Assosa University

Health science college

Department of nursing

For: 2nd YEAR PHO students

By: Birhanu A

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 Chapter 6
Urinary
Catheterization

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 Learning Objectives
 At the end of this chapter students will be able to know :
Explain purpose of catheterization
Identify different types of catheters
Describe indication of catheterization
Demonstrate sterility technique through out the
catheterization.
Intervene the procedure for those in need of it
with understanding of both male and female
patient.
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 Urinary Catheterization
 Urinary Catheterization is a sterile procedure that
accomplished by inserting a catheter (a hollow tube,
often with inflatable balloon tip) into the urinary bladder
An invasive procedure that should only be carried out by
a qualified competent health care professional using
aseptic technique because
 Catheterization is considered as the most prominent
cause of nosocomial infections.

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 Indications
Catheterization of the urinary tract should only be done
when if there is a specific and adequate clinical
indication( purpose )are there.
A. Diagnosis purposes
•Urine collection (sterile specimen)
•Post void residual (PVR)
•Instillation of contrast

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 B. Therapy purposes
• 1. Relief of obstruction
 Clots (3-way catheter used)
 Strictures
 BPH
• 2. Monitor U/O
• 3. Management of neurogenic bladder
• 4. To empty the bladder before, during and after
surgery
• 5.unconscious patients

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 Contraindications
Urethral trauma

Pelvic fracture

Urethral obstruction

Bladder neck masses

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 Types of Catheter

 Type of catheter Based on route

 Urethral, and
 Supera-pubic
 Type of urethral catheter:
 Straight (plain/Robinson)
 Retention (Foley/indwelling)
 Coude (elbowed)

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 Types of Catheters

Straight Condom
Indwelling

Suprapubic

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 Straight Catheter
Also called a red-rubber catheter or plain
catheter.
It is a single lumen and do not have a
balloon near the tip.
Straight catheter is inserted only for as
much time as it takes to drain the bladder
or obtain urine specimen so, placed into
the bladder for short periods of
time(5-10min).

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 Straight Catheter

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 purpose
To relieve discomfort due to bladder
distention
To assess the residual urine
To obtain a urine specimen
To empty the bladder prior to surgery

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 Indwelling Catheter
• Also called foley or retention catheter.
 are those placed into the bladder for
extended periods of times.
 these catheters have a balloon at the distal
end that is inflated after insertion but not for
straight catheter
N.B: The balloon holds the catheter in place for
a duration of time.

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• This Indwelling Catheter have 2 or 3 lumen,
• one lumen use for the urine drainage by
connecting with urine collection bag
• the 2nd lumen is used for inflation of the
balloon near the tip
• N.B: The most commonly indicated balloon size is 10ml. But
we need always inflate the balloon as the manufacturers
recommended volume
• if the catheter have 3rd lumen
• The 3rd lumen used for irrigation.

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Two Way and three way Foley Catheter

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 Urinary Drainage Bag

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 purpose
• To manage incontinence
• To provide for intermittent or continuous
bladder drainage and irrigation
• To prevent urine from contacting an incision
after perennial surgery (prevent infection)
• To measure urine output needs to be
monitored hourly

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 Coude catheter
• Also known as elbowed catheter:- which is
curved tip, that used for elderly men who
have benign prostate hyperplasia (BPH)-

Coude Catheter

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 Supra-pubic catheter
• Suprapubic - means the area just above your
pubic bone, above the level of your pubic hair.
• This type of catheter is inserted through a
small incision above the pubic area directly
into the urinary bladder through the
abdominal wall.
• Used for continuous drainage.
• More hygienic than ureteral, as it is away from
the genital area where infection has an easy
passage to the bladder.
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 Indications
• Suprapubic catheterization is indicated when
urethral catheterization is contraindicated or
technically not possible to relieve urinary
retention due to the following conditions:
• Urethral injuries
• Urethral obstruction
• Bladder neck masses
• Benign prosthetic hypertrophy (BPH)
• Prostate cancer
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 Condom Catheter
• It is soft, flexible device made of plastic or rubber
material which is applied externally to the penis.
• Condom catheter is not inserted into the urethra.
Purpose
 When voluntary control of urination is not possible for
male clients.
 If there is urinary incontinence
 Alternative solution after trail of indwelling catheter
or straight catheter

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 Condom Catheter

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 Equipment
• Sterile •Syringe
• catheter •Sterile water
• A bowl for antiseptic •Lubricant
• Cotton swab Clean
• Gauze Rubber and draw sheet
• Sterile towel •Antiseptic solution
• Forceps ( 3) •Receiver
• Sterile receiver • Urinary drainage bag
• Kidney dish •Screen
•Adhesive plaster

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 Procedure
Male client
• Position: supine with leg
abducted slightly, pines pull
upward and forward 90 0 from front (above the
• Cline the genital: clean the
penis with circular motion
center to outward
• Insert: around 20cm
• Lubricant : use water
soluble jelly
Female client
• Position: dorsal recumbent
• Cline the genital: clean
urethral opening ) to back
• Insert: insert around 5 cm
• Lubricant :use water soluble
jelly

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We need identify the urethral
orifice for female client

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 Procedure
 Prepare the client and equipment for perennial wash
 Position the patient – dorsal recumbent
 Wash the perennial area with warm water and soap
 Rinse and dry the area
 Prepare the equipment
 Create a sterile field
 Clean the area with antiseptic solution.
 Lubricate the insertion tip of the catheter (5-7 cm in
females)

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 Con’t
 Expose the urinary meatus adequately by retracting
the tissue or the labia minora.
 Retract the fore skin of uncircumcised male.
 Grasp the penis firmly behind the glans and hold
straighten.
 Insert the catheter into the urethral orifice.
 Insert 5 cm in females and 20 cm in males or until
urine comes.
 Collect the urine – for specimen (about 30 ml)
 Empty or drain the bladder and remove the catheter

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 Note:
 If resistance is encountered during insertion, do not
force it – forceful pressure can cause trauma.
trauma
 Ask the client to take deep breaths - relaxes the external
sphincter (slight resistance is normal).
 Dorsal Recumbent position is better:
– Female- for a better view of the urinary meatus and
reduce the risk of catheter contaminate.
– Male- allows greater relaxation of the abdominal and
perennial muscles and permits easier insertion of the
tube.

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 In case of indwelling
 After catheter insertion, the balloon is inflated to hold
the catheter in place within the bladder.
 The outside end of the catheter has two openings, one
to drain the urine, the other to inflate the balloon.
 The balloon of the catheter is located behind the
opening at the insertion tip.
 This ensures that the balloon is inflated inside the
bladder and not in the urethra (cause trauma).

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 Con’t
 Apply slight tension on the catheter until you feel
resistance:
 Resistance indicates that the catheter balloon is
inflated appropriately and that the catheter is well
attached in the bladder
 Connect the catheter to the drainage system &
Secure it to thigh or abdomen.

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 Con’t

 Place drainage bag below level of the bladder.

 Evaluate catheter function & amount, color, odor and
quality of urine.
 Remove gloves & wash your hands.
 Document what you have done.

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During Removal of indwelling
catheter
Withdraw the solution or air from the balloon
using a syringe.
And remove gently

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