the emptied cavity, which will improve the process of exposure of the chemical to the source of the disease.

Main indications for the procedure

Contraindications

urethritis of an infectious nature;
anuria (lack of urine);
spastic narrowing of the urethral sphincter.

Types of bladder catheters

In medicine, only soft (most often) and hard catheters are used. What is a soft catheter? Catheterization of the bladder with a soft catheter is carried out with an elastic tube up to 30 cm long. The outer end has an extension in the form of a funnel or an oblique cut.

Metal or hard - it is a tube, the inner end of which is rounded. It has a beak, a rod and a handle. The catheter has a curved shape that follows the physiological curves of the urethra.

The length of a female catheter is different from that of a male catheter; it is 15-17 cm shorter.

Flushing through a Foley catheter is prescribed for people who have problems with the ureters (they are inflamed or narrowed).

Administration technique

The rules of antisepsis and asepsis must be followed to prevent infection from entering the urogenital area and penetrating higher. To do this, the urologist’s hands are treated with special disinfectant solutions. The catheter is pre-sterilized.

Catheterization of the bladder in women begins with a washing procedure, while in men the head of the penis is wiped with an antiseptic applied to a cotton ball. During catheterization, the patient lies on his back with his legs apart.

The procedure is performed by a nurse if a rubber type of catheter is used. Metal - inserted only by a doctor. Because this procedure is more difficult, if it is performed incorrectly, a number of complications may develop.

Carrying out the procedure in women

Bladder catheterization algorithm in women does not have any particular difficulties.

How to insert a catheter into a woman?

The nurse is located to the right of the patient and treats the genitals with an antiseptic. After this, the inner end of the catheter, lubricated with Vaseline oil, is gradually inserted into the opening of the urethral canal. The signal for reaching the bladder is the release of urine from the tube.

The urethra in women is shorter, so the procedure is easier with both a hard and soft catheter. Urine is discharged into a container placed between the patient’s legs.

If the insertion of the catheter causes pain, immediately voice your complaints to the medical staff.

Carrying out the procedure in men

The procedure in men is more complicated due to physiological features - a longer urethra - up to 25 cm. As well as two narrowings that prevent the passage of the catheter.

A hard catheter is used only in cases where it is impossible to insert a soft one. These are prostate diseases - adenoma and urethral strictures of various etiologies.

How to insert a catheter into a man?

After treatment with an antiseptic, a rubber catheter with petroleum jelly is inserted. The tube is held with tweezers to maintain sterility principles. In this case, it is gradually promoted until urine discharge appears. The procedure using a metal catheter is carried out only by a doctor, who inserts it, holding it in one position, to avoid trauma to the walls of the urethra.

If the instrument reaches the wall, urine will stop flowing. Then you need to pull the tube towards you by 1-2 cm.

Why are catheters installed in the bladder for inflammation that occurs acutely or has a chronic course? In order to clean the cavity by rinsing it. Sometimes small stones and elements of the decay of tumor formations are removed this way. To do this, urine is removed, and then an antiseptic solution is injected. The fluid used for this procedure is filled into an Esmarch cup and connected to a urethral catheter. After this, the washing liquid is removed and the manipulation is repeated.

The result of the procedure should be a clean washing liquid. Antibacterial or anti-inflammatory agents are administered according to indications. After the procedure is completed, the patient should remain in a horizontal position for another 40-60 minutes.

Complications

Sometimes catheterization complications occur due to a number of reasons:

the examination was not carried out in full;
violation of asepsis rules;
violation of the rules for placing a bladder catheter, often a metal one;
catheterization using force.

Main complications:

infection with the occurrence of urethritis, cystitis or pyelonephritis of the bladder;
trauma to the walls of the urethra, including complete rupture of the urethra.

The first type of complications is recorded in both men and women. And the second is only for men. The use of a soft catheter reduces the incidence of complications several times.

Frequently asked questions and their answers

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Indications and contraindications

The main indications for catheterization are:

Urinary retention, which can occur with prostate adenoma, blockage of the urethra with stones, strictures of the urethra, paralysis or paresis of the bladder caused by lesions of the spinal cord, after surgical interventions, etc.
The need for laboratory testing of bladder urine.
A patient's condition in which independent urine drainage is impossible, for example, comatose.
Inflammatory diseases, in particular cystitis. In such cases, flushing the bladder through a catheter is indicated.
The need to administer medications directly into the bladder.

However, the procedure cannot always be performed even if indicated. Most often, this is prevented by acute inflammation of the urethra, which usually occurs with gonorrhea, spasm or injury to the urinary sphincter.

Attention! Before performing catheterization, the doctor must be informed about all changes in your condition, without hiding anything.

How is the procedure performed?

Today, doctors have two types of catheters at their disposal:

soft (rubber), looking like a flexible thick-walled tube with a length of 25–30 cm;
hard (metal), which are a curved tube 12–15 cm long for women and 30 cm for men with a rod, a beak (curved end) and a handle.

In most cases, catheterization of the bladder is performed with a soft catheter and only if this is impossible, a metal tube is used. The patient is placed on his back, a small pillow is placed under the buttocks, which can be replaced with a towel folded several times, and the patient is asked to spread his legs apart and bend his knees. A container designed to collect urine is placed at the perineum.

As a rule, the procedure is performed by a nurse; the assistance of a doctor may only be required when installing a metal catheter in men. She must thoroughly clean the patient’s hands and genitals to avoid infection. The tube is inserted as carefully as possible so as not to injure the delicate walls of the urethra.

Attention! The procedure is performed exclusively with a sterile catheter, the packaging of which has not been prematurely damaged.

When performing instillation, the drug is administered through a catheter into the cavity of the bladder, after which the tube is immediately removed. If it is necessary to rinse the bladder in order to remove pus, small stones, tissue decay products and other substances, an antiseptic solution is injected into its cavity through an installed catheter using a Janet syringe or an Esmarch mug. After filling the bladder, its contents are sucked out and a new portion of the solution is introduced. Rinsing is carried out until the sucked liquid is completely clean.

Important: after rinsing the bladder, the patient should remain in a supine position for half an hour to an hour.

and in this case, you need to carefully follow all the rules of hygiene in order to avoid infection of the urinary organs, and handle the probe as carefully as possible, since sudden movements can cause it to be pulled out and cause injury. If the patient has any difficulties in caring for the permanent catheter, it begins to leak, the body temperature rises, or signs of inflammation appear, you should immediately consult a doctor.

Features of the procedure in women

Typically, catheterization of the bladder in women is easy and quick, since the female urethra is short. The procedure is carried out as follows:

The nurse stands at the patient's right side.
Spreads the labia with his left hand.
Treats the vulva with water and then with an antiseptic solution.
Insert the inner end of the catheter, pre-lubricated with petroleum jelly, into the external opening of the urethra.
Checks for any discharge from the tube, which indicates that the procedure was performed correctly and that the catheter has reached its destination.

Important: you should immediately tell your healthcare provider if you experience pain during the procedure.

Features of the procedure in men

Catheterization of the bladder in men causes more difficulties than manipulation in women. After all, the length of the male urethra reaches 20–25 cm, it is characterized by narrowness and the presence of physiological narrowings that prevent the free insertion of the tube. The procedure is carried out as follows:

The nurse stands to the patient's right.
Treats the head of the penis with an antiseptic solution, paying special attention to the external opening of the urethra.
Takes the catheter with tweezers and inserts the end of the rubber tube, pre-lubricated with glycerin or petroleum jelly, into the urethra, holding the penis with his left hand.
Gradually, without violence, he advances it, resorting to rotational movements as necessary. When reaching places of physiological narrowing of the urethra, the patient is asked to take several deep breaths. This helps to relax the smooth muscles and makes it possible to advance the tube further.
If during the manipulation a spasm of the urethra occurs, its execution is suspended until the urethra relaxes.
The end of the procedure is indicated by urine flowing out of the outer end of the device.

If the patient is diagnosed with urethral strictures or prostate adenoma, installation of a soft catheter may not be possible. In such cases, a metal device is inserted. For this:

The doctor stands to the right of the patient.
Treats the head and opening of the urethra with an antiseptic solution.
Use your left hand to hold the penis in an upright position.
With the right hand, insert the catheter so that its rod remains strictly horizontal and the beak is directed clearly downward.
Carefully pushing the tube with your right hand, as if pulling the penis onto it, until the beak is completely hidden in the urethra.
Tilts the penis towards the abdomen, lifts the free end of the catheter and, maintaining this position, inserts the tube to the base of the penis.
Moves the catheter to a vertical position.
Lightly presses the index finger of the left hand on the tip of the tube through the lower surface of the penis.
After successful passage of the physiological narrowing, the catheter is deflected towards the perineum.
As soon as the beak of the device penetrates the bladder, resistance disappears and urine begins to flow from the outer end of the tube.

Hidden dangers

Although the purpose of bladder catheterization is to alleviate the patient's condition, in some cases the procedure can result in damage or even perforation of the urethra, as well as infection of the urinary organs, that is, the development of:

cystitis,
urethritis,
pyelonephritis, etc.

This can happen if, during the manipulation, the rules of asepsis were not followed, errors were made when installing a catheter, especially a metal one, or the patient was not examined sufficiently.

But perhaps it would be more correct to treat not the effect, but the cause?

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What is the purpose of catheterization?

A catheter is usually inserted before surgery. It remains in the bladder for some time after surgery.

In some diseases of the urinary system, the outflow of urine is impaired.

This can be caused by various reasons: obstruction of the urethra by a stone or tumor, neurogenic disruption of the innervation of the bladder muscles and urethral sphincters.

If the volume of the bladder increases critically, it is necessary to immediately insert a catheter to drain urine.

A catheter is also inserted to directly administer medications into the bladder.

Catheterization is often used for diagnostic purposes. A catheter is inserted to take urine for laboratory testing directly from the bladder, retrograde cystography and cystometry.

During cystoscopy, the inner mucous membrane of the bladder wall is examined. This method is the main one for diagnosing cystitis. Therefore, this procedure is most often performed on women.

This method also allows you to assess the condition of the ureters and treat some diseases of the lower urinary system.

For this manipulation, a special device is used - a cystoscope. There are three types: catheterization, operating and examination.

Using a viewing cystoscope, a visual examination of the inner surface of the bladder is performed. Before this, the bladder is washed to remove blood clots, if any, and the remaining urine is removed.

It is then filled with 200 ml of clear liquid and an optical system with lighting is inserted through the cystoscope. Based on the results of such a study, chronic or tuberculous cystitis and bladder cancer can be diagnosed.

Inside the catheterization cystoscope there are special channels for inserting the catheter, and at the end there is a lift that directs it directly into the ureter.

Through the operating cystoscope, the necessary instruments are inserted into the bladder to perform biopsy, lipotripsy, and electroresection.

Sometimes cystoscopy is performed using a contrast agent.

Cystometry allows you to evaluate the functioning of the muscles of the inner wall of the bladder and the sphincters of the urethra.

The manipulation is carried out as follows. First, a catheter is inserted into the bladder and residual urine is removed, then sterile water or an isotonic sodium chloride solution (saline) is injected through it.

The patient is asked to report when the urge to urinate can no longer be controlled. Then the catheter is connected to a special device called a cystometer.

It records bladder volume and intravesical pressure at maximum filling and subsequent urination.

Types of catheters

They are metal and flexible, made of rubber or silicone. They also vary in length and structure. The diameter is determined according to the so-called Charrière scale; there are 30 sizes in total.

Their length ranges from 24 to 30 cm. Short ones are used by women, long ones by men. The upper end is rounded, there are holes on the side for urine drainage.

The structure of the catheter is divided into:

straight or curved beak;
body;
a pavilion that is connected to a special system through which contrast agents or medications are administered and urine is removed from the bladder.

The following types of catheters are most often used in urology:

Nelaton conical catheter with one hole, inserted briefly;
Timman catheter with a curved end, which facilitates its passage through the urethra;
a Foley catheter with two holes, through one the urine is removed, the other is used to fill a special balloon. Thanks to this balloon, it is firmly held in the urethra;
A three-way Foley catheter, in addition to the two listed holes, also has a third one, through which irrigation with antiseptic drugs is carried out; this procedure is carried out after surgery on the bladder in women or on the prostate gland in men.

Catheterization technique

A catheter is installed in a woman as follows.

The procedure is performed on a couch, bed or a special urological chair. The woman is asked to lie on her back, bend and spread her legs.

Then the nurse spreads the woman's labia, takes a cotton swab with antiseptic with forceps and treats the area around the external opening of the urethra.

To make catheter insertion easier and reduce discomfort, its beak is moistened with sterile petroleum jelly.

The catheter is then inserted a few centimeters into the woman's urethra.

If urine comes out of the catheter opening, it means that it has entered the bladder.

Its free end is inserted into a container for collecting urine or connected to a device for supplying a medicinal solution.

Contraindications and prevention of complications

During catheterization, there is a very high probability of infection and the onset of bacterial inflammation. Therefore, a few days before the procedure, a prophylactic course of antibiotics is prescribed.

Fluoroquinolones (eg, levofloxacin or sparfloxacin) or protected penicillins (Augmentin or amoxiclav) are usually prescribed.

Absolute contraindications to catheterization for both women and men are:

damage and inflammation of the urethra;
cystitis in the acute phase;
bleeding due to urethral trauma.

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Indications for the procedure

Most often, women are referred for catheterization in the following cases:

for collecting urine for analysis (unlike the usual collection of morning urine in a container, this method of collecting urine allows you to obtain for research a “cleaner” biological material without foreign impurities);
for filling the bladder with medications for the treatment of various diseases of the urinary system;
for washing and disinfecting the urinary tract (catheterization will help remove pus, sand, crushed small stones, etc. from the organ);
to study the volume of residual urine filling the urinary bladder;
to empty or fill the pelvic organ before an x-ray examination (during diagnostics, the urinary bladder must be empty or filled with a special contrast agent, which, when x-rayed, will color the internal organs and tissues, thanks to which the doctor will be able to get a more accurate idea of the condition of the urinary tract);
to remove urine when it is impossible to void on your own (urine retention, acute or chronic disturbance of normal urination, etc.)

Catheterization of the bladder with a soft catheter in women is done during surgical operations on internal organs, performed under local or general anesthesia. Catheters are also installed into the urine bladder for paralyzed people, patients who cannot move, are in a coma, etc.

Algorithm for bladder catheterization in women

The technique for catheterizing the bladder of men and women is, of course, very different. Installing a catheter into the female urethra will not cause any significant difficulties for an experienced doctor or nurse. Due to the fact that women have a short urethra, insertion of the catheter and its passage through the urinary tract is very quick and, in most cases, painless.

The correct technique for bladder catheterization in women is as follows:

the patient lies down on a special chair or couch, bends her legs at the knees and spreads them apart, a sterile diaper is placed under her hips, and a sterile container for collecting urine is placed nearby (the external genitalia must first be washed);
the doctor, whose hands are wearing sterile rubber gloves, carefully spreads the woman’s labia and treats the entrance to the urethra with a disinfectant solution of furatsilin (when processing, the movements of the hands should be directed from top to bottom);
after antiseptic treatment, the physician should use tweezers to take a sterile catheter, moisten its tip in petroleum jelly or glycerin, and then insert it into the female urethra approximately 4-5 cm with light circular movements, the second end of the catheter should be lowered into a container for receiving urine;
if the entire procedure was carried out correctly, and the catheter was completely inserted into the urine bladder, urine should flow into the urine collector;
if the purpose of catheterization was to collect urine, then when filling the urine collector, the catheter must be removed and the urine must be poured into a sterile test tube or container with a scale showing the volume of liquid;
if it is necessary to rinse or fill the bladder, pre-prepared drugs are introduced into the urinary tract through a catheter, after which the device is removed from the urethra;
after emptying the urinary bladder during urinary retention, the catheter must also be removed from the urethra;
the catheter must be removed using smooth circular movements; after it is removed, the urethra must be treated again with furatsilin, and the perineum must be blotted with a napkin;
It is best to remove the catheter from the urethra at the moment when there is still a little fluid left in the bladder, because residual urine should flush the urinary tract after catheter removal.

After catheterization, the doctor must place all used instruments in a disinfectant solution; reuse of untreated devices is unacceptable.

Tools used

According to medical standards, when performing catheterization in women, a physician must use the following instruments and consumables:

sterile soft catheters of different sizes;
tweezers;
urine collector;
tray for used tools;
sterile wipes and cotton balls;
disposable syringes (for administering medicinal solutions);
medical gloves;
oilcloth;
furatsilin in the form of a solution;
glycerin or petroleum jelly.

Consequences and complications of the procedure

If the catheter size is incorrectly selected, its abrupt installation, or non-compliance with the rules, serious complications can occur in the woman’s body.

There are two most common consequences that appear after catheterization:

damage to the walls of the urethra and the bladder itself (ranging from minor injuries to ruptures);
infection in the urinary tract and, as a consequence, the development of cystitis, urethritis and other similar diseases.

If there is a sharp rise in temperature, symptoms of intoxication and pain in the lower abdomen that occurs after catheterization, the woman should urgently seek medical help.

Diagnosis and treatment of certain diseases of the urinary system require catheterization of the bladder. The essence of this procedure is the introduction of a special hollow tube into the organ cavity. As a rule, this is done through the urethra, although in some cases the manipulation can be performed through the anterior abdominal wall.

The catheter itself in the bladder is used to remove urine, flush the organ, or directly administer medications.

Indications and contraindications

The main indications for catheterization are:

Urinary retention, which can occur with prostate adenoma, blockage of the urethra with stones, strictures of the urethra, paralysis or paresis of the bladder caused by lesions of the spinal cord, after surgical interventions, etc.
The need for laboratory testing of bladder urine.
A patient's condition in which independent urine drainage is impossible, for example, comatose.
Inflammatory diseases, in particular cystitis. In such cases, flushing the bladder through a catheter is indicated.
The need to administer medications directly into the bladder.

Attention! Before performing catheterization, the doctor must be informed about all changes in your condition, without hiding anything.

How is the procedure performed?

Today, doctors have two types of catheters at their disposal:

soft (rubber), looking like a flexible thick-walled tube with a length of 25–30 cm;
hard (metal), which are a curved tube 12–15 cm long for women and 30 cm for men with a rod, a beak (curved end) and a handle.

Attention! The procedure is performed exclusively with a sterile catheter, the packaging of which has not been prematurely damaged.

Important: after rinsing the bladder, the patient should remain in a supine position for half an hour to an hour.

Indwelling urinary catheter

In cases where a permanent catheter is installed in a patient, a urine bag is attached to his thigh or at the bedside, which is usually required at night or for collecting urine in bedridden patients. In this case, you must carefully follow all the rules of hygiene to avoid infection of the urinary organs, and handle the probe as carefully as possible, since sudden movements can cause it to be pulled out and cause injury. If the patient has any difficulties in caring for the permanent catheter, it begins to leak, the body temperature rises, or signs of inflammation appear, you should immediately consult a doctor.

Features of the procedure in women

Typically, catheterization of the bladder in women is easy and quick, since the female urethra is short. The procedure is carried out as follows:

The nurse stands at the patient's right side.
Spreads the labia with his left hand.
Treats the vulva with water and then with an antiseptic solution.
Insert the inner end of the catheter, pre-lubricated with petroleum jelly, into the external opening of the urethra.
Checks for any discharge from the tube, which indicates that the procedure was performed correctly and that the catheter has reached its destination.

Important: you should immediately tell your healthcare provider if you experience pain during the procedure.

Bladder catheterization in women

Features of the procedure in men

The nurse stands to the patient's right.
Treats the head of the penis with an antiseptic solution, paying special attention to the external opening of the urethra.
Takes the catheter with tweezers and inserts the end of the rubber tube, pre-lubricated with glycerin or petroleum jelly, into the urethra, holding the penis with his left hand.
Gradually, without violence, he advances it, resorting to rotational movements as necessary. When reaching places of physiological narrowing of the urethra, the patient is asked to take several deep breaths. This helps to relax the smooth muscles and makes it possible to advance the tube further.
If during the manipulation a spasm of the urethra occurs, its execution is suspended until the urethra relaxes.
The end of the procedure is indicated by urine flowing out of the outer end of the device.

Catheterization of the bladder in men with a soft catheter

If the patient is diagnosed with urethral strictures or prostate adenoma, installation of a soft catheter may not be possible. In such cases, a metal device is inserted. For this:

The doctor stands to the right of the patient.
Treats the head and opening of the urethra with an antiseptic solution.
Use your left hand to hold the penis in an upright position.
With the right hand, insert the catheter so that its rod remains strictly horizontal and the beak is directed clearly downward.
Carefully pushing the tube with your right hand, as if pulling the penis onto it, until the beak is completely hidden in the urethra.
Tilts the penis towards the abdomen, lifts the free end of the catheter and, maintaining this position, inserts the tube to the base of the penis.
Moves the catheter to a vertical position.
Lightly presses the index finger of the left hand on the tip of the tube through the lower surface of the penis.
After successful passage of the physiological narrowing, the catheter is deflected towards the perineum.
As soon as the beak of the device penetrates the bladder, resistance disappears and urine begins to flow from the outer end of the tube.

Hidden dangers

cystitis,
urethritis,
pyelonephritis, etc.

This can happen if, during the manipulation, the rules of asepsis were not followed, errors were made when installing a catheter, especially a metal one, or the patient was not examined sufficiently.