Urinary Catheterization

Overview :

Intermittent catheterization is performed a minimum of four times a day by the patient or a care giver. The genital area near the urethral opening is wiped with an antiseptic agent, such as iodine. A lubricant may be used to facilitate the entry of the catheter into the urethra, and a topical local anesthetic may be applied to numb the urethral opening during the procedure. One end of the catheter is placed in a container, and the other end is inserted into and guided up the urethra until urine flow begins. When urine flow stops, the catheter may be moved or rotated, or the patient may change positions to ensure that all urine has emptied from the bladder. The catheter is then withdrawn, cleaned, and sterilized for the next use. Recommended cleaning practices vary, from the use of soap and water to submersion in boiling water or a disinfectant solution. Some patients prefer to use a new catheter with each insertion.

Nonintermittent catheterization, which is initiated in a hospital or nursing home setting, uses the same basic technique for insertion of the urinary tract catheter. The catheter is inserted by a nurse or other health care professional, and remains in the patient until bladder function can be maintained independently. When the catheter is removed, patients will experience a pulling sensation and may feel some minor discomfort. If the catheter is required for an extended period of time, a long-term, indwelling catheter, such as a Foley catheter, is used. To prevent infection, it should be regularly exchanged for a new catheter every three to six weeks.

Use of indwelling catheters should be restricted to patients whose incontinence is caused by urinary tract obstruction that can not be treated, and for which alternative therapy is not feasible.