Foley_s Catheterization Technique copy

Foley's Catheterization Technique

Introduction to Urethral Catheterization

  • Definition: A routine medical procedure that allows direct drainage of the urinary bladder.

  • Purposes:

    • Diagnostic: Helps in determining the etiology of various genitourinary conditions.

    • Therapeutic:

      • Relieves urinary retention

      • Instills medication

      • Provides irrigation

Anatomy of the Urinary System

  • Key Components:

    • Kidney

    • Ureter

    • Bladder

    • Urethra

  • Female Urinary Organs: Illustrated anatomical drawings, important landmarks include the bladder, urethra and associated structures.

Foley's Catheter Specifications

  • Size: 10 ml balloon, sizes indicated in French scale and millimeters.

  • Both bladder opening and urine drainage ports are included in the design.

Indications and Contraindications for Catheterization

Indications

  • Diagnostic and Therapeutic Uses:

    • Collect uncontaminated urine specimen

    • Manage acute urinary retention

    • Monitor urine output

    • Provide continuous bladder irrigation

    • Hygienic care in bedridden patients

    • Imaging of the urinary tract

Contraindications

  • Conditions to Avoid:

    • Traumatic injury to the lower urinary tract (e.g., urethral tear)

      • Signs include:

        • High riding or boggy prostate

        • Perineal hematoma

        • Blood at the meatus

Preparation for Catheterization

  • Anesthesia:

    • Use 2% Lidocaine gel; preloaded in a syringe for urethral administration.

    • Apply with a gloved finger at urethral tip for a few minutes to allow effect.

  • Equipment Needed:

    1. Povidone iodine

    2. Sterile cotton balls

    3. Water-soluble lubrication gel

    4. Sterile drapes

    5. Sterile gloves

    6. Urethral catheter

    7. Prefilled 10-mL saline syringe

Catheter Types and Sizes

Catheter Types

  • Materials:

    • Latex

    • Silastic (pure silicone or silicone-coated)

    • Silver alloy

    • Antibiotic-impregnated

Catheter Sizes

  • General Guidelines:

    • Adults (Foley with straight tip): 16-18F

    • Adult males with prostate obstruction: Coudé tip (18F)

    • Adults with gross hematuria: Foley (20-24F) or 3-way irrigation catheter (20-30F)

    • Children: Size determined by dividing age by 2 and adding 8

    • Infants under 6 months: Use feeding tube (5F) with tape

Technique of Urinary Catheterization

  • Steps:

    • Explain procedure, benefits, risks, and complications to the patient.

    • Position the patient supine in bed.

    • Use the non-dominant hand to hold and retract the foreskin.

    • Sterilize urethra and glans using iodine soaked cotton balls.

    • Instill 5-10 mL of 2% Lidocaine into the meatus, and occlude the meatus with a finger for 2-3 minutes.

    • Lubricate catheter and introduce it gently into the meatus, advancing until proximal ports reach the meatus.

Catheterization Technique (Continued)

  • Urine Flow Check:

    • Wait for urine drainage to confirm proper placement.

    • If no flow, aspirate urine with a 60-mL syringe; if no retrieval, withdraw and retry.

    • Avoid balloon inflation if there is severe pain or hematuria, which indicates possible urethral tear.

  • Securing the Catheter:

    • Use wide tape to secure catheter to the patient’s thigh.

Removing the Foley Catheter

  • Procedure:

    • Use a syringe to deflate the balloon before gentle traction to remove catheter.

    • Non-deflating catheter signs:

      • Pain, discomfort, resistance, or inability to aspirate normal saline.

Possible Complications

  • Infectious Complications:

    • Urethritis, cystitis, pyelonephritis, transient bacteremia

  • Other Complications:

    • Paraphimosis in males

    • False passages

    • Urethral strictures or perforation

    • Bleeding

    • Altered micturition

    • Non-infectious complications: accidental removal, blockage, hematuria, and leakage.