Urinary catheterization with PPT

Its a sterile procedure done for the continuous bedridden patients and patients with the urinary retention. Urinary catheterization common procedure before the surgery and in ICU.

Indications

Acute urinary retention
Urethral or prostatic obstruction leading to compromised renal function
Urine output monitoring in a critically ill or injured patient
Collection of a sterile urine specimen for diagnostic purpose
Intermittent bladder catheterization in patients with neurogenic bladder dysfunction.

Contraindications

Pelvic Fracture
Urethral Rupture

Technique

Shave, clean and drape the part.
A sterile technique is mandatory.

Retract the foreskin in a male to its fullest extent proximal to the glans penis.
In the female use the non-dominant thumb and index finger to separate the labia and
expose the urethral meatus.
Clean the exposed meatus with an antiseptic solution.

Urinary Catheterization Procedure

In a male inject the urethra with 5ml of 2% viscous lignocaine. Gently pass a 14 to 16 F
Foleys catheter (in adults) lubricated with a viscous lignocaine through the urethra and
upward into the bladder.
After passing the catheter to the hilt in all male patients slowly inflate the balloon with 10
ml of air or tap water.

Obvious resistance or patient discomfort on balloon inflation indicates malpositioning.
Immediately deflate the balloon and reposition the catheter or withdraw slightly. Then
pass it to the hilt again and reinflate the balloon.
Once the balloon is successfully inflated, slowly withdraw the catheter until the
approximation of the balloon with the bladder neck precludes further withdrawal.
In a male, reposition the foreskin in place to prevent paraphimosis from occurring.
Then connect the catheter to a sterile drainage bag.
Difficulties in male catheterization can occur in phimosis, edema of the foreskin, meatal
stenosis, urethral stricture, etc.

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