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Catheterisation and

Catheter Care

Catheterisation

Indications for
catheterisation

Retention of urine
Monitor urine output / acutely ill patient
Pre/peri/post-operatively
Assessment and investigations
Treatment (e.g. to instil chemotherapy)
Irrigation of bladder
Bypass an obstruction
Management of incontinence (as a last
resort)

Reasons for Female Urinary


Retention

Large fibroids
Pregnancy
Post partum- epidural/spinal
Urine infection
Post pelvic surgery
Post bladder surgery-TVT, anterior
and posterior repair, colposuspension

Reasons for Female Urinary


Retention
Constipation
Medication- anticholinergics,
antihistamines, morphine,
anaesthetic agents (atropine), botox,
alcohol
Genital herpes infection

Mode of catheterisation
Choices to be made:
Clean intermittent self
catheterisation
Suprapubic catheterisation
Urethral catheterisation

Catheter Selection
Points to consider;
Size
Balloon size
10ml for routine drainage, 30 ml for some
urology procedures only
Length
Female = 27cm, paediatric = 30 cm,
standard length = 40cm
Charriere size (1Ch = 0.3mm)
Material (consider latex allergy)
Drainage system (closed / link system)

Catheter Materials
Short-term materials
May stay in up to 3/52
Latex
PTFE coated latex
Siliconised latex
PVC

Long-term materials
May stay in up to 3/12
Silicone elastomer
(silastic)
Hydrogel coated
latex
Silver coated latex
100% silicone
100% silicone +
hydrogel coating

Drainage System: closed


system
Overnight drainage bag
/ 2 litre bed bag
For patients who are
bedbound or bed to
chair only
The bag attaches
directly to the catheter
and stays there for 7
days
Dont break/open the
system!

Link drainage system

Link system
Used for ambulant patients
Leg bag stays attached to catheter for 7
days and dont open this connection
Attach overnight 2 litre bag to end of leg
bag and open tap at night
Remove overnight bag in the morning,
empty and dispose of
Overnight bags are never to be re-used
the following night!

Catheter valves
No bag attached to catheter
Bladder fills and stores urine, lifting
bladder tissue off catheter tip
Discrete
But:
Patient needs good manual dexterity
Patient needs good cognitive ability to
remember to empty the bladder

Procedure
Patient preparation
- information
- consent
Aseptic technique
- to prevent the transmission of microorganisms either directly or indirectly,
thus reducing risk of infection

Equipment
Catheter pack
Two pairs sterile gloves
Sachet of normasol (to clean round
urethral meatus)
10ml syringe
Ampoule of sterile water for injections (if
not in pack with catheter)
Lubricant e.g. instillagel
6ml for females and 11ml for males

An appropriate catheter
Drainage system

Documentation
Date inserted &
date due to be
changed
Rationale for
catheterisation
Any problems
encountered
Size inserted

Batch / lot number


Expiry date
Fluid used in balloon
Type & volume

Volume of urine
drained
Drainage system
used

Risk of infection : CAUTI


Extraluminal contamination
on insertion, opportunistic
Intraluminal contamination
reflux
Bacteria > biofilm > alkaline urine >
crystallization > encrustation

Care

Meatal hygiene
Minimise handling
Maintain asepsis
Do not allow bag to become too full
Keep drainage bag below level of
bladder