Urinary catheterization



The process of urinary catheterization uses a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into the bladder through the urethra. 



It allows urine to drain from the bladder for collection. 



It may also be used as a conduit to inject liquids used for treatment or diagnosis of bladder conditions. 



While  a clinician usually performs the procedure, self-catheterization is also possible. 



A catheter may be in place for long periods of time- indwelling catheter.



A catheter can be removed after each use as intermittent catheterisation,



There are several types of catheters.



A Foley catheter is retained by means of a balloon at the tip that is inflated with sterile water. 



((Foley catheter))  balloons typically come in two different sizes: 5 cm3 and 30 cm3, and are commonly made in silicone rubber or natural rubber.



An intermittent catheter or Robinson catheter,  is a flexible catheter that is removed after each use. 



The intermittent catheter,  unlike the Foley catheter, has no balloon on its tip and cannot stay in place unaided. 



The intermittent catheter, can be non-coated or coated for use.



A coudé catheter, is designed with a curved tip that makes it easier to pass through the curvature of the prostatic urethra.



A hematuria catheter is a type of Foley catheter used for gross hematuria:


There are both two-way and three-way hematuria catheters with double and triple lumens.



A condom catheter is an external catheter that can be used by males and carries a lower risk of infection than an indwelling catheter.



Catheter diameters are sized by the French catheter scale, with the most common sizes are 10 F (3.3mm) to 28 F (9.3mm). 



The catheter  selected is  a size large enough to allow free flow of urine, and large enough to control leakage of urine around the catheter. 



Larger sized catheters are necessary when the urine is thick, bloody, or contains large amounts of sediment. 



Large urinary catheters are more likely to damage the urethra. 



Silicone or Teflon types of catheters can be used with latex allergy.



Indications for urinary catheterization include acute or chronic urinary retention, procedures that may limit a patient’s movement, the need for accurate monitoring of input and output, benign prostatic hyperplasia, incontinence, and surgical interventions involving the bladder, prostate or bowel.



Intermittent self-catheterization is useful in cases of neurogenic bladder due to damage to the spinal cord or brain. 



Intermittent self-catheterization performed by the patient four to six times a day, using a clean technique. 



A catheter that is left in place is generally attached to a drainage bag to collect the urine. 



Using a drainage bag allows for measurement of urine volume. 



Drainage bags are three types.



Leg bag 



Down drain that may be used overnight. 



A belly bag and is secured around the waist.



The leg bag, a smaller drainage device that attaches to the leg. 



The leg bag is usually worn during the day, as it fits under pants or skirts.



A down drain that may be used overnight, and is hung on a hook under the patient’s bed.



The belly bag and is secured around the waist, and can be worn at all times.



Patients undergoing major surgery are often catheterized.



Catheterization can have both short and long term complications. 



Long-term catheterization of urinary catheterization carries higher risk of complications: urinary tract infection, sepsis, urethral injury, skin breakdown, bladder stones, and hematuria.



Urinary tract infection risk of catheterization is the reason it is the last resort for the management of incontinence.



Bladder spasms may occur with catheterization and may be more common in males. 



 Bladder spasms may occur, when the catheter is blocked by blood, thick sediment, or a kink in the catheter or drainage tubing. 



Spasms can be caused by the catheter irritating the bladder, prostate, or penis. 



Bladder spasms can be controlled with medication such as butylscopolamine.



Most patients eventually adjust to the irritation and the bladder spasms abate.



Catheter and drainage bag precautions to prevent infection:



Cleansing the urethral area.



Cleansing the catheter itself.



Disconnecting drainage bag from catheter only with clean hands



Disconnecting drainage bag as seldom as possible.



Keeping drainage bag connector as clean as possible.



Drinking sufficient liquid to produce at least two liters of urine daily.






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