Male Urethral Catheterisation - Podcast Version 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x In urethral catheterisation, a flexible tube is inserted into the bladder via the urethra. Urine can then drain freely from the bladder for collection. There are various indications for urethral catheterisation, such as the treatment of acute urinary retention, preoperative bladder emptying prior to urological or pelvic surgery, and the monitoring of urine output. The process of urinary catheterisation can be divided into four steps; explanation and consent, preparation, procedure and aftercare. The procedure itself is different in men and women – due to the differing pelvic anatomy. Explanation and Consent Confirm the patients identification Check full name, DOB, and hospital number Confirm against patients wristband Explain rationale for the procedure Describe the procedure State the importance of the procedure Explain the risks of the procedure to the patient Inability to pass the catheter into the bladder Trauma to the urethra or bladder neck Infection (can be minimised by sterile equipment and aseptic non-touch technique) Paraphimosis, from failure to replace the prepuce Bladder spasm (due to presence of catheter balloon) Ask about relevant past medical history Previous urethral trauma, urethral strictures, or lower urinary tract surgery Blood clotting disorders or medication that affects blood clotting (e.g. warfarin) Recent haematuria, penile discharge, or urinary tract infection Check that the patient is happy to go ahead with the procedure. Ask the patient if they would like a chaperone present. Preferably, the patient has washed their genitals beforehand or has had assistance to do so Preparation Chose the correct catheter size, based upon sex of the patient, length of time of insertion, and any allergies to latex Catheter size (diameter measured in Ch) should be the smallest as possible to drain urine Patients with urine debris or clots may require a larger diameter catheter When in the treatment room, prepare your equipment on an appropriate equipment trolley. Decontaminate your hands Clean your trolley and plastic tray with appropriate aseptic agent (e.g. Chlor-clean), allowing to dry fully. Decontaminate your hands Gather the equipment into the plastic tray on the trolley and move to the patients bedside Equipment required catheter pack, catheter, drainage bag, instillagel, saline vial, chlorhexidine wipe, sterile forceps, 2x pairs sterile gloves, apron, and inco pad Catheter pack should contain J-tray, sterile swabs, cotton wool balls, plastic pot, and sterile drape Once at the patient’s bedside Re-confirm the patients identification Expose the patient from the waist down Throughout the procedure, ensure the patients dignity is maintained Prepare your sterile field next to the patient’s bedside Open the outer packaging of the catheter pack onto the trolley and decontaminate your hands Carefully open the catheter pack, touching only the outside border, and arrange the contents of the catheter pack using the sterile forceps. Place the cotton wool balls in the plastic pot. Discard the forceps once used. Clean the top of the saline vial with the chlorhexidine wipe, open the vial, and pour the saline onto the cotton wool balls Open the sterile gloves package onto the sterile field Procedure Put the sterile gloves on Take the sterile drape and tear a hole in the centre, draping over the penis A sling may be made from sterile gauze, placed around the patient penis, to aid mobility of the penis during the procedure Using at least 5 cotton wool balls, clean the glans of the penis and penile shaft from tip to base Best practice is to use one hand to pick the cotton wool balls and hold the sling whilst using the other to clean the penis Hold the penis erect and inject 11ml instillagel into the urethra and gently squeeze the tip to prevent leakage Remove your gloves and decontaminate your hands Carefully open the catheter and syringe onto your sterile field Open another sterile gloves package Decontaminate your hands Put the sterile gloves on and open up the syringe Place the J-tray between the patients legs Carefully open the catheter from its sterile packaging, exposing only the catheter tip Without touching the catheter directly, insert the catheter along the urethra into the bladder If any resistance is felt, ask the patient to cough to ease insertion Once the urine begins to flow, advance the catheter a further 5cm Inject the contents of the syringe into the catheter to inflate the balloon in the catheter Monitor the patient for any signs of discomfort Gently withdraw the catheter to ensure the balloon is secure against the bladder neck Attach the catheter to the drainage bag Attach the drainage bag to the patients leg, patients bed, or catheter stand Replace the foreskin Discard all waste into the correction disposal bins and ensure the patient is comfortable Remove your gloves and decontaminate your hands Aftercare Instruct the patient to: Regularly wash with warm soapy water at least twice a day, washing in a direction away from the urethra Do not pull on the catheter Inform the nursing staff if any pain or discomfort Thank the patient and leave the patient’s bedside. Ensure the correct catheterisation documentation is filled out completely and placed in the patients notes. Frequent questions What is the purpose of male urethral catheterisation? Male urethral catheterisation is performed to drain urine from the bladder for various reasons, including treating acute urinary retention, emptying the bladder before surgery, and monitoring urine output. This procedure allows for effective management of urinary issues in patients. What are the key steps involved in the urethral catheterisation procedure? The urethral catheterisation procedure consists of four main steps: explanation and consent, preparation, the catheterisation procedure itself, and aftercare. Each step is crucial to ensure patient safety and comfort during the process. What equipment is necessary for male urethral catheterisation? Essential equipment for male urethral catheterisation includes a catheter pack, drainage bag, instillagel, saline vial, chlorhexidine wipes, sterile gloves, and a sterile drape. Proper preparation of these items is vital for maintaining a sterile environment. What are the potential complications of urethral catheterisation? Complications of urethral catheterisation can include trauma to the urethra or bladder neck, urinary tract infections, and paraphimosis. Awareness of these risks is important for both patients and healthcare providers to ensure safe practice. How should aftercare be managed following urethral catheterisation? Aftercare involves instructing the patient to wash the catheter site with warm soapy water at least twice daily, avoiding pulling on the catheter, and reporting any pain or discomfort to nursing staff. Proper aftercare is essential for preventing infections and ensuring patient comfort. Rate This Article