How to insert a bladder catheter. Types of urological catheters and features of their use

In this article we will look at how to place a urinary catheter in a woman.

People very often have to get acquainted with a wide arsenal of all kinds of medical instruments. And one of them is a urinary catheter for women and men. What is it and why is it used at all?

Main purpose

Why is a urinary catheter required for women and men? In urology, catheters of various shapes and sizes are used to perform certain activities. The device is selected individually for each patient. At the outlet, such a probe is usually connected to a drainage bag, that is, directly to a collector designed to collect urine.

The bag is fixed on the patient's leg so that he can move freely and the collector can be used throughout the day. At night, larger containers are used that are hung from the bed.

Indications for the procedure are:

• The need to obtain bladder urine for analysis.
• The presence of inflammatory diseases of the bladder in women.
• The appearance of acute or chronic urinary retention.

Description

A catheter is a tube designed to create a kind of passage between the internal cavities of the body and the external environment. An instrument is used to inject medicinal solutions, and, in addition, to rinse the organ and perform surgical procedures.

A urinary catheter is required for women and men to achieve forced emptying of the organ. For example, catheterization may be required immediately after childbirth, when the woman in labor is unable to urinate on her own for the first time. Sometimes the procedure is performed due to damage to the bladder. For example, due to injury, the lumen often closes, and urine is not naturally excreted from the human body. In a number of situations, the use of female urological catheters is required during the examination to make a diagnosis. It is often necessary:

• Determination of the volume of urine present in the bladder.
• Obtaining a sterile portion of urine for analysis.
• Performing X-rays of the urethra and bladder by injecting a contrast component into the organs.

Types of catheters

There are many types of urinary catheters today. The type of medical instrument chosen directly depends on the specific case, for example:

• A device called a Foley catheter is used for long-term catheterization (when patients are in a coma). It is also suitable for short-term manipulation. It is used for washing, eliminating blood clots, draining urine, and so on.
• The Nelaton Catheter is designed for periodic catheterization in situations where the patient cannot independently urinate. Until the invention of the Foley catheter, this device was intended for continuous use.
• A device called a Pezzer Catheter is well suited for maintaining continuous catheterization and drainage of urine through a cystostomy. This tool, unfortunately, has quite a lot of shortcomings; therefore, they work with it only in the absence of other possibilities.

Which ones are used more often?

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

Difference between female and male models

The difference between a female and a male urological catheter is determined by the anatomical features of the body. Although the purpose of the devices can be said to be the same, they still differ in structure:

• Male models are intended for insertion into narrow and curved urethra, which is why the tube is made thin and long.
• Urinary catheters for women are made with a short, wide and straight urethra in mind, so such an instrument is endowed with the appropriate characteristics, that is, a relatively large diameter, short length and the complete absence of any bends.

Today, urological catheters are available in most medical stores. Usually in the description of each such product it is indicated for which gender of the patient this or that instrument is designed. The approximate cost of the product ranges from nine to two and a half thousand rubles. The price largely depends on the type of catheter, and at the same time on the place of purchase and the material of manufacture.

How is a urinary catheter placed in a woman?

Installation Features

This procedure itself is not at all difficult, since the female body is very convenient for inserting a tube. For example, in a man, in order to be able to get to the bladder, you will need to overcome the genital organ. But in women, the urethra is located directly behind the labia.

Let’s take a closer look at how a catheter is placed in a woman’s bladder.

Before the catheterization procedure, the patient must take a shower, wash thoroughly and come to the room for manipulation. If the procedure is carried out to collect urine, then at first the doctor or nurse may try to do without inserting an instrument into the urethra. For this:

• The patient needs to lie down on a couch on which a diaper or oilcloth has been previously spread.
• Next, the bent legs must be spread apart so that a bedpan can be placed between them in order to accumulate urine.
• A warm heating pad is placed on the patient's lower abdomen. This helps stimulate reflex urination. For similar purposes, the genitals can be watered with slightly heated water.

Stages of catheterization

How to insert a urinary catheter into a woman, what are the stages of the procedure? In cases where urination cannot be provoked, doctors proceed to the catheterization procedure. It includes the following main steps:

• Carrying out disinfection of the urethra.
• Carefully insert the catheter into the urethra at a distance of five to seven centimeters. In this case, the doctor will need to keep the patient’s labia apart.
• Collecting urine, which flows through the tube into a container prepared for this purpose.
• Then, if necessary, perform the following procedure (that is, wash the bladder, administer medications, etc.).

Every specialist with the appropriate qualifications knows how to place a catheter in a woman’s bladder.

What are the inconveniences?

Despite the fact that catheterization is much less unpleasant for women than for men, this kind of manipulation is still quite stressful. Many patients do not experience any particular pain or any other physical discomfort, but they absolutely always have to experience obvious psychological inconvenience. A good doctor manages to create a trusting and at the same time calm atmosphere in which women feel relaxed. It is very important that the patient is not afraid or embarrassed, then the procedure will be very easy, painless and fairly quick.

In simple situations, catheterization can be performed by a nurse, for example when a diagnosis needs to be confirmed. In the event that the manipulation is performed for medicinal purposes, then only a qualified doctor should work. It is important to do catheterization very carefully, since a sharp or too fast movement can damage the urethra, causing an inflammatory process (such as cystitis or urethritis).

The female urinary catheter is one of the medical achievements whose importance is very great and cannot be overestimated. Thanks to this simple device, diseases of the urinary system simply cease to be difficult for people: they are easier to recognize and treat. It would be superfluous to recall patients suffering from severe brain or back injuries, when the use of a catheter is one of the main conditions for providing comprehensive care for the patient. How to insert a catheter into a woman’s bladder is now clear.

For what pathologies is catheterization necessary?

So, catheterization of an organ such as the bladder in women is a procedure necessary in a number of cases with the development of pathologies of this organ. The procedure itself involves inserting a catheter in the form of a flexible latex tube, which can also be made of silicone or Teflon. Such a tube can pass through the urethra directly to the bladder.

Often, the need for the described event in women arises in the postoperative periods against the background of gynecological or diseases. Catheterization is done to control the volume of urine produced. In addition, it can promote the healing of postoperative wounds.

In some situations, the procedure is required for patients to rinse in case of bleeding, administration of medications, detection of general obstruction, urine output due to neurological pathologies (paralysis), incontinence or retention in a number of certain diseases.

For cancer

Bladder cancer, which is often diagnosed in women, often requires the insertion of a catheter. Typically, this disease can develop against the background of papillomas. In this case, as a rule, patients have an excessive amount of blood in their urine, which is very easily detected even with the naked eye.

Cancer is often diagnosed in smokers and those who work with aniline dyes. Often, such a pathology develops against the background of chronic inflammation of this organ, after irradiation, and in those who often do not urinate on demand. Various sweeteners and a number of medications also have an effect.

We looked at how to place a urinary catheter in a woman. This procedure is very useful, necessary for carrying out in the presence of pathologies of the bladder.

Bladder catheterization is a widespread medical procedure that can be performed for both diagnostic and therapeutic purposes. Placing a catheter is not difficult, but you need to know all the intricacies of the manipulation and have good command of the technique, otherwise complications are possible.

What is the procedure

Catheterization involves inserting a thin tube (catheter) through the urethra into the inside of the bladder. Manipulation can only be carried out by an experienced specialist - a urologist or a nurse with certain skills.

The procedure itself can be short-term or long-term:

• For a short period of time, a catheter is installed during surgical interventions on the urinary organs or after surgery, as well as for diagnostic purposes or as an emergency aid for acute urinary retention.
• A transurethral catheter is placed for a long time for certain diseases when urination is seriously difficult or impossible.

The advantage of the procedure is that thanks to it you can quite easily carry out certain diagnostic measures, for example, taking a portion of sterile urine for analysis or filling the bladder space with a special contrast agent for subsequent retrograde urography. Urgent drainage in some situations may be the only way to empty a full bladder and avoid hydronephrosis (a pathology characterized by dilation of the renal pelvis followed by atrophy of the parenchyma). For bladder diseases, transurethral catheterization is an effective way to deliver medications directly to the site of the inflammatory process. Urinary drainage through a catheter can also be part of the care program for seriously ill bedridden patients, especially the elderly.

Bladder catheterization is performed for diagnostic and therapeutic purposes.

The disadvantages of the procedure include a high risk of complications, especially if the catheter is inserted by an inexperienced healthcare worker.

Excretion of urine can be carried out using different devices. Catheters that are placed for a short time can be soft (flexible) or hard:

• Flexible ones are made of rubber, silicone, latex, they come in different sizes. The Tieman or Nelaton models are most often used. They can be placed by a mid-level health worker with experience in performing such manipulations.
• Rigid catheters are made of metal - stainless steel or brass. Only a urologist can introduce such a design. Rigid catheters are used only at one time.

A metal catheter can only be inserted by a urologist.

Indwelling catheters, intended for long-term use, can be of different shapes and configurations - have 1,2 or 3 strokes. Most often, a latex Foley catheter is installed, which is fixed in the lumen of the bladder by a small balloon filled with sterile saline solution. Due to the risk of complications (urethritis, prostatitis, pyelonephritis, orchitis), it is recommended to leave the catheter in the urethra for no longer than 5 days, even if accompanied by antibiotics or uroantiseptics. If longer-term use is required, designs with nitrofuran coating or silver plating are used. Such devices can be changed once a month.

Soft catheters come in different models and sizes

There is another method of draining the bladder - through a puncture in the abdominal wall. For this purpose, special suprapubic devices are used, for example, a Pezzer catheter.

Catheterization of the bladder can be not only transurethral, ​​but also percutaneous suprapubic

Indications and contraindications for catheter installation

Catheterization can be performed for therapeutic purposes:

• with acute or chronic urinary retention;
• if independent urination is impossible, for example, if the patient is in a state of coma or shock;
• for postoperative restoration of the urethral lumen, urine diversion and diuresis recording;
• for intravesical administration of medications or rinsing of the bladder cavity.

Through transurethral drainage of the bladder, diagnostic tasks are also achieved:

• collection of sterile urine for microbiological analysis;
• assessment of the integrity of the excretory tract in various injuries of the pelvic region;
• filling the bladder with a contrast agent before X-ray examination;
• carrying out urodynamic tests:
  • determination and removal of residual urine;
  • bladder capacity assessment;
  • diuresis monitoring.

Bladder catheterization is usually performed in the postoperative period

Transurethral catheterization is contraindicated in the following conditions:

• acute pathologies of the genitourinary organs:
  • urethritis (including gonorrheal);
  • orchitis (inflammation of the testicle) or epididymitis (inflammation of the epididymis);
  • cystitis;
  • acute prostatitis;
  • abscess or neoplasm of the prostate;
• various urethral injuries - ruptures, damage.

How does catheter placement occur in men?

The procedure is carried out with the consent of the patient (if he is conscious), and the medical staff is obliged to inform about how the manipulation will be carried out and why it is needed. Most often, a flexible catheter is inserted.

Due to the pain and risk of injury, transurethral drainage with a metal catheter is rarely performed and only by an experienced urologist. Such manipulation is required for strictures (pathological narrowings) of the urethra.

To carry out the procedure with a flexible catheter, the nurse prepares sterile instruments and consumables:

• gloves;
• disposable catheter;
• medical oilcloth;
• forceps for working with consumables;
• tweezers for inserting a catheter;
• sterile dressing material;
• trays;
• Janet syringe for rinsing the bladder.

Before the procedure, the health care provider must inform the patient about the upcoming catheterization

Pre-sterilized petroleum jelly, a disinfectant solution for treating the hands of medical staff, for example, Sterillium, a solution of furatsilin or chlorhexidine for disinfecting the penis are also prepared. Povidone-iodine can be used to treat the urethral outlet, and Kategel (gel with lidocaine and chlorhexidine) can be used for local anesthesia.

If there is a strong spasm of the sphincter (closing muscle) of the bladder, preparation is carried out before the procedure: apply a warm heating pad to the suprapubic area and inject an antispasmodic - a solution of No-shpa or Papaverine.

Gel Cathegel with lidocaine is intended for pain relief and prevention of complications during bladder catheterization

Sequence:

1. The patient is placed on his back with his legs slightly apart, having previously laid down an oilcloth.
2. Hygiene treatment of the genitals is carried out by wetting a napkin in an antiseptic solution, while the head of the penis is washed with a disinfectant solution from the opening of the urethra downwards.
3. After changing gloves, the penis is taken with the left hand, wrapped in a gauze cloth and straightened perpendicular to the patient’s body.
4. The foreskin is pushed down, exposing the urethral outlet, the area is treated with an antiseptic - Povidone-iodine or chlorhexidine, and Katedzhel (if available) is injected into the urethra.
5. Treat the end of the tube that will be inserted with Cathegel or Vaseline oil.
6. Using sterile tweezers, held in the right hand, the catheter is clamped at a distance of 50–60 mm from the beginning, the end is pinched between two fingers.
7. Carefully insert the end of the tube into the urethral opening.
8. Slowly move the tube along the canal, intercepting it with tweezers, while carefully pulling the penis up with your left hand, as if “stringing” it onto a catheter. In areas of physiological narrowing, short stops are made and the tube continues to be advanced with slow rotational movements.
9. There may be resistance when entering the bladder. In this case, they pause and ask the patient to take slow, deep breaths several times.
10. After inserting the tube into the cavity of the bladder, urine appears from the distal end of the catheter. It is poured into a tray provided.
11. If a permanent catheter is inserted with a urine bag, then after urine flows out, the fixing balloon is filled with saline solution (5 ml). The balloon will hold the drainage in the bladder cavity. After this, the catheter is connected to a urinal.
12. If you need to rinse the bladder cavity, this is done using a Janet syringe after the outflow of urine. Usually a warm solution of Furacilin is used.

Video: bladder catheterization technique

When determining significant resistance to the advancement of the catheter along the urethra, you should not try to overcome the obstacle by force - this can lead to serious complications, including rupture of the urethra. After 2 unsuccessful attempts to perform transurethral catheterization of the bladder, it is necessary to abandon it in favor of other techniques.

Catheterization with a rigid instrument requires even greater caution. The insertion technique is similar to catheterization with a soft tube. After standard hygienic treatment of the genitals, a sterile metal catheter is inserted into the urethra with the curved end downwards. Carefully move along the canal, pulling up the penis. To overcome the obstacle in the form of a muscle sphincter created by the bladder sphincter, the penis is positioned along the midline of the abdomen. The successful completion of the administration is indicated by the flow of urine from the tube and the absence of blood and pain in the patient.

Catheterization of the bladder with a metal catheter is a complex procedure that can lead to injury to the urethra or bladder

Traditionally, a catheter is inserted into the urethra of men without anesthesia, and to facilitate the sliding of the tube, it is simply treated with sterile glycerin or petroleum jelly. When my husband was in the urology department, the procedure was performed this way for the first time. Moreover, everything was done very quickly and rather roughly. The husband complained that there was very little pleasant about it. Severe discomfort during and after the procedure: burning, false urge to urinate, nagging pain in the lower abdomen. Going to the toilet for another two days was accompanied by noticeable pain. The next time we had to insert a catheter, we asked to use Katedzhel and a catheter of a smaller diameter. The manipulation was carried out by another nurse, and she acted very carefully: she advanced the catheter slowly, paused, giving the husband the opportunity to relax and breathe calmly. Anesthesia and the correct technique did their job - there was practically no pain and after removing the catheter, the discomfort went away much faster.

Removing the catheter

If the purpose of catheterization was a one-time excretion of urine, after completion of this process the tube is slowly and carefully removed, the urethral outlet is treated with an antiseptic, dried, and returned to the place of the prepuce.

Before removing the indwelling catheter, use a syringe to release the fluid from the balloon. If it is necessary to rinse the bladder cavity, do this with Furacilin solution and remove the catheter.

Possible complications

The procedure is intended to alleviate the patient’s condition, but if the technique or asepsis rules are not followed, it can lead to complications. The most serious consequence of unsuccessful catheterization is injury to the urethra, its perforation (rupture) or damage to the bladder neck.

The most serious complication of the procedure is urethral perforation

Other complications that may arise after manipulation:

• Arterial hypotension. The vasovagal reflex - a sharp excitation of the vagus nerve, which causes a decrease in blood pressure, a decrease in pulse, pallor, dry mouth, and sometimes loss of consciousness - occurs as a response to moderate pain or discomfort when a catheter is inserted or to the rapid collapse of an overly distended bladder. Hypotension may develop later after drainage against the background of increased post-obstructive diuresis.
• Micro- or macrohematuria. The appearance of blood in the urine most often occurs due to rough insertion of the tube with injury (deposition) of the mucous membrane.
• Iatrogenic paraphimosis is a sharp compression of the head of the penis at its base by a dense ring of preputial tissue (foreskin). The cause of this phenomenon may be gross exposure of the head and prolonged displacement of the foreskin during catheterization.
• Ascending infection is one of the most common complications caused by neglecting the rules of asepsis. The introduction of pathogenic microflora into the urinary tract can lead to the development of urethritis (inflammation of the urinary canal), cystitis (inflammation of the bladder), pyelonephritis (inflammation of the pelvis and kidney parenchyma) and ultimately lead to urosepsis.

One of the possible complications of bladder catheterization is ascending infection.

Due to the high risk of complications, bladder catheterization in men is used only for absolute indications.

Despite the possible discomfort that the patient may experience when inserting a catheter, often this procedure can bring considerable benefits and become one of the stages on the path to recovery.

Catheterization is used to diagnose and treat certain diseases of the lower urinary system. Men are less susceptible to such diseases.

Female genitourinary system

Therefore, it is much more common for a woman to have a catheter inserted through the urethra into the bladder. How is this manipulation carried out?

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.

Cystoscopy

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.

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.

Catheter placement

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.

Installation of a urinary catheter- a procedure performed in a hospital by a nurse and urological doctors. Bladder catheterization differs between women, men, and children, as do the devices themselves.

A urinary catheter can only be installed in a hospital.

Indications for installation of a urinary catheter

Installation of a urinary catheter is indicated for the following conditions:

1. Urinary retention as a result of infections and surgical interventions.
2. Unconscious patient with uncontrolled outflow of urine.
3. Acute inflammatory diseases of the urinary organs, requiring lavage and administration of medications into the bladder.
4. Injury to the urethra, swelling, scars.
5. General anesthesia and postoperative period.
6. Spinal injuries, paralysis, temporary incapacity.
7. Severe cerebral circulatory disorders.
8. Tumors and cysts of the urinary organs.

For inflammatory diseases of the urinary organs, installation of a urinary catheter is indicated.

Catheterization is also carried out if it is necessary to collect urine from the urinary bladder.

Types of catheters

The main type of device used in urology is the Foley catheter. It is used for urination, washing the urine bladder during infections, to stop bleeding and administering medications to the genitourinary organs.

You can see what this catheter looks like in the photo below.

Foley catheter comes in different sizes

There are the following subtypes of the Foley device:

1. Two-way. It has 2 openings: through one, urination and rinsing are performed, through the other, liquid is introduced and pumped out of the balloon.
2. Three-way: in addition to standard moves, it is equipped with a channel for introducing medications into the patient’s genitourinary organs.
3. Foley-Timman: has a curved end, used for prostate catheterization in men with a benign tumor of the organ.

A Foley catheter can be used for procedures on any urinary organ. The service life depends on the material: devices are available in latex, silicone and silver-plated.

The following devices can also be used in urology:

1. Nelaton: straight, with a rounded end, made of polymer or rubber. Used for short-term catheterization of the bladder in cases where the patient is unable to urinate on his own.
2. Timmana (Mercier): silicone, elastic and soft, with a curved end. Used to drain urine in male patients suffering from prostate adenoma.
3. Pezzera: A rubber device whose tip is shaped like a plate. Designed for continuous drainage of urine from the bladder through a cystostomy.
4. Ureteral: a long PVC tube 70 cm long, installed using a cystoscope. Used for catheterization of the ureter and renal pelvis both for the outflow of urine and for the administration of drugs.

The Nelaton catheter is used for short-term catheterization of the bladder

All types of catheters are divided into men's, women's and children's:

• female - shorter, wider in diameter, straight in shape;
• men's - longer, thinner, curved;
• children's - have a smaller length and diameter than adults.

The type of device installed depends on the duration of catheterization, gender, age and physical condition of the patient.

Types of catheterization

Based on the duration of the procedure, catheterization is divided into long-term and short-term. In the first case, the catheter is installed on a permanent basis, in the second - for several hours or days in a hospital setting.

Depending on the organ undergoing the procedure, the following types of catheterization are distinguished:

• urethral;
• ureteral;
• renal pelvis;
• vesical.

Urethral catheterization

Catheterization can also be divided into male, female and pediatric.

Preparing for bladder catheterization

The procedure does not require special preparation. Before catheterization, the patient should wash himself and, if necessary, shave the hair in the intimate area.

The nurse or attending physician must sterilize and prepare the necessary instruments for use. The catheterization kit includes the following:

• sterile tray for instruments;
• diaper or oilcloth;
• disposable rubber gloves;
• antiseptic for rubber processing;
• gauze napkins;
• Vaseline or glycerin;
• tweezers;
• Janet syringe;
• furatsilin solution;
• 2 new catheters.

Catheterization kit

You may also need a container to collect urine for analysis.

Before performing the procedure, the specialist thoroughly washes his hands, puts on disposable gloves and treats them with an antiseptic. The tip of the selected device is lubricated with Vaseline or glycerin.

Algorithm of actions when installing a urinary catheter

To prevent catheterization from harming the body, you should read the instructions for its implementation. The steps for inserting a catheter are different for men, women, and children.

Carrying out catheterization in women

Installation of a urological catheter in women is performed as follows:

1. The patient takes a horizontal position: lies on her back, bends her knees, spreads them apart. A diaper is placed under the patient’s buttocks.
2. The labia are washed, treated with an antiseptic and pulled apart.
3. The entrance to the urethra is treated with a solution of furatsilin.
4. A tube soaked in Vaseline is inserted into the urethra using tweezers.
5. When the device is inserted 7 cm deep, urine begins to flow through the tube. The second end of the catheter is fixed in the urinal bag.

Depending on the purpose of the procedure, it can end at this point, or continue with rinsing, administering medications and further removing the device.

Due to physiological characteristics, women tolerate this procedure much easier than men.

Staging technique for men

Placement of a urethral catheter for men is carried out as follows:

1. The patient lies in a horizontal position on his back. Legs are bent at the knees and spread apart. Oilcloth is placed under the buttocks.
2. The penis is wrapped in a napkin, the urethra is treated with furatsilin solution and wiped.
3. The catheter is taken with tweezers and inserted into the urethral canal. The penis is slowly and gently pulled onto the tube until it moves towards the external sphincter.
4. The device is slowly lowered into the scrotum until the obstacle is overcome.
5. The second end of the catheter is fixed in the urine bag. The specialist waits for the outflow of urine from the bladder.

Urethral catheter in men

Further instructions depend on how long the catheter is placed. For short-term use, the device is removed after urine drainage or medication administration. For long-term use, catheterization is completed after insertion.

If the procedure was carried out correctly, there is no pain.

How is a catheter placed in children?

The general algorithm for installing a catheter in children does not differ from adult instructions.

There are important features when performing the procedure in children:

1. The urethral catheter for children should have a small diameter so as not to damage the child’s genitourinary organs.
2. The device is placed on a full bladder. You can check the fullness of the organ using ultrasound.
3. Treatment with medications and strong antibacterial compounds is prohibited.
4. In girls, you need to spread the labia carefully so as not to damage the frenulum.
5. The insertion of the tube should be gentle, slow, without applying force.
6. The catheter must be removed as soon as possible so as not to provoke inflammation.

The procedure in children, especially infants, should be performed by a urologist with pediatric training.

Urinary catheter care

An indwelling urinary catheter should be carefully cared for to avoid urinary tract infections. The algorithm for processing it looks like this:

1. Place the patient on his back, place an oilcloth or bedpan under the buttocks. Drain the drainage fluid and carefully remove the device.
2. Drain the urine from the drainage bag, rinse it with water, treat it with an antiseptic: Chlorhexidine, Miramistin, Dioxidine, boric acid solution.
3. Flush the catheter using a 50 or 100 mg syringe. Pour an antiseptic into it, and then rinse with running water.
4. For inflammatory processes of the urinary tract, treat the catheter with a solution of furatsilin, diluting 1 tablet in a glass of hot water.

Miramistin - antiseptic for treating urinals

The urine bag must be emptied 5-6 times a day and washed with antiseptics at least once a day. The catheter should be cleaned no more than 1-2 times a week.

In addition, it is necessary to thoroughly wash the patient's genitals.

How to change a catheter yourself at home?

Replacing a catheter at home is a dangerous procedure that can cause serious injury to the urinary organs. Carrying out the procedure yourself is only permissible for a soft urethral device, and if there is a serious need.

To replace the device, you must remove the old catheter:

1. Empty the urine bag. Wash your hands with soap and wear gloves.
2. Lie in a horizontal position, bend and spread your legs to the sides.
3. Wash the device tube and genitals with an antiseptic or saline solution.
4. Locate the device's cylinder opening. This is the second hole, not used for draining urine and flushing the bladder.
5. Empty the balloon using a 10 ml syringe. Insert it into the hole and pump out the water until the syringe is completely filled.
6. Gently pull the tube out of the urethra.

Correct position when changing the catheter

After removing the device, a new one is inserted into the urethra, according to the instructions given above for representatives of different sexes.

The nurse should change the ureteral and renal pelvic catheter. The replacement and removal of the suprapubic (vesical) device is performed by the attending physician.

Possible complications after the procedure

Pathologies resulting from catheterization include:

• damage and perforation of the urethral canal;
• injury to the urethral bladder;
• urethral fever;
• urinary tract infections.

If catheterization is performed incorrectly, inflammation of the urethra may occur.

These complications can be avoided if you use a soft catheter and carry out the procedure in medical institutions, with the help of a nurse or attending physician.

Bladder catheterization is used for urinary stasis and infections of the genitourinary system. If the device is correctly selected and its placement is observed, the procedure cannot harm the patient or cause discomfort.