Rigid urinary catheter. Types of urinary catheters and features of their use. Indications and contraindications for catheter placement

Bladder catheterization is a medical manipulation, which consists in inserting a catheter into. This procedure is carried out, regardless of the age and gender of the patient. Catheterization is carried out only in stationary conditions.

With the help of this manipulation, a normal outflow of urine is ensured. The introduction of the device is carried out in the external opening of the urethra. It is gradually advanced through the urethra.

When urine appears in the catheter, one can judge the correct and successful completion of the procedure. The manipulation should be carried out only by a specialist who has the appropriate medical education.

Indications and contraindications for the procedure

Catheterization should be carried out in strict accordance with the indications. Manipulation is prescribed if blood clots are observed in the organ. With the help of catheterization, a variety of diagnostic procedures are performed.

The use of the device is carried out for the introduction of contrast drugs. This manipulation is recommended before a cytourethrographic study.

Rigid

The catheter is made of a hard material and is characterized by a low level of flexibility. The use of the device is recommended for one-time collection of urine.

Robinson (Nelaton) catheter

The device is characterized by a high level of rigidity and is used for one-time collection of urine. The catheter is intended for patients who cannot empty themselves. Carrying out procedures using the device is carried out 4 to 5 times a day.

Tiemann system catheter

The Tiemann system is used when it becomes necessary to collect urine from patients with. With the help of the device, short-term catheterization is performed. The end of the device is characterized by the presence of a special bend, which ensures the most efficient removal of urine.

Foley catheter

Due to the universal design of the device, long-term catheterization is carried out. The maximum period of use of the device is 7 days. The material for the production of the device is hypoallergenic rubber, which makes it possible to use it for various categories of patients.

At the end of the device there is a special cylinder into which water, air or saline is launched. Thanks to this design of the device, it is most securely fixed in the bladder.

Pezter system catheter

The device is made of rubber, which provides it with a high level of flexibility. The tip of the device is made in the form of a plate, which makes it possible to securely fix it in the bladder. The device can be used for long-term urine collection.

Catheter Insertion Technique

To ensure the effectiveness of the procedure, it is necessary to insert the catheter in accordance with certain rules. Specialists use special equipment to perform the manipulation.

Among women

At placing a catheter in a woman's bladder consists in performing certain manipulations:

In men

The procedure for inserting a urinary catheter for men is slightly different, due to the anatomical features of their genitourinary system. It consists in performing such manipulations:

In children

In childhood, catheterization is carried out according to the same scheme as in adult patients. With the help of this manipulation, the normal outflow of urine is restored. A catheter is inserted into a small patient as carefully as possible. This is because the mucous membranes are overly sensitive.

Incorrect insertion of the device increases the risk of damage to them. For catheterization of children, devices of small diameters are used.

What are the possible complications?

Catheterization must be carried out in strict accordance with established rules. Otherwise, there is a risk of developing complications, which manifest themselves in the form of:

• cystitis;
• pyelonephritis.

These diseases are those that occur with improper disinfection of the urinary tract during the period of manipulation.

Improper manipulation can lead to accidental or damage to the walls of the urethra. Some patients experienced a sharp drop in blood pressure during the procedure.

During the procedure, against the background of damage, the development or perforation of the urethra can be diagnosed. With damage to the mucous membranes, the development of bleeding is observed.

Caring for a urinary tube

To avoid complications, it is necessary to properly care for the urinary probe. The urinal should be flushed with water regularly. To ensure effective cleaning of the device, it is recommended to add a small amount of vinegar to the water.

The urinal must be emptied every 3 hours. It must always be below the bladder. If urine leaks from under the device, it is recommended to urgently inform the doctor about this.

If you experience pain in the abdomen or a feeling of fullness, it is also recommended to consult a doctor. When the device is clogged, it is urgently replaced.

Probe removal process

Removal of the probe should be carried out in a hospital setting. It is strictly forbidden to independently perform this procedure.

Before removing the probe, hygienic procedures of the external genitalia are performed, as well as the treatment of the urethral canal with furatsilin. After that, the probe is removed by rotational movements.

At the next stage, the urethral canal is re-treated with an antiseptic solution.

Catheterization is an effective manipulation that ensures the outflow of urine from the bladder. The manipulation should be carried out in accordance with certain rules, which will exclude the possibility of complications.

Catheterization is the procedure of inserting a catheter (for men and women) into the bladder through the urethral canal. Catheterization is used quite often and is used for the purpose of diagnosis and therapy.

Rules for installing a catheter

The catheter can be installed for a short period of time, for example, a short-term installation of a catheter is necessary for surgical intervention, and for a long time if the patient has difficulty urinating. The latter can be caused by certain diseases.

The male can be affected by various pathological processes resulting from infection, trauma, and neoplastic syndrome. Violation of urination can provoke the development of such unpleasant consequences as kidney failure and infertility. In this article, we will consider in detail the algorithm for bladder catheterization in men.

Indications for the procedure

The catheter may be inserted for diagnostic purposes:

1. To obtain samples of urine in the cavity of the bladder. The samples are further used in laboratory research, for example, to determine the microflora of the bladder.
2. In order to determine the volume of urine that is excreted, to observe its organoleptic characteristics.
3. To determine the level of patency of the urinary tract.

During treatment

In addition, catheterization can be performed in the treatment of:

1. When restoring the urethra after surgery.
2. In the presence of decompression of the bladder.
3. In the presence of an acute urinary retention, which may occur against the background of urethritis, a pathological change that affects the prostate gland.
4. In order to treat the walls of the bladder with medicinal solutions.
5. With chronic obstruction, which can be caused by hydronephrosis.
6. For the purpose of excreting urine, if the patient is not able to perform the act of urination. For example, if the patient is in a coma.

The algorithm for catheterization of the bladder in men is quite complicated, but patients should not cause fear for their health, since experienced specialists are trusted to carry out this procedure.

Contraindications for catheterization

Despite the fact that there are many indications, catheterization can not always be performed. There are some contraindications:

• The presence of blood in the scrotum.
• The presence of bruising in the perineum.
• presence in the blood.
• Injured condition of the bladder.
• Injured condition of the urethra.
• Prostatitis in acute form.
• Anuria.
• Some diseases of the genitourinary system, for example, gonorrhea.
• Spasm of the urethral sphincter.
• Acute inflammatory processes occurring in the bladder or urethra.
• Fracture of the penis.

Features of catheterization in men

Due to the anatomical features of the urethra in men, only experienced specialists should perform the catheterization procedure. Difficulties in conducting catheterization arise due to the fact that the male urethra has a relatively large length, about 25 centimeters. In addition, there are two physiological constrictions in the urethra that prevent the free insertion of the catheter. Also, it is very narrow.

The greatest care must be taken if the procedure is performed using a metal catheter. If excessive force is applied during the manipulation, then the walls of the urinary system can be damaged, as a result of which the occurrence of false passages is not excluded.

The algorithm for catheterization of the bladder in men must be strictly observed.

Instruments used in catheterization

For the catheterization procedure, you will need the following tools:

Algorithm for bladder catheterization in men

If the procedure is performed using a soft catheter, then the specialist should perform the following steps:

1. The health worker must first prepare their hands, wash them thoroughly, and treat with a disinfectant solution.
2. The patient is laid on his back, his legs are slightly pushed apart, while the knees should be bent. A tray is required between the legs, and a diaper is placed under the pelvic area.
3. The medical worker should put on sterile gloves, clasp the penis below the head with a sterile napkin. This will open the external opening of the urethra.
4. Next, you need to treat the head with a cotton swab, previously moistened with furacilin. Processing should be carried out in the direction from the urethra to the edge of the head.
5. By squeezing the glans penis, it is necessary to open the external urethral opening. After the hole has opened, a few drops of sterile glycerin are poured into it.

With the help of tweezers, the catheter is captured, and its rounded hole is moistened with vaseline oil or glycerin. The catheter is then inserted into the open urethral opening. With the help of sterile forceps, the first five centimeters of the catheter are inserted, while holding the head.

Immersion of the catheter

It is necessary to immerse the catheter into the urethra slowly, intercepting it with tweezers. In this case, the penis must be pushed onto the catheter with the free hand. This technique will allow you to move the catheter through the urethra with greater ease. In the area at the junction of the membranous part and the spongy part, slight resistance may occur. If it occurs, then it is necessary to pause for two to three minutes to wait for the muscle spasm to disappear, and then continue inserting the catheter.

Physiological narrowing is also present at the entrance of the urethra to the bladder. In this area, the occurrence of re-introduction of the catheter is not excluded.

After the first portion of urine appears, the opposite tip of the catheter must be lowered into the urinal.

Before the end of urination, the bladder must be washed. After that, observing safety measures, the catheter is carefully removed.

After the end of urine output, a Janet syringe filled with a furatsilin solution is attached to the catheter, which is poured into the bladder cavity very slowly. The volume of the injected solution should be about 150 milliliters. After that, the catheter is directed into the tray to remove the liquid. The washing procedure should be carried out until the contents of the bladder become clear.

After flushing is completed, the catheter is removed from the urethra by performing gentle rotational movements. After that, the external opening of the urethra is re-treated with a cotton ball, pre-moistened in a solution of furacilin. At the end of the catheterization procedure, all instruments should be placed in a disinfectant solution.

If the use of a soft catheter does not allow the procedure, then the use of a metal catheter will be required. A similar procedure for introducing a urinary catheter should be carried out exclusively by a qualified doctor, because the technique is very complex, requiring special care and attention.

The patient is placed on his back, the opening of the urethra is treated. I turn the catheter down with the “beak” and advance it along the urethra until it reaches the bladder. To overcome the sphincter area, the penis should be directed along the midline. The catheter is inserted further, slowly moving the urethra in the direction of the instrument.

If the procedure is performed correctly, then there is a discharge into the urine container, while the patient does not experience pain. Due to the fact that catheterization with a metal catheter is quite painful and traumatic, it is rarely performed.

Complications during catheterization

In some cases, some complications may occur, for example:

• Infection of the urinary system. As a result, pyelonephritis, cystitis, urethritis can develop.
• Damage to the urethra, sometimes significant, up to perforation.

Complications may arise due to errors made during the introduction of a catheter, especially a metal one, or due to insufficient preliminary examination of the patient. Most often, complications arise as a result of a violation of asepsis.

In order to recognize and treat a variety of diseases and dysfunctions of the female urogenital organs, endoscopic manipulations are often performed, one of which is the catheterization of the bladder of patients. This concept means the introduction of a special instrument into the indicated organ through the urethra.

Device and types of catheters

The catheter is an empty thin tube made of soft or hard material. It consists of an anterior, middle, and posterior portions, which are respectively called the beak, body, and pavilion. The beak is made in the form of a cylinder or a cone; it can be either bent at an angle of 20–35° or straight. There are one or two holes on the front of the catheter.

The instrument pavilion has been slightly expanded. This is provided so that the catheter does not accidentally slip into the bladder entirely and can be attached to a flexible system. With the help of the latter, the organ is washed or irrigated with medicinal solutions.

The number 1 indicates the beak of the catheter, the number 2 - the body, and the number 3 - the pavilion

The length of flexible catheters ranges from 22–38 cm, rigid ones - 11–16 cm. Short instruments are usually used for women.

Depending on the internal diameter, 30 calibers of catheters are produced. This size for each subsequent tool number is 1/3 mm larger than the previous one. The most commonly used catheters for adult women are 16-20 gauge.

According to the type of material they are made of, tools are hard, or rigid, and soft. The first are made of steel and have a smooth nickel-plated surface. Metal catheters do not change the angle of the beak.

Soft (elastic) catheters are less traumatic for patients; their introduction is better tolerated. The material for them can be polyethylene or rubber. Elastic instruments made of polymers can change the angle of the beak when heated, taking the shape of the urinary tract.

Various types of urological catheters: 1 - Nelaton; 2 - Timan; 3 - Pezzera; 4a, 4b - Maleko and Maleko - Casper; 5a, 5b, 5c - Foley

Catheters are single and reusable. The first are stored in sealed sterile bags. The latter need special treatment and sterilization before each reuse.

Single-use urological catheters should be taken out of the package before use

Aims and objectives of the procedure

The goals of performing bladder catheterization can be diagnostic, for example:

• detection of residual urine;
• calculation of organ capacity;
• infusion of a contrast agent into the bladder for subsequent X-ray images (cystograms);
• monitoring of urination after any injuries or surgical interventions;
• receiving a portion of urine directly from the bladder for laboratory analysis.

The first two indications for diagnostic catheterization are appropriate when a safer method for examining the bladder - ultrasonography - for some reason was not available or did not provide comprehensive information.

This procedure can also be prescribed to perform therapeutic measures, such as:

• release of the bladder from urine during its acute or chronic retention;
• washing the mucous membrane of the organ from the decay products of tumors, pus, remnants of stones and sand;
• injection of medicinal solutions into the bladder for their local effect on the affected mucous membrane;
• excretion of urine in paralyzed bedridden patients with dysfunctions of the organs of the lower half of the body.

When is catheterization not possible?

Do not perform catheterization under the following conditions:

• acute inflammation in the bladder or urethra;
• spasm of the locking mechanism of the bladder (manipulation will become possible after the use of antispasmodic drugs);
• hematoma or bruise of the perineum;
• mechanical damage to the urethra;
• urethral bleeding of unknown origin.

How women are catheterized

The female urethra is several times shorter than the male and much wider; it has a constant curvature. The urethra is directed from top to bottom along the anterior wall of the vagina to the pubic joint, ending with its external opening in the vestibule of the vagina. Due to these anatomical features, it is much easier for a woman to insert an instrument into the bladder than for a man.

Women have a short and wide urethra, so they can easily insert a catheter

Preparation for manipulation

Catheterization should be preceded by a detailed survey and study of the patient's history. The doctor finds out if she has cardiovascular diseases or allergies to the medications used; the results of laboratory tests of blood and urine are studied.

A gynecological examination of the genital organs is mandatory. This helps to determine the tactics of catheterization in the presence of tumor formations in the female reproductive system or in congenital malformations of the latter.

Execution technique

The introduction of a catheter into the bladder is performed under antiseptic conditions. The nurse performing the manipulation, before starting the procedure, treats her hands with an antiseptic, puts on sterile gloves and a mask.

Catheterization of the urinary organ in women can be carried out with both a rigid and a polyethylene device. To facilitate sliding along the urethra, the beak of the prepared instrument is lubricated with sterile liquid paraffin or glycerin.

The procedure is carried out in the following order:

1. The patient lies on a couch or gynecological chair with knees bent and legs spread apart.
2. The woman's body is covered with a clean sheet, leaving the external genitalia visible.
3. A container for urine is placed between her thighs.
4. The paramedic stands on the right side of the lying woman.
5. Having parted the large labia of a woman with the fingers of his left hand, with his right hand he makes a toilet of the external genitalia and the entrance to the urethra with a cotton swab dipped in a disinfectant solution.
6. If a soft catheter is used, then the physician grabs it with sterile forceps at a distance of 4-6 cm from the beak and introduces it into the urethra with smooth rotational movements. The outer part of the flexible instrument should be clamped between the extreme fingers (little and ring fingers) of the right hand, and it is better if an assistant holds it.
7. If the procedure is carried out with a female steel catheter, then it is taken in the right hand and carefully, without any effort, is inserted into the urethra.
8. Urine leakage from the outer end of the instrument is evidence that the catheter is in the bladder. The biological fluid is taken to a special tray.
9. If it is necessary to sanitize or irrigate the bladder after it has been emptied, a special large syringe filled with a drug is attached to the catheter.
10. After completion of the procedure, the device is carefully removed. If the patient's condition allows, she is recommended to wash the external genitalia with a weak solution of potassium permanganate or a decoction of chamomile for 2-3 days after catheterization.

The introduction of a metal catheter to a woman: the numbers 1, 2, 3 indicate the stages of the procedure; the arrows show the direction of movement of the tool

Sometimes there are cases when this manipulation must be done systematically or leave the device in the urinary organ for a certain time. Women, unlike men, usually easily endure many hours of stay of the urological tube in the urethra; they are less likely to experience complications of the procedure.

Long-term diversion of urine is carried out using a Foley balloon catheter. After the device is in the bladder, liquid is injected into the balloon and, if indicated, the organ is washed with an antiseptic solution (potassium permanganate 0.3: 1000 or Rivanol 1: 1000). A flexible catheter is fixed with adhesive tape on the patient's thigh and left in the bladder. After 5-6 days, it is removed and, if necessary, a new one is introduced.

Video: placing a flexible catheter in a woman

Possible consequences

Due to the ease of manipulation for women, they have practically no negative consequences. Sometimes during the insertion of the catheter, spasms or damage to the urethra, accompanied by bleeding, may occur. In such a case, the procedure must be terminated immediately. As a rule, this happens with strictures (cicatricial narrowing) of the lower urinary tract, which are much less common in women than in men.

In case of insufficient compliance with the sterility of the instruments and hands of a nurse, pathogens can be introduced into the urinary tract. The consequence of this is acute cystitis.

Another rare complication in female patients is the so-called urethral fever, which is expressed by chills and temperature fluctuations. This condition is treated with antibiotics and antipyretic drugs.

I am familiar with this procedure firsthand - I know from my own experience what bladder catheterization is. I had it done after a complicated birth right on the delivery table. This was needed to assess kidney function. I can only say one thing: after 14 hours of contractions and prolonged stitching of the tears, it cost me nothing to survive the introduction of a metal catheter into the bladder. I didn’t even feel it and didn’t immediately notice that I had some kind of cold instrument in my urethra. I lay with the catheter in the bladder for about an hour, after which the doctors safely took it out and said that urine was being excreted, which means that everything would be fine. If this procedure had happened at another time, maybe I would not have liked it, but immediately after the birth I almost did not feel it.

Inserting a catheter into the bladder is not the most pleasant manipulation for women, but you should not be afraid of it. With skillful and coordinated actions of the hands of a medical worker, it will not cause you the slightest discomfort. The procedure is necessary for the timely recognition and treatment of various diseases of the urinary system. For women, it is painless, and the introduction of an instrument into their bladder in the vast majority of cases does not cause any particular difficulties for medical personnel.

Bladder- serves to accumulate urine continuously coming from the ureters, and performs an evacuation function - urination. The size depends on the filling with urine, the capacity is from 250 to 700 ml. If for some reason the evacuation of urine is difficult, a urinary catheter is installed - an elastic tube that is inserted into the urinary tract to drain urine.

In cases where a urinary catheter is required for a long time, it is necessary to install a cystostomy (epicistostomy) - the creation of an artificial outlet channel from the bladder in a surgical way. The exit of the channel is in the suprapubic region. Indications for cystostomy appear, as a rule, with serious pathologies of the urinary tract:

• the impossibility of installing a catheter through the urethra if a long stay of drainage in the bladder is necessary;
• benign prostatic hyperplasia;
• unsynchronized work of the muscles of the bladder and its sphincter, which leads to stagnation of urine;
• pelvic injuries with urethral ruptures;
• operations performed on the urethra, penis

There are several types of catheters, but the Foley catheter is now mainly used in medical urological practice. This is the most common and popular type of catheters.

This is a urinary catheter with an inflatable balloon filled with a sterile liquid (water or saline) that fixes the catheter in the bladder. On the other hand, the tube is attached to a special container (package) in which urine accumulates.

Foley catheters can be with a different number of internal channels, made of different materials. They also differ in coverage. A silicone-coated latex dual-lumen catheter is an inexpensive option. The most expensive is a silver coated silicone catheter.

The advantage of a silver-coated silicone catheter is that the silver layer inhibits the growth of pathogenic microbes, reducing the likelihood of a urinary tract infection. Therefore, after the catheter is inserted, it can remain inside for a longer period. In this case, a higher price means more safety and a lower risk of catheterization infections.

An uncoated silicone catheter can be used if there is an allergy to latex. Silicone itself has the ability to prevent the deposition of salts on the inner layer of the catheter.

Urine excretion is possible in two ways:
1. In the mode of constant opening of the locking device, urine outflow occurs in small portions into a bag-shaped urinal attached to the sleeve.
2. In the closed state, when the outflow of urine is carried out at once, for a certain period of time, directly into the toilet or storage bag.

Catheter replacement

On average, a month after the installation of a cystostomy, it needs to be replaced. This procedure is performed by a urologist. Depending on how much the patient's mobility is preserved, you can either come to the medical center for an appointment, or call a doctor at home. In the future, the timing of the replacement of the catheter is discussed with the doctor individually for each patient and depends on the type of catheter and how it is used, whether there are any complications. On average, during normal operation of the cystostomy catheter, it will need to be changed once every 4-8 weeks.

Now doctors do not recommend washing catheters, it is much safer to change them, since when washing with antiseptic solutions, it is highly likely that the flora present on the walls will become resistant to these agents and if inflammation occurs, it will be very difficult to cope with it. Removal and replacement of a cystostomy is also mandatory for a doctor who additionally examines the injection site and makes appointments for the underlying disease.

Caring for a cystostomy (epicystostomy)

An indwelling catheter to remove urine from the bladder requires adequate hygiene and fluid intake.

The most important thing in care is keeping clean:

• The free catheter tube must be kept clean, as should the catheter entry site in the lower abdomen. If there are no special doctor's recommendations for treatment, then the skin around the catheter should be washed with warm water and soap or wiped with a swab moistened with water 2 times a day.
• You can take a shower, a bath is not recommended.
• If there are no signs of inflammation around the catheter, the bandage can be omitted.

How to properly handle a urinal bag

• The catheter and urinal should not be bent.
• If the patient walks, the urinal is fixed below the bladder, on the thigh. If the patient is lying down, the urinal is fixed below the level of the body, but not on the floor. The location of the urinal should allow urine to drain into the bag and not fall back into the bladder.
• Empty the urinal when it is half full. Change once a week on average, unless required sooner due to damage or clogging.

When setting up and replacing the catheter, the urologist should talk about training the accumulative function of the bladder. It is carried out in order to maintain the contractility of the walls of the bladder. The mode of constant outflow of urine disrupts the functioning of this organ, it is important to periodically create conditions for its filling.

The training of the accumulative function of the bladder consists in clamping the drainage of the cystostomy, until the urge to urinate occurs. When an urge occurs, the drainage should be opened and the bladder should be emptied. This method has absolute and relative contraindications. It is impossible to start training without consulting a doctor, this can lead to serious complications.

Absolute contraindications, in these cases, training is prohibited:

• Vesicorectal, urethroperineal and other fistulas
• Acute inflammation of the urinary tract
• Gross hematuria and urethrorrhagia.

• Bladder atony
• Bladder stones
• Vesicoureteral reflux.

Patients with a cystostomy should immediately contact their healthcare professional if:

• There is pain in the lower abdomen
• Decreased amount of urine excreted
• The color of urine changes, an admixture of blood or sediment appears, turbidity, a sharp unpleasant odor occurs
• If the catheter is clogged or damaged, it slips out of the bladder.

In order to combat urological diseases, a urinary catheter is used - a system of rubber tubes that is inserted into the bladder through the urethra to control the amount of urine excreted or to diagnose its composition. It is also intended for the implementation of the act of urination, if a person has urea dysfunction.

General information

Diseases such as cancer of the genitourinary system, prostate adenoma, urinary retention and kidney ailments entail problems with urine output. One of the methods of their therapy is the introduction of a catheter into the urethra. This is done to drain the bladder and make it easier to urinate. The conductor can be latex or rubber (soft) or plastic, metal (hard). It looks like a straight or curved tube with holes at both ends. At the same time, soft ones have an oblique cut, and hard ones have a handle, a beak and a rod.

Types and sizes

Classification is made depending on the material from which the devices are made, the time spent in the body. The number of channels and organs into which the device is inserted are taken into account. The length of the tube depends on the physiological characteristics of the organism. Female catheters are usually shorter. The optimal length for women is 12-15 cm, for men - about 30 cm.

According to the material of manufacture, they distinguish:

• elastic (rubber);
• soft (made of latex or silicone);
• hard (plastic or metal).

Depending on the length of stay in the ureter:

• permanent (introduced for a long term);
• disposable.

Taking into account the organ of administration, there are:

• urethral;
• ureteral;
• tools for the pelvis of the kidney;
• bladder stents.

By location there are:

• internal (completely located inside the body);
• external (one end goes out).

By the number of channels, there are options:

• single-channel;
• dual channel;
• three-channel stent.

The most common types

Different types of catheters are used to catheterize the bladder. Their choice depends on the function they will perform. The quality of the device is also important, since in some cases it leads to irritation or allergic reactions. Including the above factors, the most common are:

• Foley urethral catheter. Considered an indwelling urinary catheter. It has a blind end and two holes. At the end there is a rubber reservoir, to which a thin channel is connected. Used to flush the bladder, remove blood clots or urine.
• Nelaton catheterization device. Straight, elastic, with rounded ends. It has a smaller diameter than Foley. Not used permanently. Inserted into the urinary canal for drainage.
• Tiemann stent. It has one channel for drainage and 2 holes near the tip. Used in diseases of the prostate gland.
• Pizza fixture. Rubber conductor with 2-3 holes and cup-shaped tip. Set as permanent for draining the kidneys when their main function fails.
• Melekote is identical to the Pizzer pattern.
• Poisson's stent is a rubber smooth thread with three holes and a spiral end. Enter using a metal probe, which then must be removed. Rarely used for the treatment of the genitourinary system.

Each of the examples of catheterization devices has advantages and disadvantages in use. If the introduction of the catheter is provided for a short time, the best disposable Nelaton catheter. The Foley stand is more suitable not only for excretion of urine, but also for the administration of drugs. If the patient is unable to urinate, the Pizzer variant is most suitable.

How are they set?

To put a catheter into the urethra, you must follow some rules. First, the placement of the catheter must be sterile. To do this, in order to avoid sepsis, the instrument and genitals are treated with antiseptic disinfectants. Secondly, patients who have undergone the procedure claim that it hurts. To relieve such sensations, Lidochlor gel or other approved painkillers are used.

Insertion of a urinary catheter is much more difficult for men than for women. The problem is that in men, the urethra is narrower and longer than the female.

The technique of inserting a catheter in men is complex. During the procedure, the patient should lie on his back, bending his knees, and relax. The doctor treats the genitals and the apparatus with an antiseptic, and begins to slowly insert the instrument. In this case, the penis should be in a position perpendicular to the body. The signal that the manipulation is taking place correctly is the appearance of liquid in the catheter.

The bladder catheter in men has a length of 20-30 cm with a narrow diameter. This is due to the physiological characteristics of the body. Therefore, you need to use the appropriate instance. At the end of the procedure, the insertion site of the adapter is disinfected with an antiseptic, and the urinal is attached to the inside of the thigh. If the patient is lying - to the bed.

Catheterization in women

Inserting a urethral catheter for women is simple. In this case, the patient lies on her back, spreading her legs, bent at the knees. The labia and the instrument are treated with disinfectants. A urethral catheter is inserted 4-6 cm into the urinary canal, lowering the second edge into a special reservoir. It is attached to the thigh with a tight bandage bandage. During manipulation, blood may appear, but this is not dangerous. If the doctor did everything correctly, the bleeding is insignificant and does not repeat. A urethral catheter can damage the neck and walls of the bladder.

Both cystostomy and urethral catheters have advantages and disadvantages. When installing the urethral option, you can damage the neck and walls of the bladder. Suprapubic is less traumatic for a person. A cystostomy is easier to handle and less likely to cause inflammatory infections. Moreover, an incision in the abdomen heals faster and brings less discomfort than a tube in the genitals. Among other things, if the device becomes clogged, urine flows down it, infecting the genitals. And if such a problem occurs in the suprapubic sample, urine is excreted anyway.

The suprapubic catheter has advantages in diameter. It is much wider than in the urethral. But, cystostomy also has a number of negative aspects. Firstly, it is blocked more often, since it is allowed to install it only for a long time. Secondly, the side effects of its stay in the body are: urinary retention, spasm or stones. Thirdly, it is difficult for overweight patients to place a suprapubic catheter.