Urinary Foley Catheter Insertion

OBJECTIVES:
• List the indications for urethral
catheterization.
• Describe the types of urethral catheters.
• Know how to prepare the patient for
urethral catheterization.
• Describe the technique for urethral
catheterization.
• Describe what to do in cases of difficult
urethral catheterization
CATHETERIZATION
 Size: 1 French (Fr) = 0.33 mm outer
diameter
Rule of Thumb: To determine the diameter of a
catheter divide the Fr size by 3 (i.e. 18 Fr = 6mm)

 Material
Latex
Rubber
Silicon
Simplastic
 Catheter Types
A. Robinson (“red rubber”) Straight cath
D. Coude-Curved Tip
Difficult catheterization
BPH
Stricture
Self-Retaining
G. Pezzar
E,F. Malecot
Long-term
H. 2-Way Foley
I. 3-way Foley
Indications

Diagnosis
• Urine collection (sterile specimen)
• Post void residual (PVR)
• Instillation of contrast
• Cystogram, VCUG, RUG)
• Urodynamics (quantitative pressure-volume-flow
studies)
Indications
• Therapy
1. Relief of obstruction
Clots (3-way catheter)
Strictures
BPH
Urethral inflammation
2. Monitor U/O
3. Management of neurogenic bladder
4. Stent an anastomosis in urethral or bladder surgery
(i.e RRP)
Contraindications

• Pelvic Trauma
• Blood at meatus
• DREhigh riding prostate
• Perineal hematoma
Patient Prep & Technique

• STERILE TECHNIQUE- prep. & drape

• Standard Foley Catheter Kit
• Drape and sterile gloves
• Prep solution and applicator
• Surgi-lube jelly
• 16 Fr. Foley Catheter and collection bag
• 10 cc STERILE WATER
• Collection container
Catheterization
DEVICE FOR MEASURING & COLLECTING URINE
The stuff men are made of!
The stuff men are made of!
Patient Prep & Technique

• STERILE TECHNIQUE- prep. & drape

• Liberally lubricate catheter
• Female
• Urethral meatus is identified by spreading the
labia
• Superior orifice
• Catheter is gently advanced until urine is seen
• Do not need to advance the catheter to hub
Patient Prep & Technique

• STERILE TECHNIQUE- prep. & drape

• Liberally lubricate catheter
• 2% lidocaine jelly
• Urojet
• Complex catheterizations
• Male
• Place penis on stretch perpendicular to body (without pressing urethra)

• Gentle advancement of catheter by holding cath at tip

• Point penis toward feet when slight resistance is first encountered
(bulbomembranous urethra)
• Inflate balloon only when urine is noticed in catheter and catheter hub is
at the urethral meatus
Complications

• Bleeding
• Infection
• False lumen
• Perforation
Difficult Catheterization

• BPH
• Coude Catheter
• If meeting resistance, ALWAYS go up in size (i.e 18 Fr
Coude)
• Pushes lateral lobes of the prostate out of the way
• Use Urojet
• Stricture (Urethral or Meatal)
• Decrease size of catheter
• Silicon Catheter
Difficult Catheterization

• Urology Consult
• Councill tip catheter
• Filiform- followers
• Heyman Dilators
• Cystoscopy
• Suprapubic cystostomy