Urethral Catheterization: Female (Internal Medicine)

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SAMPLE EXCERPT
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PRE-PROCEDURE
INDICATIONS
  • Acute urinary retention
  • Urine output monitoring in a critically ill or injured patient
  • Collection of a sterile urine specimen for diagnostic purposes
  • Intermittent bladder catheterization in patients with neurogenic bladder dysfunction
  • Urologic study of the lower urinary tract
CONTRAINDICATIONS
  • There are no absolute contraindications for urethral catheterization in female patients.
EQUIPMENT
  • Foley catheter of appropriate size
  • Water-soluble lubricant for catheter
  • 10-mL syringe of sterile water for Foley balloon
  • Sterile drainage bag with tubing
  • Sterile drapes
  • Sterile gloves
  • Povidone-iodine
  • Sterile gauze pads or cotton balls
  • Sterile specimen cup with lid
  • Cloth, paper, or plastic tape (to secure catheter to trunk or leg)
  • Benzoin (for increasing tape adherence)
  • Forceps
ANATOMY
  • The female urethra is a short (approximately 4 cm), straight tube, usually of wide caliber, lying on top of the vagina.
  • The female urethral meatus is oval but may appear as an antero-posterior slit with rather prominent margins situated directly superior to the opening of the vagina and approximately 2.5 cm inferior to the glans clitoris.

PROCEDURE
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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

POST-PROCEDURE
CARE
  • Following successful catheter passage and Foley balloon inflation, slowly withdraw the catheter until the approximation of the balloon with the bladder neck precludes further withdrawal.
  • Connect the catheter to a sterile leg bag or closed-system bedside drainage bag.
  • Secure the catheter to the thigh with adhesive tape or simply place it under the knee to drain dependently into the bedside drainage bag.
  • If the patient will be discharged from the hospital or medical facility with an indwelling Foley catheter, it can be connected to a leg bag, which is then comfortably fastened to the lower thigh and upper calf.
    • The patient and family must be instructed regarding proper care of the catheter and drainage device.
COMPLICATIONS

Although urethral catheterization performed by skilled personnel in appropriate circumstances has an acceptable complication rate, untoward sequelae of catheterization are not unusual.

  • Infection
  • Urethral stricture
  • Bladder stones
  • Hematuria
  • Retained catheter
  • Other rare complications of long-term indwelling urethral catheterization include bladder stones, recurring bladder spasm, periurethral abscesses, bladder perforation, and urethral erosion.
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