Bladder Catheterization—Female (Emergency Medicine)

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  • To obtain sterile urine for analysis and culture in patients unable to provide a clean voided specimen
  • For placement of indwelling catheter to monitor urine output and assess fluid status
  • To measure bladder residual urine volume
  • To instill radiologic contrast dye for radiologic studies
  • To empty neurogenic bladder
  • To relieve urinary retention or obstruction
  • To maintain urethral patency in patients with perineal injury (e.g., burns, contusions)

Absolute Contraindications

  • Complete labial fusion
  • Known or suspected urethral trauma, indicated by blood at the meatus, perineal soft tissue trauma

Relative Contraindications

  • Patient unlikely to have sufficient urine in the bladder
  • Immunocompromise
  • Congenital genitourinary malformations
  • Recent urethral surgery
  • Previous difficulties with catheterization
  • Potential allergy to latex or iodine
  • Sterile urethral catheter
  • Syringe with sterile water or saline for balloon, if a Foley catheter is placed
  • Water-soluble bacteriostatic lubricant
  • Povidone-iodine swabs, or povidone, soap, and/or water or normal saline
  • Cotton balls or sponges
  • Forceps to handle cotton balls
  • Sterile drapes—one nonfenestrated and one fenestrated
  • Specimen collection tube(s) or cup(s), if urine is collected
  • Gloves, preferably latex-free
  • Nonsterile, warm, wet washcloth(s) to clean the perineum
  • Oral sucrose may decrease pain in neonates and infants up to 6 months of age.
  • Tape (plastic or cloth)
  • Benzoin
  • Connector tubing
  • Closed urine collecting receptacle
  • 2% viscous lidocaine gel and applicator to anesthetize the urethra before Foley placement is optional.
  • Equipment for bladder catheterization is also available as prepackaged commercially available kits.
  • The pediatric female urethra is short—approximately 2 cm at birth and 3 cm by age 5 years.
  • The urethral meatus is immediately superior to the vaginal introitus and inferior to the clitoral hood.
  • Female hypospadias may make catheterization difficult, because the meatal opening is in the superior anterior vaginal wall, and other urethral/vaginal anatomic abnormalities may be present. A curved-tipped Coudé catheter may be necessary for catheterization in this circumstance.

Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

  • Sample handling
    • Divide sample, if necessary, and place in tightly closed containers.
    • Label specimen container(s), and send to the laboratory as soon as possible.
  • Wash the perineum with a warm wet washcloth or cotton balls to remove all remaining povidone-iodine.
  • Vaginal catheterization
  • Urethral irritation
  • Urethral or bladder trauma
  • Catheter-associated urinary tract infection
  • Knotting of the catheter within the bladder
  • Urethral stricture
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