Continuous catheterization of the bladder. Urinary catheter for women: description, purpose, installation features. Subtleties of installing a catheter in a man’s bladder

Catheterization is the insertion of a special tube (catheter), which may have different shape and length, diameter and material of manufacture, into certain cavity structures or channels of the body for the purpose of treatment or diagnosis.

Kidney catheterization

Renal catheterization is the insertion of a catheter into the ureter or pelvis. A similar procedure is performed using a special urethrocystoscope through which a ureteral catheter is advanced. The procedure requires strict adherence to antiseptic and aseptic rules. Sometimes catheterization is prescribed for the purpose of sounding or drainage.

Why is a catheter placed?

In general, catheterization is indicated in the following cases:

To determine ureteral patency and the degree of obstruction in it;
In order to obtain separate urine for the diagnosis of leukocyturia and determine its origin;
To eliminate urinary stasis;
Bougienage;
Reduction of stones;
To carry out the retrograde pyeloureterography procedure;
To restore urinary outflow when acute form pyelonephritis or ureteral stone occlusion.

Indications for the procedure may vary depending on the gender and age of the patient.

During pregnancy

Pregnant women are at risk of developing renal pathologies increases significantly, which is associated with changes in genitourinary organs during the period of bearing a child. Kidney damage negatively affects pregnancy and fetal health.

Catheterization may be prescribed for pregnant women in the following cases:

Renal hydronephrosis;
Chronic or gestational pyelonephritis.

Catheterization in pregnant women with pyelonephritis performs a serious therapeutic task - it relieves the patient of renal blockade.

In men

The catheterization procedure in men is technologically a more complex procedure, since the length of the male urethra is longer than that of the female.

Indications for catheterization in male patients are:

Urinary outflow disorders;
Inflammatory processes in the urinary system (for the purpose of rinsing);
For chronic or acute urinary retention;
To obtain urine from the pelvis for the purpose of studying it in more detail;
For therapeutic purposes, the technique is used to administer medications.

Usually a soft catheter is used, but if it is not possible to insert it, then a rigid tube is used, for example, for prostate adenoma or for strictures urethra.

Among women

In women, catheterization of the kidney and ureter, in addition to diagnostic purposes and some of the above diseases, can also be performed for acute nephritis and urolithiasis. When to do this is decided by the attending physician.

If there are stones in the kidneys, a catheter helps restore urinary flow, which is blocked by the stone.

Executing the procedure

Most often, during the catheterization process, rubber catheters of different lengths and diameters are installed. The procedure is carried out using a cystoscope, at the end of which there is specialized equipment for the most accurate installation of the tube - an Albarran lift.

The microcamera on the device visualizes the advancement of the catheter:

Before placing a catheter, bladder a cystoscope is inserted; if the procedure is performed on men, then a solution is first injected local anesthesia. Before insertion, the urethral opening must be treated with an antiseptic.
The cystoscope is thoroughly disinfected before insertion and treated with vaseline or glycerin oil.
Women this procedure performed in a supine position with hips apart and knees bent.
If necessary, the bladder cavity is first washed to remove bloody or urinary debris and filled with saline solution.
Then they look for an outlet into the ureter by rotating the microcamera of the cystoscope. When the ureteral orifice is located, the microcamera is brought to it so that it enlarges and is located directly in the center of the visual field.
Then the catheter is carefully inserted. Having reached the right place, it is fixed. How long the procedure lasts depends on your goals.

As for the period for which a catheter is placed, it all depends on the purpose. For diagnostic purposes, the doctor obtains the necessary biomaterial and removes the device back. If the procedure is carried out with therapeutic purposes, then the catheter can be left indefinitely, for example, to drain urine from the pelvis. Then a special tube is used, which has loops at the end for better fixation.

If there are problems with urination, catheterization is carried out 6 times a day (every 4 hours). If you wear a catheter for a long time, you may experience infectious process, so periodically the doctor takes it out, washes it and puts it back. Please note that only an experienced specialist can flush the catheter.

Diagram of catheter insertion into the kidney

Inserting a catheter into a man's bladder through the urinary (urethral) canal is a fairly commonly used medical procedure. This method is widely used for diagnostic and therapeutic purposes. A bladder catheter in men can be placed on short term, as a rule, this is necessary during long difficult surgical operations or long term. Long-term catheterization is often carried out in diseases, in cases where the physiological act of urination is difficult or impossible, for example, with prostate carcinoma.

Knowledge of the anatomy of the male urethra is important for all professionals performing this procedure—bladder catheterization is one of the most commonly performed procedures in healthcare. The male urethra is very susceptible to various pathological conditions: from traumatic infectious to neoplastic. Pathophysiological processes in the urethra can have catastrophic consequences, such as renal failure or infertility. Therefore, catheterization should only be performed by an experienced specialist.

A bladder catheter in men is installed for the following diagnostic indications:

Obtaining a urine sample for subsequent studies directly from the bladder cavity. This is often necessary to determine the species composition of the microflora found in it.
Constant monitoring of the amount of urine excreted and its organoleptic characteristics during the process.
Study of urinary tract patency.

Therapeutic catheter placement includes the following reasons:

Acute retention of urine, for example due to benign prostatic hypertrophy, blockages in the bladder neck or urethra.
Chronic obstruction caused by hydronephrosis.
Irrigation internal walls bladder medications.
Intermittent decompression of the neurogenic bladder. Catheterization in this case is an integral part of therapy.
Ensuring urine excretion in patients for whom organizing the physiological act of urination presents certain difficulties. Often required in bedridden patients.

A catheter for emptying the bladder, depending on the additional purposes of the procedure, can be temporary, permanent, hard or soft.

In some cases, a bladder catheter in men may not be recommended or completely contraindicated. This is relevant when:

Fractures of the penis.
Injuries of the lower urinary tract– urethra, cervix or bladder sphincter.
Other injuries in the pelvic area, in which insertion of a catheter may be difficult or provoke additional disorders: extensive deep hematomas in the perineal area, bone fractures, and so on. In this case, the insertion of the catheter is necessarily preceded by a retrograde urethrogram.

The procedure for removing urine from the bladder in women by catheterization can have both diagnostic and therapeutic significance. This manipulation is indicated if it is impossible to urinate on your own, in the absence of the ability to retain urine, in order to introduce a series of medications, and is also carried out while the patient is under narcotic pain relief. Most often, in women, this manipulation does not present significant difficulties and is carried out by nursing staff. At the same time, it must be remembered that as a result of an incorrectly performed procedure, complications in the form of an infectious and inflammatory lesion cannot be excluded. urinary tract and traumatic damage to the bladder wall.

What is the procedure

Catheterization is a manipulation in which urine is removed using a catheter inserted into the cavity of the bladder. Catheters are medical products in the form of rigid or elastic tubes, which are made from metal or plastic materials, rubber latex or synthetic polymers; mandatory sterilization is required before use. They have different sizes; for manipulation in women, products with sizes from 16 to 20 are usually used. Catheters are also disposable; they come from production already sterile and individually packaged.

Metal catheters are dangerous traumatic injury the walls of the urethra and bladder should only be inserted by a specialist with higher medical education.

To teach the bladder catheterization procedure, special dummies are used that simulate the elasticity and firmness of the urethral walls.

Indications for catheterization

Exists wide range Indications for prescribing the catheterization procedure:

inability to independently perform the act of urination due to acute or chronic urinary retention;
emptying the bladder for patients under general anesthesia;
urine excretion in patients with spinal injury;
taking urine for analysis;
the need to collect urine for diagnostic purposes at specified intervals;
flushing the bladder to free it from blood clots, stone residues, and pus;
introduction with therapeutic purpose medicinal solutions.

In addition, catheterization is indicated for filling the bladder with contrast during ascending cystography and injecting fluid into the bladder in preparation for ultrasound examination.

Contraindications to catheterization

The procedure is contraindicated if traumatic injury and injury to the organs of the urinary system, as well as in the presence of an acute infectious and inflammatory process in the urinary tract.

Emptying the bladder of urine for the purpose of its removal, as well as diagnosing acute urinary retention, should be carried out in all women after delivery. Immediately after the birth of a child, women are asked to urinate on their own, but if due to a number of physiological or psychological reasons If she is unable to do this, she is given a catheter. Fortunately, I managed to avoid the catheterization procedure, but for those women who underwent the operation caesarean section using general anesthesia, I had to go through it. Sharing their impressions, they mentioned slight discomfort during subsequent independent urination, but noted that the feeling of discomfort passed quite quickly.

Features of catheterization in women

Because the female urethra is much wider and shorter than the male urethra, this procedure is usually much easier for women. At the same time, the short and wide urethra facilitates the upward penetration of pathogenic microorganisms that do not encounter serious obstacles on their way. That is why, when carrying out catheterization in women, it is important to prevent the penetration of pathogenic bacteria into the upper sections urinary tract, which is ensured by strict adherence to the rules of asepsis and antiseptics. This manipulation usually does not require special preparation and is performed without prior anesthesia.

Because the female urethra is shorter and wider than that of men, bladder catheterization is easier to perform in women.

Equipment used for manipulation

To perform catheterization, the following equipment and materials are required:

bix with sterilized catheters or disposable sterile catheters in individual packaging;
sterile tweezers for removing the catheter;
urinal;
sterile gloves;
disinfectant solution and sterile beads for treating the external entrance to the urethra;
sterile petroleum jelly;
tray for waste material.

Types of catheters

The main requirements for urethral catheters are their atraumaticity, elasticity, high biological compatibility and chemical resistance. Silicone has minimal irritating and allergic effects, but silicone products are very expensive. Currently, the most popular are latex catheters with an external silicone coating.

The best material silicone is considered to be used for the manufacture of a urethral catheter, but such products also have the highest cost

Catheters are divided into permanent and temporary, flexible and rigid; depending on the number of additional passages, they can be one-, two-, or three-channel. In addition, there is also a division of catheters into male and female models - the latter have a larger width and a shorter length. To catheterize the female bladder today, various modifications of Foley and Nelaton catheters are used.

Nelaton catheters

Nelaton catheters are straight elastic tubes with a rounded blunt end with two drainage holes. They are usually made from latex or polymer materials. They are most often used for one-time urine removal when independent urination is impossible. As permanent catheters for modern stage are practically not used.

Foley catheters

Another type of urine removal products used in urological practice are Foley catheters. They are used when prolonged catheterization of the bladder and a number of medical procedures are necessary. At the end of the catheter inserted into the bladder there is a special balloon, which is filled with liquid through a narrower additional channel. The balloon is inflated, and thus the catheter can be fixed in the bladder for a fairly long period.

A Foley catheter is used for long-term installation in the bladder and has a special fixation balloon

Algorithm for bladder catheterization in women

No special preparation is usually required for catheterization of the female bladder. Particularly impressionable women with a labile nervous system should be prepared psychologically, explaining to them the need for this procedure and assuring them of its safety and painlessness. A medical worker treats hands with a special disinfection solution (for example, 0.5% chlorhexidine digluconate solution) and performs the following manipulations:

Using the fingers of his left hand, he spreads the woman’s labia and thereby frees the entrance to the urethra.
Using a cotton gauze ball soaked in a disinfectant solution, treat the external opening of the urethra in a circular motion.
Using sterile tweezers, remove the catheter and generously moisten its inserted end with sterile Vaseline oil(or glycerin).
Takes a catheter into right hand at a distance of 4–6 cm from the inserted end and with smooth forward movements moves it along the urethra towards the bladder.
The appearance of urine at the opposite end of the catheter indicates that catheterization was carried out correctly and the catheter has reached the bladder.
To remove urine, the catheter is connected to a urinal; after the urine is released, you should press on the lower abdomen, thereby facilitating the final emptying of the bladder. If there is a need to measure the amount of urine excreted, it is poured from the urine bag into a measuring container.
If it is necessary to rinse the bladder, a disinfectant solution is injected using an additional channel on the catheter.

Video: bladder catheterization technique in women

How long can a catheter last?

Duration of stay medical device in the patient's bladder depends on the material from which the catheter is made or covered. Thus, latex catheters with a silicone coating can be installed for a week, those made entirely of silicone can last a month, and applying a special silver coating to the silicone catheter extends the possibility of their use up to three months.

To prevent infection of the urinary organs, it is necessary to carefully care for the installed urinary catheter. The skin around it must be treated with warm water and soap twice a day. After bowel movements, women should be washed from front to back to avoid infection from anus. The urinal must be emptied of accumulated urine at least every 3-4 hours, and the urinal itself must be fixed below the level of the bladder to prevent the backflow of urine.

All manipulations with the urinary catheter must be carried out with medical gloves, observing the rules of asepsis.

If installed urinary catheter becomes clogged, it must be washed periodically. For this purpose, a sterile saline solution is used, and when the urine collected in a urinal bag is cloudy or contains flakes, it is better to use an antiseptic solution for rinsing. This can be furatsilin at a dilution of 1:5000, 2% chlorhexidine solution, 3% solution boric acid or miramistin. A disinfectant solution is poured into a Janet syringe treated with an antiseptic; after disconnecting the urinal bag, the syringe is connected to the free end of the catheter and the bladder is filled with the solution, starting with small portions of 25–30 ml. After this, the syringe is disconnected and the solution is allowed to come out freely. The manipulation is repeated until clean wash water is obtained.

In some cases, the patient can remove the installed permanent catheter herself, but it is better to entrust this manipulation to specialists, since complications may arise when removing the catheter. The catheter is removed until the bladder is completely emptied so that the remaining urine accumulated in it can wash the urethra and free it from pathogens.

Before removing the catheter, it is necessary to disconnect it from the urinal bag.

First, the urinal bag is removed, freeing it from collected urine. After this, the patient is recommended to lie on her back, bend her knees and slightly spread them, and treat the area around the entrance to the urethra at the site of the installed catheter with a disinfectant solution. Before removing the catheter, the first step is to empty the balloon that holds the catheter in the bladder cavity from the liquid. For this, it is recommended to use a 10 ml syringe, since the volume of the fixation balloon usually does not exceed 4–6 ml. After this, the catheter itself is removed. If problems arise when removing it, it is possible that the fixing balloon was not completely emptied; the remaining liquid should be removed and then the manipulation should be repeated.

If the catheter appears damaged after removal, you should immediately inform your doctor. After removing the catheter, you should drink more fluid; large amounts of urine help flush out pathogens. It is recommended to take sitz baths with disinfectant solutions, which can be chamomile decoction or a weak solution of potassium permanganate.

Consequences and possible complications of catheterization

The most common complication is urinary tract infection, and the longer the catheter is in place, the higher the likelihood. Every second patient with an indwelling urinary catheter has bacteriuria. The most severe manifestation of an infectious complication during catheterization is urethral fever, in which pathogenic organisms enter the bloodstream through damaged mucous membranes. To reduce risk infectious complications and their treatments are prescribed antibacterial therapy.

One of frequent complications catheterization is the development of an infectious-inflammatory process in the urinary tract

Another possible complication of catheterization is “empty bladder” syndrome, which occurs mainly in elderly and debilitated patients. Its essence is that with a quick and sharp emptying of the bladder with overstretched due to long delay urine walls may cause decompensation of cardiac activity (drop in pressure, increased heart rate) and disruption of the excretory function of the kidneys, up to a delay in urine production. To avoid such complications, such patients should remove urine slowly and in small portions.

Violations of the integrity of the walls of the urinary system organs can occur when using rigid catheters, as well as during rough and forced installation of the product. Complications of this kind are less common in female patients than in male patients. These complications are characterized by perforation of the wall of the urethra or the bladder itself, creating a “false passage.” As a rule, they are accompanied by pronounced pain syndrome With further development peritonitis clinics.

Catheterization of the female bladder is common medical manipulation, which has both diagnostic and therapeutic value. Appointed during surgical interventions, carried out under general anesthesia, if it is impossible to perform the act of urination independently, before carrying out a series of diagnostic procedures for the purpose of introducing radiopaque substances. The technique of catheterization of the largest organ of the urinary system in women is simpler to perform compared to men, and the procedure itself is accompanied by fewer traumatic complications. At the same time, it is necessary to remember the need to strictly adhere to the rules of asepsis both during the catheter insertion procedure itself and in the process of caring for it in order to avoid the development of an infectious process.

A catheter is a medical device that consists of a long, thin tube and can be equipped with various attachments to perform various functions. Catheters are placed during various medical procedures, for example, they are used to examine for bleeding in the genitourinary canal, when monitoring intracranial pressure and even for the administration of certain medications. Typically, a catheter is placed in the patient's urethra and bladder to drain urine. Like many common medical procedures, this one requires the necessary medical knowledge and compliance with sanitary and safety standards.

Steps

Part 1

Preparations for entry

Explain the entire process to the patient before you begin. For many patients, the thought of having something inserted into their urethra, especially a long tube, is alarming. Although this procedure is generally rarely described as “painful” and more often “unpleasant,” it can be quite uncomfortable. Out of respect for the patient, describe all of your catheter placements before starting the procedure.

Telling the patient what to expect and what you will do will help them relax and not feel anxious.

Ask the patient to lie on their back. The patient's legs should be spread and feet should be pressed together. This position will relax the patient's urethra and bladder, making it easier to insert the catheter. A tense urethra can resist the catheter, compressing it, which in some cases leads to pain and sometimes damage to the urogenital meatus and its tissues. IN special cases this may lead to bleeding.
- Assist the patient into a supine position if necessary.
Wash your hands and put on sterile gloves. Gloves are an important part of the PPE (Personal Protective Equipment) that medical professionals use to protect themselves and the patient during medical procedures. If a catheter is installed, this is done to prevent bacteria from getting into the patient’s urethra and biological fluids from getting onto the staff’s hands.

Open the catheter. Disposable catheters are packaged in sealed, sterile packaging. Before opening the package, make sure you have the correct catheter for your intended use. You will also need a catheter that is the right size for your patient. Size groups of catheters are designated in a unit called French (1 French = 1\3 mm) and are available from 12 (small) to 48 (large) French.
- For a more comfortable procedure, it is better to use small catheters, but in some cases large ones are also used, for example, if the urine is viscous, or you need to keep the catheter in place.
- Some catheters have special tips that allow you to manipulate the product. For example, a Foley catheter is used to drain urine and has a special inflatable cuff to secure it to the neck of the bladder.
- Also bring medical disinfectant, cotton swabs, surgical wipes, lubricant, water, tubing, drain bag, and tape. Everything must be clean and disinfected.
Sterilize and prepare the patient's genital area. Wipe the patient's genital area with cotton pads soaked in disinfectant liquid. Wipe or rinse the genital area with sterile water or alcohol to remove any remaining contamination. Repeat if necessary. Once finished, place the surgical drapes around the genitals, leaving access to the penis or vagina.
- For female patients, be sure to wipe the labia and urethra (located in the upper part above the entrance to the vagina), and for men, the head of the penis and also the urethra.
- Brushing should go from the opening of the canal to the outside of the genitals, in other words, start rubbing from the opening outward in a circular motion.
If the procedure is performed on a woman, spread the labia with your hand and insert the catheter into the genitourinary opening. Hold the catheter in your dominant hand and open your lips with your non-dominant hand so that you can see the opening of the urethra. Gently insert the end of the catheter into the urethra.

If the patient is male, hold the penis and insert the catheter into the urethral opening. Holding the penis in your non-dominant hand, pull it perpendicular to the patient's body. Using your dominant hand, insert the catheter into the patient's urethra.

Continue pushing the catheter until it enters the bladder. The length of the catheter should allow it to be gently passed through the urethra and bladder until urine appears. Once urine begins to flow, gently push the catheter about 5 cm more to ensure that the catheter is in the bladder neck.
If you are using a cuffed catheter, fill it with sterile water. Use a syringe filled with water to fill the catheter through the sterile tubing. The inflated cuff serves as an anchor, which will prevent the catheter from moving when moving. Once you have inflated the cuff, gently pull on the catheter and make sure it is firmly seated at the neck of the bladder.
- The amount of water used to fill the cuff depends on its size - typically 10 cc. see water, but it's better to check the cuff size.
Attach the catheter to the drainage bag. It is better to use a sterile medical tube for draining. Secure the catheter to the patient's thigh or abdomen with adhesive tape.
- Make sure the urine drainage bag is below the patient's bladder. The catheter works by gravity - urine cannot flow "up".
- In a medical setting, the catheter can be installed for up to 12 weeks before it needs to be replaced, but, as a rule, they are removed much earlier. Some catheters are removed immediately after urine stops flowing.

Catheters are made from a variety of materials, such as latex, silicone, and Teflon. They also have different cuff sizes or come without them at all.
Empty the drain bag every eight hours.
Most health care workers use generally established standards of protection, wearing gloves, a mask, goggles, and capes when inserting a catheter.
Assess the amount, color, and smell of urine entering the bag.
If a person is bedridden, the area around the catheter must be cleaned to prevent infection. Signs of a bladder and urethral infection: weakness, red or brown urine, confusion, slurred speech. If you experience one or more of these symptoms, consult your doctor without delay. If you are caring for a patient at home, we also recommend contacting your doctor if these signs appear.

Warnings

Some patients are allergic to latex. Watch the reaction.
If the catheter is leaking and little urine is collected in the urine bag, it is likely not installed correctly.
Watch for possible complications: strong odor, cloudy urine, fever, or bleeding.
Foley catheters should only be placed medical workers or under their supervision. Improper placement of a Foley catheter can result in catastrophic urethral injury.

Urinary catheter is a system of tubes placed in the body to drain and collect urine from the bladder.

Urinary catheters are used to drain the bladder. Bladder catheterization is often the last resort due to possible complications from prolonged use of a catheter. Complications associated with catheter use may include:

Bubble Stones
Blood infections (sepsis)
Blood in the urine (hematuria)
Skin damage
Urethral injury
Urinary tract or kidney infections

There is a wide variety of urinary catheters. Urinary catheters vary in the material they are made from (latex, silicone, Teflon) and type (Foley catheter, straight catheter, curved tip catheter). For example, a Foley catheter is a soft plastic or rubber tube that is inserted into the bladder to drain urine.

Urologists recommend using smallest size catheter. Some people may need larger catheters to prevent urine from leaking around the catheter or if the urine is concentrated and contains blood or large amounts of sediment.

It must be remembered that large catheters can damage the urethra. Some people may develop an allergy or sensitivity to latex with long-term use of latex catheters. In these patients, Teflon or silicone catheters should be used.

Long-term (permanent) urinary catheters

A catheter that is inserted into the bladder long time, connected to a urinal to collect urine. There are two types of urinals.

The first type of urine bag is a small bag that is attached to the leg with an elastic band. This urine bag can be worn during the day, as it can be easily hidden under trousers or a skirt. The bag is easy to empty in the toilet.

Another type of urine bag is a large bag that is used at night. This urine bag is usually hung on the bed or placed on the floor.

How to care for your urinary catheter

If the catheter becomes clogged, painful, or infected, the catheter must be replaced immediately.

To care for an indwelling catheter, you must wash the urinary area (where the catheter exits) daily with soap and water. Also thoroughly clean the genital area after each bowel movement to prevent the catheter from becoming infected. Urologists no longer recommend the use of antibacterial ointments for cleaning catheters, since their effectiveness in preventing infection has not been proven.

Increase your fluid intake to reduce the risk of complications (if you are healthy enough to drink plenty of fluids). Discuss this problem with your doctor.

The urine bag should always be positioned below the bladder to prevent urine from flowing back into the bladder. Empty the urine bag either every 8 hours or as it becomes full.

Make sure that the urine bag outlet valve remains sterile. Wash your hands before and after handling the urine bag. Do not let the outlet valve touch anything. If the outlet valve is dirty, wash it with soap and water.

How to treat a urinal?

Clean and deodorize the urine bag by filling the bag with a solution of two parts vinegar and three parts water. Water solution You can replace vinegar with chlorine bleach. Soak the urine bag in this solution for 20 minutes. Hang the urine bag with the outlet valve open to dry it.

What to do if the catheter leaks?

Some people may experience urine leakage around the catheter. This phenomenon may be due to a small catheter, an improperly sized balloon, or bladder spasm.

If bladder spasm occurs, check that the catheter is draining urine properly. If there is no urine in the urine bag, the catheter may be blocked by blood or coarse sediment. Or, the catheter or drainage tube has become twisted and formed a loop.

If you have been taught how to flush a catheter, try to flush the catheter yourself. If you cannot flush the catheter, consult a doctor immediately. If you have not been instructed how to flush the catheter and urine does not flow into the urine bag, you should immediately contact your doctor.

Other causes of urine leakage around the catheter include:

Constipation
Urinary tract infections

Potential complications of using urinary catheters

Contact your doctor if you develop any of these complications:

Bleeding in or around the catheter
Catheter drains a small amount of urine, or no urine despite adequate fluid intake
Fever, chills
Leakage large quantity urine around the catheter
Strong-smelling urine or urine that is cloudy or thick
Swelling of the urethra around the catheter

Suprapubic urinary catheters

Suprapubic urinary catheter is an indwelling catheter that is inserted directly into the bladder through the abdomen above the pubic bone. This catheter is inserted by a urologist in either a clinic or hospital setting. The catheter exit site (located on the abdomen) and the catheter should be cleaned daily with soap and water and covered with dry gauze.

Suprapubic catheters are replaced by a qualified medical staff. The suprapubic catheter can be connected to the standard urine bags described above. A suprapubic catheter is recommended:

After some gynecological operations
For patients who require long-term catheterization
For patients with trauma or urethral blockage

Complications caused by the use of a suprapubic catheter may include:

Bladder stones
Blood infections (sepsis)
Blood in the urine (hematuria)
Skin damage
Urine leakage around the catheter
Urinary tract or kidney infections.

After prolonged use of a catheter, bladder cancer may develop.

How to place a urinary catheter in a man?

Wash your hands. Use betadine or a similar antiseptic (if not available) special instructions) to treat the external opening of the urethra.
Wear sterile gloves. Make sure you don't touch with your hands outer surface gloves with hands.
Lubricate the catheter.
Take your penis and hold it perpendicular to your body. Pull the penis slightly towards the navel.
Begin to gently insert and advance the catheter.
You will encounter resistance when you reach the external sphincter. Ask the patient to do a few deep breaths to relax the muscles that close the urethral opening and continue to advance the catheter.
If urine appears, continue to advance the catheter to the level of the “Y” connector. Keep the catheter in one position while you inflate the balloon. Inflation of the catheter balloon in the urethra causes severe pain and may cause injury. Check that the catheter is in the bladder. You can try flushing the catheter with a few milliliters of sterile water. If the solution does not return easily, the catheter may not be inserted far enough into the bladder.
Secure the catheter and attach a urine bag to it.

How to place a urinary catheter in a woman?

Gather all the equipment: catheter, moisturizing gel, sterile gloves, clean wipes, syringe with water to inflate the balloon, urine bag.
Wash your hands. Use betadine or another antiseptic to clean the urethral meatus. In women, it is necessary to treat the labia and urethral opening with gentle movements from top to bottom. Avoid the anal area.
Wear sterile gloves. Make sure that you do not touch the outer surface of the gloves with your hands.
Lubricate the catheter.
Separate the labia and locate the urethral opening, which is located below the clitoris and above the vagina.
Slowly insert the catheter into the opening of the urethra.
Advance the catheter gently.
If urine appears, advance the catheter another 2 inches. Keep the catheter in one position while you inflate the balloon. Check that the catheter is in the bladder. If the patient feels pain when inflating the balloon, it is necessary to stop. Deflate the balloon and advance the catheter an additional 2 inches and attempt to inflate the catheter balloon again.
Secure the catheter and attach a urine bag.

How to remove a urinary catheter?

Indwelling catheters can be removed in two ways. The first method is to attach a small syringe to the opening of the catheter. Remove all liquid. Slowly pull out the catheter.

Caution: Never remove your indwelling catheter unless your doctor has instructed you to do so. Remove the catheter only after your doctor's permission.

Some urologists instruct their patients to cut the catheter balloon inflation tube above the main tube. After all the water has drained, slowly pull out the catheter. Be careful, the catheter cannot be cut anywhere else.

If you cannot remove the urinary catheter with little effort, inform your doctor immediately.

Tell your doctor if you do not pass urine within 8 hours after the catheter is removed, or if your stomach is swollen and painful.

Short-term (intermittent) catheters

Some patients require periodic bladder catheterization. These people should be taught how to insert a catheter themselves to drain the bladder when necessary. They do not need to wear a urine bag all the time.

People who may use intermittent catheterization include:

Any patient who is unable to properly empty the bladder
Men with large prostates
People with defeat nervous system(neurological diseases)
Women after certain gynecological operations

The process is similar to the procedures described above. However, the balloon does not need to be inflated and the catheter is removed immediately after the urine flow has stopped.

The article is for informational purposes only. For any health problems, do not self-diagnose and consult a doctor!

V.A. Shaderkina - urologist, oncologist, scientific editor