When performing an indwelling catheterization on a male the catheter should be inserted approximately?
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An indwelling urinary catheter (IUC), generally referred to as a “Foley” catheter, is a closed sterile system with a catheter and retention balloon that is inserted either through the urethra or suprapubically to allow for bladder drainage. External collecting devices (e.g. drainage tubing and bag) are connected to the catheter for urine collection Show
Indwelling urinary catheters are recommended only for short-term use, defined as less than 30 days (EAUN recommends no longer than 14 days.) The catheter is inserted for continuous drainage of the bladder for two common bladder dysfunction: urinary incontinence (UI) and urinary retention. Two Types of Indwelling CathetersIndwelling urinary catheters are either inserted:
Suprapubic catheterization is usually used for bladder drainage following in bladder, urethral or pelvic surgery, or following genitourinary trauma. Both methods of indwelling catheterizations are associated with complications. In practice, transurethral catheterization is the typical approach because the procedure can be organized and managed by nurses whereas suprapubic catheterization requires a more complex procedure. However, if in place long-term, defined as more than 30 days, the insertion, changing and management are done by nurses (registered nurses, licensed practical nurses). Transurethral Catheterization Transurethral indwelling catheterization or urinary catheterization is defined as passage of a catheter into the urinary bladder via the urethra (urethral catheter). Transurethral indwelling catheterization is also called urethral catheterization. In this site, we only use the term urethral catheterization. Suprapubic CatheterizationSuprapubic catheterization is the insertion of a catheter into the bladder via the anterior abdominal wall. The catheter is inserted through an incision made above the pubic bone and below the umbilicus. The insertion of this type of catheterization is done by a urologic specialist. Long term catheterization can be associated with many serious problems including urinary tract infections, urethritis, bladder spasms with pain and urinary leakage, and other bladder complications. Use PatternsShort TermShort-term uses include:
Long Term & CAUTILong-term use, defined as greater than 30 days, is discouraged because it provides access for bacteria from a contaminated environment into a vulnerable body organ and system. As a result, catheter-associated urinary tract infection (CAUTI) is the most common type of infection acquired in hospitals and nursing homes. At least 15% to 25% of patients may have an indwelling catheter inserted sometime during their hospital stay, with most only used for the short-term (defined as < 30 days). Prevalence is greater in high acuity patient units, with critical care and intensive care units having the highest prevalence. CAUTIs are associated with multiple complications and side effects, can lead to increased length of stays, mortality rates, and ultimately higher hospital costs. Urinary catheters are used to drain the bladder. Your health care provider may recommend that you use a catheter if you have:
Catheters come in many sizes, materials (latex, silicone, Teflon), and types (straight or coude tip). A Foley catheter is a common type of indwelling catheter. It has soft, plastic or rubber tube that is inserted into the bladder to drain the urine. In most cases, your provider will use the smallest catheter that is appropriate. There are 3 main types of catheters:
INDWELLING URETHRAL CATHETERS An indwelling urinary catheter is one that is left in the bladder. You may use an indwelling catheter for a short time or a long time. An indwelling catheter collects urine by attaching to a drainage bag. The bag has a valve that can be opened to allow urine to flow out. Some of these bags can be secured to your leg. This allows you to wear the bag under your clothes. An indwelling catheter may be inserted into the bladder in 2 ways:
An indwelling catheter has a small balloon inflated on the end of it. This prevents the catheter from sliding out of your body. When the catheter needs to be removed, the balloon is deflated. CONDOM CATHETERS Condom catheters can be used by men with incontinence. There is no tube placed inside the penis. Instead, a condom-like device is placed over the penis. A tube leads from this device to a drainage bag. The condom catheter must be changed every day. INTERMITTENT CATHETERS You would use an intermittent catheter when you only need to use a catheter sometimes or you do not want to wear a bag. You or your caregiver will insert the catheter to drain the bladder and then remove it. This can be done only once or several times a day. The frequency will depend on the reason you need to use this method or how much urine needs to be drained from the bladder. DRAINAGE BAGS A catheter is most often attached to a drainage bag. Keep the drainage bag lower than your bladder so that urine does not flow back up into your bladder. Empty the drainage device when it is about one half full and at bedtime. Always wash your hands with soap and water before emptying the bag. HOW TO CARE FOR A CATHETER To care for an indwelling catheter, clean the area where the catheter exits your body and the catheter itself with soap and water every day. Also clean the area after every bowel movement to prevent infection. If you have a suprapubic catheter, clean the opening in your belly and the tube with soap and water every day. Then cover it with dry gauze. Drink plenty of fluids to help prevent infections. Ask your provider how much you should drink. Wash your hands before and after handling the drainage device. DO NOT allow the outlet valve to touch anything. If the outlet gets dirty, clean it with soap and water. Sometimes urine can leak around the catheter. This may be caused by:
POSSIBLE COMPLICATIONS Complications of catheter use include:
Call your provider if you have:
If the catheter becomes clogged, painful, or infected, it will need to be replaced right away. Alternative NamesCatheter - urine; Foley catheter; Indwelling catheter; Suprapubic catheters ReferencesDauw CA, Wolf JS. Fundamentals of upper urinary tract drainage. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 12. Davis JE, Silverman MA. Urologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 55. Panicker JN, DasGupta R, Batla A. Neurourology. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 45. Sabharwal S. Spinal cord injury (lumbosacral). In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 158. Review Date 1/10/2021Updated by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. How far should male catheter be inserted?Encourage your patient to breathe deeply as you gently insert the catheter tip into the meatus. Advance it 7 to 9 inches (17.5 to 22.5 cm) or until urine starts draining, then advance it another inch (2.5 cm). If you meet any resistance, rotate or withdraw the catheter slightly.
How far should you insert an indwelling urinary catheter into a male patient's urethra when first placing the catheter?Male patient: Hold penis perpendicular to body and pull up slightly on shaft. Ask patient to bear down gently (as if to void) and slowly insert catheter through urethral meatus. Advance catheter 17 to 22.5 cm or until urine flows from catheter.
How far should a male catheter be inserted before inflating the balloon?Insert the catheter into the urethral opening, upward at approximately 30-degree angle until urine begins to flow freely. Advance the catheter a further 2-4 cm to ensure the balloon is clear of the urethra.
Where should indwelling catheters be placed?An indwelling catheter may be inserted into the bladder in 2 ways:. Most often, the catheter is inserted through the urethra. This is the tube that carries urine from the bladder to the outside of the body.. Sometimes, the provider will insert a catheter into your bladder through a small hole in your belly.. |
