- Diagnosis
- History
- Examination
- Investigations
- History
- Management
- Interventions
Male Catheters
Male Catheters
Urinary catheters are used for a wide variety of indications including to relieve urinary retention, measure urine output and collect urine samples. Male catheterisation can be more difficult and higher risk than female catheterisation due to the length and course of the male urethra.
Clinical Use
Equipment & Preparation
Insertion
- Explain the procedure and ask for patient's consent
Positioning
Patient supine with legs spread and feet together
- Place a drape underneath the patient's buttocks
Prepare Sterile Field
- Don apron & goggles
- Scrub and don sterile gloves
Prepare Sterile Equipment
Inflate balloon to check patency
Prepare the Periurethral Area
E.g. with chlorhexidine
Decontaminate a wide area, starting with the glans, withdraw the foreskin
- Apply the fenestrated drape
- Hold the penis with the non-dominant hand and lift it straight up into the air
Inject Xylocaine Gel
Through the urethra and hold the meatus closed
Insert the Catheter
Gently, with a twisting motion, to the hilt
Inflate the balloon
Using volume of sterile water indicated on catheter (usually 10mL)
- Retract the catheter until resistance is felt
- Connect the drainage bag
- Remember to replace the foreskin
- Secure the catheter as required
Clean Up
Dispose of waste, remove gloves and wash hands
Complications
Urinary Tract Infection
Cystitis / pyelonephritis / sepsis
Traumatic Insertion
Haematuria, false passage creation, urethral stricture
Iatrogenic Hypospadias
Erosion of urethral meatus due to downward pressure
Bladder Stones
With long-term catheterisation
Bladder Cancer
Rare, but long-term catheterisation is a risk factor
Indications for Catheterisation
Overview
Indications
- Bladder drainage - for relief of acute urinary retention or bladder outlet obstruction
- Prevention of urinary retention due to clots
- Measurement of urine output
- Perioperative use - urologic surgery, prolonged surgery, large volumes of intraoperative infusion or diuretics, intraoperative urine output measurement
- Urine specimen collection in patients who are unable to voluntarily void
- To assist in the healing of perineal wounds in incontinent patients
- Instillation of medications into the bladder
Not Indications
- Urinary incontinence
- Confusion
- Prolonged bed rest with no indication for catheterisation
- Measuring urine output in patients who are able to void where hourly output is not required
- Prolonged postoperative catheterisation without an indication
Last updated on January 1st, 2018
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