How to put a catheter in the bladder. Bladder catheterization in men: procedure algorithm, tools. When is catheterization needed?

Anatoly Shishigin

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Bladder catheterization is an extremely necessary intervention in the patient's body, which is carried out in order to diagnose or treat a number of diseases of the urinary system. Let us consider in more detail the main indications for bladder catheterization, the technique and possible types of conduct, as well as the features of removing the device from the patient.

In diseases of the genitourinary system in a patient, for example, oncological tumors, pathologies of the kidneys or prostate adenoma, there is a great difficulty with the outflow of fluid from the patient's body. During catheterization, a special device is introduced into the cavity of the urethral canal to drain urine forcibly.

Such manipulations are performed by specialists with special skills and knowledge, as well as experience in the procedure. Manipulations are performed both in a planned mode and on an emergency basis in case of complications and accumulations of urine.

Bladder catheterization is performed for diagnostic, therapeutic or hygienic purposes. Drainage in the diagnosis is necessary to identify the cause of the occurrence and development of any pathology of the genitourinary system. Urine, which is taken directly from the organ, is sterile and clinically accurate in a number of analyses. This method allows you to diagnose using a contrast agent injected into the cavity of the bladder.

For hygienic purposes, the probe simplifies the care of patients with severe illnesses who have difficulty emptying themselves. For treatment, the probe is necessary in cases of stagnation of urine, and the following types of manipulations are carried out:

with a delay in deurination of more than 12 hours, an emergency removal is necessary forcibly. Such cases are possible with the development in the patient's body of various diseases in the urological field;
during the rehabilitation of a patient after a surgical operation on the organs of the genitourinary system;
with pathologies in the bladder innervation system, when the function of fluid secretion fails.

Catheterization is not a very pleasant procedure, it is especially difficult for the patient psychologically, but it is essential to avoid health complications, and often saves the patient from death.

Any probe that is used for bladder catheterization must be inserted into the urethra. It is a hollow tube, straight or slightly curved, at the end of which there is a hole. These fluid conductors can be used for short periods of time as well as for extended periods.

When surgical interventions are performed in the urinary tract, patients are given disposable devices that are removed after a few days. If urinary retention has become chronic, a long-acting drain will be required to connect the bladder to the urinal.

Such probes differ in the material of their manufacture, they can be either elastic or rigid. Rigid structures are made of non-ferrous metals, alloys with the addition of impurities. They are very traumatic, but necessary for complications and the need to install drainage.

The physiological structure of the genitourinary system in men and women is different, so the structures themselves also have a different structure. Elastic probes are much more convenient, both during installation and in use by the patient. They are made of sufficiently flexible plastic, special very soft rubber or silicone. Installation is carried out by an experienced specialist with the necessary knowledge.

Types of catheters at the place of installation

All catheters can be internal, urethral or external, placed above the pubis. Each of these varieties has its own advantages and disadvantages, in particular, the device above the pubis does not affect the urethra when urine is excreted. It is easy to install, it does not injure the surface of the urethra, it is easier to care for, which provides convenience to the patient. With such drainage, the patient can maintain his sexual activity, which is extremely important when installing the device for a long time.

The urethral probe often damages the walls of the organs, the neck of the bladder, as well as the surfaces of the urethral canal even at the installation stage. Urine that leaks from the device can infect the patient's genitals, leading to severe inflammation.

According to their design, drainage devices can be of different types, but there are 4 main categories. Each of these groups has its own characteristics, both installations and applications. Let's take a closer look at each of these types.

Disposable probes Robinson (Nelaton)

Such a catheter is a very soft curved tube with a small diameter, at the end of which there is a rounding. The principle of operation is very simple. Catheterization with such a device is carried out quickly for both men and women during diagnosis and fluid collection from the bladder, as well as during surgery.

Tiemann stent

In some cases, diseases of the genitourinary system and the development of complications require a Tiemann stent, which is characterized by a rigid structure and a curved end of increased elasticity. Thus, the specialist and the surgeon manage to get into the bladder in cases where the walls in the urethral canal are inflamed or damaged.

The most common and convenient Foley probe is used when the device is installed for a long time. It consists of two or three passes, is a very flexible tube with holes, a urine collection reservoir that holds the installed system inside the patient's body. With such a catheter, medicinal medications are introduced, the organ is washed from the accumulation of pus or blood, and the urethra is also cleansed of blood clots.

Pezzera catheter

The most rarely used Pezzera probe is used only in the case of a cystostomy drain, which is necessary when the patient's renal system fails. The system is very simple and consists of a flexible tube with several openings to the outside.

The diameters of all catheters differ among themselves and are used for each patient individually. The specialist selects the necessary size, based on the characteristics of the anatomy of the patient and the type of disease.

Main indications for catheter placement

When prescribing a manipulation, during which a probe will be installed, the specialist must necessarily take into account possible contraindications and the main indications for its implementation.

Emergency response in case of an urgent need to divert urine forcibly, when the natural process is disturbed or impossible. This happens with adenocarcinoma, bladder paresis, and also with prostate adenoma in men;
For diagnostic purposes, when it is extremely necessary for a specialist to make a correct diagnosis and choose an effective therapy. Sterile urine directly from the organ is the most reliable for analysis in the laboratory;
Special diseases of the bladder and urethral canal, in which it is extremely necessary to irrigate their cavity with medications, rinse from blood clots and pus.

What are the contraindications for the placement of a catheter?

Installation of drainage is prohibited for the following diseases:

The peculiarity of contraindications for catheterization lies in their sudden occurrence, which happens when the catheter is not professionally inserted and the surfaces of the organs of the genitourinary system are injured.

Preparation procedure for drainage

In order for the installation of the probe into the bladder to take place without complications, it is necessary to carefully prepare for it. At the same time, specialists must comply with the following conditions:

take good care of the patient;
observe unconditional sterility;
choose devices from high-quality materials;
avoid mistakes when installing the device in the patient's body.

Before starting the procedure, the specialist must wash the patient, observing the direction from front to back, which is necessary to ensure that infection from the anus does not enter the urethral canal. When washing, an antiseptic drug of low concentration, for example, Furacilin, is often used.

Standard set for catheterization

As a rule, such a kit includes a reservoir for collecting urine, a rigid or soft catheter chosen by a specialist, consumables in the form of napkins and cotton wool, instruments for the surgeon, syringes and tweezers, petroleum jelly or glycerin to facilitate insertion into the urethral canal, and an anesthetic drug. such as lidocaine.

Carrying out catheterization

For ease of insertion of the catheter, the patient must lie on his back, bend his knees and slightly spread them apart. The task of the patient is to relax, which is achieved by the introduction of painkillers, while the doctor and nurse must have sufficient experience in installing a drain. The injection algorithms for men and women do not differ, but due to the peculiarities of the structure of organisms in men, the procedure is much more complicated.

How is a catheter inserted in men?

The installation of men is especially difficult due to the longer urethral canal than in the female body, and also because of the presence of constrictions in it. As a rule, a soft catheter is used for such manipulation. The procedure requires the specialist to have certain skills and abilities so that the execution technique is not violated.

Once the preparatory procedures are carried out, the invasion into the bladder consists of several stages:

The penis of a man on its surface is treated with an antiseptic preparation, while the head must be carefully processed by a specialist and anesthesia is administered;
A lubricant is dripped into the opening of the urethra, which must be sterile. This will facilitate the introduction of the tube and reduce pain;
The device itself must be lubricated with petroleum jelly or glycerin;
Drainage in the form of an elastic tube is inserted with tweezers into the urethral canal through the external opening;
The catheter is turned around its axis and driven into the urethra as deep as possible;
Catheterization is considered completed after the release of urine into the cavity of the drainage tube.

The actions of the specialist after this depend on the need indicated by the attending doctor, but with strict adherence to the technique of the procedure. As soon as the bladder is emptied, it is washed with an antiseptic through a special syringe that is connected to the catheter.

In many cases, a permanent fixation of the tube of the device is made and a urinal is equipped for long-term use, the patient is told about the features of care. With a metal catheter, the procedure is done in exactly the same way, except for some features of the passage of difficult areas that are in the urethra due to physiological characteristics.

How is a catheter inserted in women?

The urethral canal in women is much wider and shorter than in men, making insertion easier. Catheterization in women consists of the following steps:

The patient is being prepared, instruments and external genitalia are being processed;
The elastic catheter is inserted with forceps outside the urethral canal approximately 6 cm deep;
As soon as urine appears in the tube, it is considered that the catheterization was successful.

In order to avoid infection during the manipulation, it is necessary to strictly observe the rules of hygiene. When using the device for a long time, its outer end must be connected to a urine collection tank that is attached to the thighs. A soft catheter is not always effective, so metal drainage is used in some cases.

When catheterizing a child, it is necessary to observe enhanced hygiene measures and pay special attention to the procedure. It is prescribed only in case of urgent need, since many complications are possible. A catheter for a child is selected based on his age, a metal catheter is prohibited, only elastic tubes can be used.

Children's immune system is very weak, so the risk of infection and inflammation is too high. Exceptional sterility with such an invasion is the main and indispensable condition for the procedure.

Possible complications

With professional catheterization, complications should not arise, but in the absence of the skills and abilities of a specialist, a number of unpleasant symptoms may occur. This procedure is done without general anesthesia in order to timely identify the patient's pain syndromes. The most unpleasant consequences after catheterization are as follows:

Perforation of the walls or their damage to the urethra;
Infection in the urethra and other genital organs in men and women, which causes urethritis and cystitis, pyelonephritis and paraphimosis;
If the urethral canal is damaged, infection may enter the circulatory system;
The occurrence of fistulas and open bleeding.

If a device with a diameter larger than necessary was used, women develop an enlargement of the urethral canal. If the drainage is worn constantly and for a long time, it is necessary to strictly follow the recommendations issued by the attending physician for caring for it.

Invasion of the bladder requires mandatory hygiene of the perineum and the catheter itself to prevent complications. If there are urine leaks, blood appears in the urinal, or any symptoms of discomfort, it is necessary to notify the specialist.

The catheter is removed from the body only on the recommendation of a doctor, as a rule, this is carried out in a hospital, but in exceptional cases it can be removed at home. If the patient's catheterization is carried out correctly, this will facilitate the work of his urinary system, enhance the effectiveness of the treatment of infectious diseases and, in general, improve the patient's quality of life.

Bladder catheterization is a common procedure prescribed for patients with a violation of the natural outflow of urine. In addition to cases of bladder dysfunction, this measure is used to control the composition and amount of urine excreted.

Urinary system catheters are used as a short-term auxiliary instrument for removing fluid, devices are also provided for long-term installation in the development of a number of diseases of the urogenital area. There are two types of catheters: flexible, elastic, made of rubber and rigid - made of metal.

Violation of urination leads to the development of hydronephrosis and can cause renal failure. Properly performed bladder catheterization does not cause pain or discomfort in the patient, although the recommended drainage of the urethra can alert and frighten the patient.

To avoid misunderstandings, men and women should know how to insert a catheter into the urinary canal. Competently and timely conveyed information about the expediency of the procedure inspires confidence in the patient.

The sequence of actions of a specialist is described in detail below.

The patient is manipulated to install a catheter for diagnostic, hygienic or therapeutic purposes. Bladder catheterization with a soft catheter for diagnostic purposes is recommended for:

examinations for patency of the urinary tract;
obtaining a liquid to determine the microflora inside the organ;
measurement of the volume of the output liquid;
identifying the cause of the disease of the urethra;
obtaining information about the residual volume of urine after the act of urination;
studying the organoleptic characteristics of the liquid (color, smell, transparency);
determination of the features of the functioning of the organ during an x-ray examination (a catheter is placed in the bladder to introduce a substance into the urinary system).

For therapeutic purposes, a catheter in the bladder is necessary:

to empty the bladder in patients who are unable to urinate on their own due to illnesses (due to surgery, in a coma or weakness after a long illness);
with intermittent decompression of the bladder, when bladder catheterization is used as an obligatory part of therapy;
with sudden or prolonged retention of urine;
to introduce disinfectants and drugs into the bladder for local treatment of the organ;
to introduce drugs into the area of \u200b\u200bdirect inflammation;
to organize the washing of the bladder with a medicinal solution at home in bedridden patients;
after surgery, during the recovery period of the urinary tract.

For laboratory studies, bladder catheterization for a woman and a man is prescribed in the treatment of diseases of the urinary tract.

This is necessary to access the internal walls of the organ. In the study of dysfunction of the male genital organs in order to exclude inflammatory diseases, it is necessary to insert a catheter into the bladder. It is planned to take urine for analysis with a catheter in women during menstruation.

Contraindications for the catheterization procedure

But the placement of a urinary catheter is not always acceptable, sometimes such manipulations have limitations. The procedure is contraindicated in:

complaints of the patient on the release of blood in the process of urination;
detection of bruises in the perineal area;
fracture of the penis in men;
acute inflammatory processes in the genitourinary system of an infectious nature (gonorrhea, other sexually transmitted diseases);
exacerbation of prostatitis;
serious injuries of the bladder or urethra;
spasm of the sphincter of the urethra.

In order not to cause harm and pain to the patient, in these cases it is worth using other methods of treatment and diagnosis.

Types of bladder catheters

Based on the individual characteristics of the patient, his state of health, the specialist will recommend the ideal bladder catheter. Distinguish tools by:

material: soft - latex and hard - metal or plastic;
duration of stay in the body: permanent and short-term bladder catheters;
frequency of use - reusable for bedridden patients and disposable for a single procedure.

Some catheters are used as a rubber tube to deliver medication to the bladder. There are instruments that are installed not through the urinary tract, but directly through the abdominal wall (suprapubic).

To choose the right tool, you need to pay attention to the diameter. Existing sizes are numbered from 1 to 30 inclusive, but for adults, products in the range from 14 to 18 are used.

Based on the anatomical features of patients, the length and configuration of such metal catheters differ. Characteristically curved and short are intended for women. Long devices (up to 25 cm) made of solid materials in the form of a hollow tube, the blind end of which has a rounded edge, are used for men.

The purpose of the devices depends on the appearance and material, as follows:

Foley 2-Way has an inflatable reservoir to hold the device inside the bladder and a tube to drain fluid, intended for long-term use;
Foley 3-way is actively used to treat the bladder cavity with drugs and remove blood clots;
the Mercier catheter (Tiemann) has a curved blind tip and is relevant for men suffering from prostatic hyperplasia;
Nelaton urological catheter - a soft disposable straight instrument, has a rounded end and two drainage outlets;
Pezzera is a latex tube with a hat-shaped seal attachment, used in cases of need for long-term suprapubic catheterization.

While catheterization of the bladder with a soft guidewire is performed by a nurse, the insertion of a solid instrument into the urethra should be entrusted only to an experienced doctor.

Preparatory stage

For the successful conduct of the procedure, the medical staff must not only be fluent in the technique of bladder catheterization, but also properly prepare the patient and the workplace. Previously, the patient is washed with an antiseptic solution.

All instruments used must be sterile, as well as consumables used for manipulation. The nurse has the right to use a catheter in sealed factory packaging or an instrument processed in special sterilizers for bladder catheterization.

Prepare for work:

diapers or oilcloths, latex gloves, gauze napkins and cotton pads;
tweezers;
vaseline oil, gel with analgesic effect;
reservoir for excreted urine;
syringe with safety tip;
hygiene products for the care of the genitals.

It is recommended that a woman wash thoroughly and it is advisable to douche so that vaginal discharge does not enter the urethra.

Patients with the correct procedure do not experience discomfort and pain. To facilitate the advancement of the instrument, you need to introduce a couple of drops of gel with an anesthetic effect into the urinary opening. After the manipulations, the instruments and catheter are treated with a solution of chloramine.

Bladder catheterization in women: technique

Due to physiological characteristics, catheterization in women does not cause any particular difficulties. It is recommended to use a soft latex instrument. The size of the device is selected individually. The algorithm for performing actions during catheterization of the bladder in women is simple.

Manipulations are carried out as follows:

the pre-washed patient is comfortably positioned on the diaper, spreading her legs bent at the knee joints;
a sterile napkin is placed on the woman's pubis by a nurse, the outer labia are gently moved apart in order to have access to the urethral opening;
the genitals are carefully processed with an antiseptic composition;
gloves are replaced;
a urine catheter is captured with tweezers (for women it is shorter), the rounded part of which should be moistened in glycerin, petroleum jelly to improve gliding in the canal;
the bladder is catheterized to a woman with light rotating movements, the instrument is immersed in the urinary canal by 5 cm;
a well-conducted technique for performing bladder catheterization does not cause pain to the patient, but if pain occurs, a smaller diameter catheter should be taken;
the outer end of the catheter is lowered into the reservoir;
signals the correct location of the instrument in the cavity of the bladder urine stream from the catheter;
catheterization performed using a soft conductor provides not only urination, but also allows you to effectively irrigate the bladder cavity with antiseptic or drugs;
you should know how to properly remove a catheter from the bladder in women, since you should not allow the organ cavity to be completely emptied;
when the flow of urine stops, it is necessary, by rotating the device, to carefully remove the catheter from the bladder of a woman;
the nurse gently presses on the abdomen so that the urethra is washed with the remains of urine after the catheter is removed;
then, with blotting movements, the opening of the urinary canal is treated with a cotton pad previously moistened in a solution of furacilin.

The tools used for manipulations are disinfected for an hour in a 3% solution of chloramine. Knowing how to put a catheter in the bladder of a woman, not only in a hospital, can facilitate the care of a bed patient at home.

After being instructed by medical professionals, self-catheterization is allowed in women who have difficulty urinating. But the initial installation of the catheter should be carried out under the supervision of a specialist.

Procedure for men

In addition to a length of up to 25 cm, the canal has 2 physiological constrictions. Manipulations are allowed to health workers who have extensive experience and are fluent in the technique of catheterization of the male bladder. Amateurs can only do harm.

Algorithm for performing bladder catheterization in men:

a previously prepared patient lies on his back on an oilcloth, slightly bending and spreading his knees, between which a reservoir is installed;
with a hand with a sterile napkin, the specialist supports the penis under the head, providing access to the opening of the urinary canal;
the head of the penis is wiped with a cotton pad soaked in a disinfectant solution;
a few drops of gel are applied into the opening of the urethra during catheterization of the bladder with a soft or hard catheter for pain relief;
a flexible catheter is captured with tweezers, the rounded edge of which is moistened in petroleum jelly or glycerin, after which, supporting the head, a 5 cm tube is inserted;
the subsequent introduction of a catheter to men requires accuracy. Intercepting the instrument with tweezers, it is carefully advanced further along the channel;
if muscle spasm occurs due to resistance during the passage of the spongy and membranous portion of the canal, you should wait a couple of minutes and continue advancing the catheter;
the following resistance is felt when the instrument is inserted into the bladder through the physiological constriction;
the outer end of the catheter should be lowered into the tray, flowing urine signals successful drainage of the urethra;
when the process of urine excretion is completed, 150 ml of furatsilin is injected through the tube with Janet's syringe to disinfect the inner walls of the bladder, after which the remaining liquid is removed through the drainage;
with rotational movements, a tube 25-30 cm long is taken out;
with a cotton pad moistened with a disinfectant solution, gently wipe the head of the penis;
All appliances are disinfected.

If it was not possible to install a flexible catheter, the doctor introduces a rigid metal one on his own. This happens in exceptional cases.

The installation technique of such a device requires skill on the part of a specialist. If the patient experiences pain, it is necessary to immediately inform the specialist about it.

Possible complications

The bladder catheterization procedure prescribed by specialists rarely leads to complications in women.

They are mainly associated with non-compliance with the sterility regime during manipulations, which leads to infection in the urinary tract.

Bladder catheterization performed with violations in both women and men can cause pyelonephritis, cystitis, urethritis. Serious complications can occur when the urethra is injured with a metal catheter, so this device is installed in extreme cases and only by a doctor.

Finally

A urinary catheter is installed to alleviate the patient's condition in case of violation of the outflow of urine. In order to avoid the development of hydronephrosis, this procedure is vital.

Competent work of specialists with patients at the preparatory stage and during catheterization, the correct selection of instruments - all this eliminates the possibility of complications.

Content

This procedure is prescribed for therapeutic and diagnostic purposes. A urinary catheter is introduced to patients with a variety of urogenital pathologies. Learn about the features of this medical manipulation in men and women.

Types of catheterization

Emptying the patient's bladder is carried out using a special tool that looks like a regular tube. In this case, depending on the condition of the patient, his age and the goals of the procedure, permanent or short-term (periodic) catheters are used. Regarding the former, we can say that they are used for continuous urine diversion. Periodic, or intermittent, devices are designed for a single collection of urine.

In addition, there are the following types of catheterization, or epicystostomy:

sterile - carried out permanently;
clean epicystostomy of the bladder - carried out at home;
using soft rubber tubes (set in most cases);
catheterization involving the use of hard metal instruments;
epicystostomy of the renal pelvis:
ureteral catheterization;
with access through the urethra or stoma (set after surgery);

Bladder catheterization technique

A nurse can insert a tube made of soft materials, while only a doctor can insert a rigid device. The technique of bladder catheterization involves strict adherence to the rules of septic and antiseptic, which is due to a multiple increase in the risk of secondary urogenital infection. Such consequences are very dangerous for a woman during childbearing.

Bladder catheterization algorithm

Epicystostomy in men and women is carried out the same way. At the same time, the bladder catheterization algorithm in patients of different genders still has its own characteristics. Differences are observed only in the technique of introducing the tube. In general, female epicystostomy is considered a simpler option for manipulation. The installation of a urinary catheter in men is carried out using a long tube and requires some patience from the patient. Nevertheless, with strict adherence to the algorithm of actions, the procedure does not cause the patient any pronounced discomfort.

Bladder catheterization in men

Some complexity of the technique for conducting epicystostomy in the stronger sex is due to the long urethra and physiological constrictions that prevent the introduction of the tube. Bladder catheterization in men with a rigid device is performed only if there are special indications (adenoma, stenosis). It is important to say that in order to relax the smooth muscles and ensure further advancement of the instrument, doctors often advise patients to take a couple of deep breaths during the procedure.

Urinary catheter for men

Representatives of the stronger sex have some structural features of the urethra. For this reason, the length of the urinary catheter for men reaches 25-40 cm. In addition, curved tubes are selected for the procedure, repeating the physiological characteristics of the patient's urethra. In addition, the male urinary catheter features a small tube lumen diameter. It is important to note that disposable type devices have recently been used for a single excretion of urine.

Inserting a catheter into the bladder of a man

Before the procedure, the doctor conducts a short conversation with the patient, during which he explains to the patient the features of the manipulation. As a rule, the installation of a catheter in the bladder of a man, as well as its removal, does not cause pain. Nevertheless, the specialist should warn about the possibility of such sensations. In addition, the male catheterization algorithm is briefly explained to the patient, which is as follows:

The patient lies on the couch with his knees bent.
Before catheterization, an antiseptic is applied to the surface of the patient's glans penis. Sterile glycerin is instilled into the urethral canal, which also processes the end of the tube.
A vessel is placed between the patient's legs to collect urine. When performing a permanent epicystostomy, the patient is knowingly explained what care for the catheter in the bladder includes, and at the end of the procedure, a urinal is installed. It is worth saying that often after surgery, patients are offered to remove the stoma.
During catheterization, the doctor takes the tube with sterile tweezers at a distance of about 6 cm from the edge and begins to gradually insert into the patient's urethra. To avoid uncontrolled urination, the urologist holds the head of the penis, slightly squeezing it.
When the urethral catheter reaches its intended destination, there is a release of urine.
After removing the biological fluid, the tube is connected to a special syringe with a solution of furacilin, through which the doctor flushes the organ. As needed, catheterization can be used to treat urogenital infections with antibiotics and other medications.
After the doctor has flushed the bladder through the catheter, the device is removed from the urethra. The removed tube is disinfected. To avoid complications after catheterization, removal of the flushing device is carried out only after the removal of air or water from the fixing balloon.
Residual moisture in the form of drops of urine and solution is removed from the genitals with a napkin from a sterile individual set. Within an hour after completion of the procedure, the patient should be in a horizontal position.

Bladder catheterization in women

Epicystostomy in women is considered a simpler option for manipulation, which is due to the presence of a shorter urethral canal compared to the male. In addition, the procedure takes much less time. Bladder catheterization in women in most cases passes without any complications. It is worth noting that when working with ladies it is especially important to create a trusting environment.

Urinary catheter for women

The procedure for the fairer sex is carried out using a short (up to 15 cm) direct device and a syringe, through which the doctor flushes the excretory organ. At the same time, the urinary catheter for women is wider in diameter. In fact, the type of epicystostomy, as well as the nature of the flush, are determined taking into account the age and concomitant diseases of the patient. If the doctor ignores individual characteristics, a variety of complications can occur: from kidney disease to rupture of the urethral canal with subsequent blood poisoning.

Video: Foley catheter placement algorithm

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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The catheter is made in the form of a drainage tube, which is installed in the human urinary tract by medical personnel. Depending on the gender of the patient and the material used to make the device, the installation procedure must be carried out by a qualified specialist and in accordance with the rules.

Catheterization is used in urology for the treatment of patients suffering from diseases associated with a violation of the outflow of urine.

What are catheters

Devices are classified according to several factors, divided into male and female, which differ in length, diameter and shape.

According to the material of manufacture, types of urological tubes are distinguished:

elastic or rubber (Timman);
soft or latex, silicone (Foleya, Pezzera);
hard - plastic (Mercier, Nelaton) and metal (brass or stainless steel). They are installed in the case of the procedure with other types of catheters.

Catheters can be made from various materials

Elastic and soft devices look like a transparent tube with a funnel at the end and are distinguished by a small diameter.

According to the installation time, the types of the device are distinguished:

permanent. When installing this type of device, it is necessary to perform daily hygienic washing of the external opening of the urethra, as well as to observe the toilet of the external genital organs after urination. All patients are taught the rules for flushing the urological system. Suprapubic catheters, which are inserted through the abdominal wall, must be changed every 4 weeks.
short-term or one-time. It is made of latex or metal (the attending physician is allowed to insert a catheter) and are used for a single need for catheterization.

Catheters differ in the installation time

Depending on the place of installation, catheters are divided into:

internal - introduced into the human body;
external - one end remains outside;
single-channel, two-channel and three-channel.

Male and female devices are made in accordance with the anatomical features of the sexes. The first devices are made narrow, long (up to 30 cm) and flexible, while the second ones differ in diameter (caliber), 12-15 cm long and the absence of bends.

Based on the diagnosis, age and gender of the patient, the doctor selects a urological catheter.

Indications for holding

The introduction of a catheter into the patient's body is carried out for therapeutic purposes in the following cases:

urinary retention;
blockage of the urethral canal to prevent hydronephrosis;
the introduction of drugs to the focus of the inflammatory process;
tumors in the urethra;
washing to remove pus and remnants of stones from the bladder;
surgery and the use of epidural anesthesia.

The catheter is inserted into the patient's body for therapeutic purposes.

This manipulation is performed when pathologies such as prostate adenoma, urolithiasis, glomerulonephritis, tuberculosis of the genitourinary system, urolithiasis, bladder paralysis are detected.

For diagnostic purposes, catheterization is performed for:

taking a sample of clean urine, uncontaminated by external bacteria, which makes it possible to identify the cause and pathogen of the disease;
visualization of the urinary organs by filling them with a certain contrast agent;
determination of the residual volume of urine and diuresis in the postoperative period.

As a hygiene product, this urological system is used to care for bedridden patients.

Equipment for the procedure

In order for the manipulation to install the device to be successful, you need to have medical materials and medicines:

catheter;
sterile gauze pads and cotton balls;
oilcloth and diapers;
tweezers (2 pcs.);
syringes 10 and 20 ml;
medical gloves;
vessel or pallet;
glycerin or vaseline oil;
antiseptic - furatsilina solution (1:5000);
anesthetic - 2% lidocaine in the form of a gel.

Before starting the treatment manipulation, the doctor explains the procedure to the patient. Then the genitals are disinfected with a bandage, tweezers and an antiseptic solution.

Manipulation in women

The female urethra, unlike the male, has a shorter length and larger diameter, so the catheterization process is quick and easy.

The manipulation algorithm includes the following steps:

Hygiene of the genitals.
The woman is laid in a horizontal position on her back, her legs should be spread apart and tucked in.
The nurse is located to the right of the patient and spreads her labia with her left hand.
The vulva is treated with an antiseptic solution.
The tip of the catheter is lubricated with emollient oil and inserted into the urethra by 5-10 cm. If you feel pain, you should immediately inform the medical staff conducting the procedure.
A woman should remain in this position for at least 1 hour. To collect urine, a special container is placed between her legs.

Manipulation in women

Usually, in the fairer sex, the procedure is painless, and only when urinating can they experience slight discomfort. This is due to the fact that the tube during the insertion process causes minor damage to the bladder mucosa, which causes burning during urination.

At the end of the process of outflow of urine, the bladder is washed with furatsilin through an attached syringe to the catheter. Then the device is taken out by slightly scrolling around its axis and the urethra is treated with an antiseptic to prevent infection.

Performing medical work in men

The urethra of the stronger sex is a narrow tube that has its narrowing, and is designed not only to remove urine, but also sperm. It is very sensitive to damage of a different nature, so catheterization is contraindicated in the presence of injuries to the urethra. The manipulation itself is more complex than that of the female and is performed in accordance with the following rules:

The outer part of the head and the foreskin are disinfected with a solution of furacilin, and it is important to hold the latter during the procedure in order to avoid injury.
The man lies down in the same position as the woman.
The medical staff is to the right of the patient and inserts the tube of the device to a depth of 6 cm, which is pre-lubricated with an emollient, into the urethra using tweezers. The penis must be held with the left hand.
Advance the catheter slowly by 4-5 cm, with extreme care, using rotational movements as necessary.
At the moment when the device reaches the constrictions, the man takes 2 deep breaths, which will ensure relaxation of the smooth muscles and allow the tube to be advanced. If a canal spasm occurs, the procedure is suspended until the urethra becomes relaxed.
If the device is placed correctly, urine should flow from the tube. A vessel is placed between the patient's legs to collect it.

When diagnosing a patient with prostate adenoma or urethral stricture, a metal system is used. The procedure has soy features:

During the introduction of the device, it is necessary to monitor the position of the rod, which should be horizontal, while the beak is turned down.
The movement of the tube is performed with the right hand and the penis is pulled onto it until the beak is hidden in the urethra.
Then the penis is lowered towards the abdomen, raising the free end of the device, and the device is inserted to the very base of the penis.
The catheter is placed vertically and the tube is pressed through the lower surface of the penis with the index finger.
As soon as the narrowing is passed, the device is tilted towards the perineum.
When the beak of the device is immersed in the bladder, urine outflow is observed.

At the end of the procedure, the same manipulations are performed as in women.

Possible complications

Like many types of treatment, this manipulation can lead to the development of some complications that arise as a result of an erroneous diagnosis, choosing the wrong catheter, performing the procedure without following the rules, which entails injury to the walls of the urethra and bladder, as well as introducing various kinds of infections.

Cystitis is one of the possible complications

Main complications:

cystitis;
the formation of fistulas during perforation of the urethra;
bleeding;
pyelonephritis;
paraphimosis;
urethritis;
carbunculosis;
sepsis;
mucosal damage.

This procedure greatly facilitates the treatment and diagnosis of diseases, but not every patient agrees to it. This is due to a lack of understanding and lack of complete information in a person about how the catheterization process is carried out. The therapeutic effect of this manipulation has an invaluable effect on the human body, improving its well-being and preventing the development of dangerous complications in various diseases.

Insertion of a urinary catheter- a procedure performed in a hospital by a nurse and urological doctors. Bladder catheterization in women, men and children is different, as are the devices themselves.

The placement of a urinary catheter can only be done in a hospital.

Indications for a urinary catheter

The installation of a urinary catheter is indicated in the following conditions:

Urinary retention due to infection and surgery.
Unconscious state of the patient with uncontrolled outflow of urine.
Acute inflammatory diseases of the urinary organs, requiring lavage and administration of drugs into the bladder.
Injury to the urethra, swelling, scars.
General anesthesia and postoperative period.
Spinal injuries, paralysis, temporary incapacity.
Severe circulatory disorders of the brain.
Tumors and cysts of the urinary organs.

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

Also, catheterization is carried out if it is necessary to take 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 urinary bladder for infections, to stop bleeding and injecting drugs into the genitourinary organs.

What this catheter looks like can be seen in the photo below.

Foley catheter comes in different sizes

There are the following subspecies of the Foley device:

Two-way. It has 2 holes: through one, urination and washing is performed, through the other, liquid is injected and pumped out of the balloon.
Three-way: in addition to standard moves, it is equipped with a channel for the introduction of medicinal preparations into the patient's urinary organs.
Foley-Timman: has a curved end, is used for prostate catheterization in men with a benign tumor of the organ.

A Foley catheter can be used for procedures on any urinary tract. Duration of operation depends on the material: devices are available in latex, silicone and silver-plated.

The following devices can also be used in urology:

Nelaton: straight, with a rounded end, consists of a polymer or rubber. It is used for short-term bladder catheterization in cases where the patient is unable to urinate on his own.
Timman (Mercier): silicone, elastic and soft, with a curved end. Used to drain urine in male patients suffering from prostate adenoma.
Pizzera: A rubber appliance with a bowl-shaped tip. Designed for continuous drainage of urine from the bladder through a cystostomy.
Ureteral: a long PVC tube 70 cm long placed with a cystoscope. It is used for catheterization of the ureter and renal pelvis, both for the outflow of urine and for the administration of drugs.

Nelaton's catheter is used for short-term bladder catheterization

All types of catheters are divided into male, female and children:

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

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

Types of catheterization

According to 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.

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

urethral;
ureteral;
renal pelvis;
bladder.

Urethral catheterization

Also, catheterization can be divided into male, female and children.

Preparation for bladder catheterization

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

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

sterile tray for instruments;
diaper or oilcloth;
disposable rubber gloves;
rubber antiseptic;
gauze napkins;
vaseline or glycerin;
tweezers;
Janet's syringe;
furacilin solution;
2 new catheters.

Catheterization kit

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

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

Algorithm of actions when installing a urinary catheter

In order for catheterization not to harm the body, you should read the instructions for its implementation. Procedures for inserting a catheter are different for men, women, and children.

Carrying out catheterization in women

The installation of a urological catheter in women is performed as follows:

The patient takes a horizontal position: lies on her back, bends her knees, spreads them apart. A diaper is placed under the buttocks of the patient.
The labia is washed away, treated with an antiseptic and pushed apart.
The entrance to the urethra is treated with a solution of furacilin.
A tube soaked in petroleum jelly is inserted into the urethra using tweezers.
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.

Depending on the purpose of the procedure, it may end at this point, or continue with flushing, drug administration, and further removal of the device.

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

Setting technique for men

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

The patient lies in a horizontal position, on his back. The legs are bent at the knees and spread apart. An oilcloth is placed under the buttocks.
The penis is wrapped with a napkin, the urethra is treated with a solution of furacilin and wiped.
The catheter is taken with tweezers, inserted into the urethral canal. The penis is slowly and gently pulled over the tube until it advances to the external sphincter.
The device is slowly lowered into the scrotum until the obstacle is overcome.
The second end of the catheter is fixed in the urinal. The specialist waits for the outflow of urine from the bladder to begin.

Urethral catheter in men

Further instructions depend on how long the catheter is placed. For short-term use, after the outflow of urine or the introduction of drugs, the device is removed. With prolonged use, catheterization ends 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 for children does not differ from the adult instructions.

There are important features when performing the procedure in children:

The urethral catheter for children should have a small diameter so as not to damage the genitourinary organs of the child.
The device is placed on a full bladder. You can check the fullness of the organ using ultrasound.
Treatment with medicines and strong antibacterial compounds is prohibited.
Pushing the labia in girls should be done carefully so as not to damage the frenulum.
The introduction of the tube should be soft, slow, without force.
It is necessary to remove the catheter as soon as possible so as not to provoke inflammation.

The procedure in children, especially in infants, should be handled by a urologist with a pediatric education.

Caring for your urinary catheter

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

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

Miramistin - antiseptic for the treatment of the urinal

The urinal must be emptied 5-6 times a day, and washed with antiseptics at least 1 time per day. The catheter should be processed no more than 1-2 times a week.

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

How to change the catheter yourself at home?

Performing a catheter replacement at home is a dangerous procedure that can cause serious injury to the urinary organs. Self-administration of the procedure is permissible only for a soft urethral device, and if there is a serious need.

To replace the device, the old catheter must be removed:

Empty the urinal. Wash your hands with soap and put on gloves.
Lie in a horizontal position, bend and spread your legs to the sides.
Flush the tube of the device and genitals with an antiseptic or saline solution.
Locate the bottle opening of the device. This is the second hole not used for urine output and bladder lavage.
Empty the balloon with a 10 ml syringe. Insert it into the hole and pump out the water until the syringe is completely filled.
Gently pull the tube out of the urethra.

Correct position for catheter replacement

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

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

Possible complications after the procedure

Pathologies resulting from catheterization include:

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

Incorrect catheterization may cause inflammation of the urethra

You can avoid these complications 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 stagnation of urine and infections of the genitourinary system. With a properly selected device and compliance with its setting, the procedure is unable to harm the patient and cause discomfort.