Male Catheterization

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SAMPLE EXCERPT
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PRE-PROCEDURE
INDICATIONS

Short-Term Catheterization

  • Acute urinary retention
  • Collection of uncontaminated urine specimen for analysis, culture, and sensitivity
  • Diagnostic studies
  • Irrigation of the bladder or instillation of medication
  • Bladder drainage after surgery
  • Intermittent (in and out) for neurogenic bladder

Long-Term Catheterization

  • Chronic urinary retention
  • Incontinence with complicating skin breakdown

Filiforms and Followers

  • After unsuccessful Foley and coudé catheterization attempts in males
CONTRAINDICATIONS
  • Known or suspected urethral disruption resulting from pelvic trauma
  • Recent reconstructive surgery of the urethra or bladder neck (relative contraindication)
  • Known urinary tract obstruction such as a urethral stricture (relative contraindication)
  • A combative or uncooperative patient (relative contraindication; consider sedation)
  • Acute infection of the prostate and/or urethra (relative contraindication)
EQUIPMENT
  • Urethral catheter
  • Lubricant
  • Sterile towels and gloves
  • Sterile cotton-tipped applicators and antiseptic solution
  • Closed urinary drainage system
ANATOMY
  • Obstruction is commonly encountered at two points when a catheter is passed: the point of acute upward angulation between the bulbous and the membranous urethra, and at the bladder neck, where a bladder neck stenosis or an enlarged median lobe of the prostate gland may be present. In younger males, urethral folds or valves may resist insertion of a catheter.

PROCEDURE
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  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE

Catheter Management

  • Discomfort at the meatus may be reduced by applying petroleum jelly or vitamin E ointment daily.
  • Long-term indwelling catheters usually are replaced every 6 weeks.
  • Robinson and non–self-retaining coudé catheters will have to be secured to the penis.

Antibiotic Therapy

  • For suspected urinary tract infection or prophylaxis, check culture and sensitivity, and prescribe at least a 3-day course of broad-spectrum antibiotics.
COMPLICATIONS
  • Urinary tract infection
  • Transient hematuria
  • Creation of a false passage or perforation
  • Conversion of a partial urethral tear into a complete tear
  • Urethral stricture
  • Obstruction of flow
  • Epididymitis, pyelonephritis, or urosepsis
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