Monday, January 23, 2023

Catheterizing The Female Urinary Bladder

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Warnings And Common Errors

CATHETERIZING THE MALE & FEMALE URINARY BLADDER (INDWELLING) PERINEAL CARE

Types Of Urinary Catheter

There are 2 main types of urinary catheter:

  • intermittent catheters catheters that are temporarily inserted into the bladder and removed once the bladder is empty
  • indwelling catheters catheters that remain in place for many days or weeks and are held in position by a water-filled balloon in the bladder

Many people prefer to use an indwelling catheter because it’s more convenient and avoids the repeated catheter insertions associated with intermittent catheters. However, indwelling catheters are more likely to cause problems such as infections .

Inserting either type of catheter can be uncomfortable, so anaesthetic gel is used to reduce any pain. You may also experience some discomfort while the catheter is in place, but most people with a long-term catheter get used to this over time.

Read more about the risks of urinary catheterisation

Preventing Urinary Tract Infections

  • Drink plenty of fluids
  • Do not place your catheter on surfaces that are not clean or sterile
  • Empty your bladder at prescribed intervals to maintain lower bladder pressures
  • Use a sterile catheter for each catheterization
  • Wash and clean around the urethra
  • Keep skin clean and dry
  • Change clothing if it becomes soiled or wet
  • Wash hands before and after each catheterization

Recommended Reading: How To Do Bladder Training

How Can I Help Prevent An Infection

  • Wash your hands: Always wash your hands with soap and water before you catheterize yourself.
  • Clean and dry reusable catheters: Clean all reusable catheters with soap and warm water after every use. Sterilize all reusable catheters in a pan of boiling water for 20 minutes. Set the catheters on a clean paper towel to dry.
  • Store catheters correctly: Store dry catheters in a clean plastic bag. Throw away torn, hardened, or cracked catheters.
  • Wear cotton underwear: These allow airflow and keep your genital area dry.
  • Drink plenty of liquids: Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. This helps prevent a urinary infection.

Preventing Infections And Other Complications

Budget Female Catheter Model with Bladder

Having a long-term urinary catheter increases your risk of developing urinary tract infections , and can also lead to other problems, such as blockages.

You will be advised about measures to take to minimise these risks, such as:

  • regularly washing your hands, body and catheter with warm water and soap its particularly important to clean your hands before and after touching your equipment
  • ensuring you stay well hydrated you should aim to drink enough fluids so that your urine stays pale
  • preventing constipation staying hydrated can help with this, as can eating high-fibre foods such as fruits, vegetables and wholegrain foods
  • avoiding kinks in the catheter and making sure any urine collection bags are kept below the level of your bladder at all times

Read more about the risks of urinary catheterisation.

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When Away From Home

If soap and water are not available, use pre- moistened antibacterial towelettes for cleaning hands, between labia, and catheter.

Urine may be drained into a toilet or into a clean diaper.

If water is available, rinse the catheter after use and place in a re-sealable bag.

Throw away the re-sealable bag after the catheter has been cleaned at home.

Prevention And Management Of Complications

SC is not recommended for routine use for the long-term management of neurogenic LUT dysfunction. Long-term management of LUT dysfunction in tetraplegic patients with SC is still controversial. Some centers across the world highly favor SC as a safe and effective long-term management,, , but others are concerned about complications during its long-term use. Prevention and treatment of UTI, and the screening of bladder cancer are the same as those with ID.

Read Also: Can A Ct Urogram Detect Bladder Cancer

When To Call The Doctor

  • Blood in the urine
  • Chills or fever over 100°F by mouth or axillary
  • Nausea or vomiting
  • Pain or tenderness across the lower back
  • Dark, cloudy urine
  • Change in the smell of the urine
  • Trouble inserting the catheter

Please call the Urology Nurses at 614-722-6630 or send a MyChart message to the Urology Clinic or the Myelomeningocele Clinic at 614-722-5275.

Care Of The Reusable Catheter

Urinary Catheter Insertion for Females | Ausmed Explains …

If you are have a catheter that can be used over and over, you will need to keep it clean. This will help keep you from getting an infection. Follow the steps below for cleaning the catheter:

  • Wash your hands with soap and water.
  • Wash the catheter, inside and out, with soap and water by rubbing it between your hands.
  • Rinse the catheter well and dry it with a clean towel or tissue.
  • Put the catheter in a plastic bag, pencil case, toothbrush holder or other carrying case.Use a new plastic bag every day.If you use another type of case, wash it out once a day with soap and water and let it air-dry.
  • Wash and dry your hands.
  • You may rinse the catheter, inside and out, with full-strength distilled white vinegar as needed to prevent crystals from forming inside the catheter.

    Also Check: Heavy Feeling In Bladder And Frequent Urination

    Why Urinary Catheters Are Used

    A urinary catheter is usually used in people who have difficulty passing urine naturally. It can also be used to empty the bladder before or after surgery and to help perform certain tests. Specific reasons include:

    • to allow urine to drain if you have an obstruction in the tube that carries urine out of the bladder for example, because of scarring or prostate enlargement
    • to allow you to urinate if you have bladder weakness or nerve damage which affects your ability to pee
    • to drain your bladder during childbirth, if you have an epidural anaesthetic
    • to drain your bladder before, during and/or after some types of surgery, such as operations on the womb, ovaries or bowels
    • to deliver medication directly into the bladder, such as during chemotherapy for bladder cancer
    • as a treatment for urinary incontinence when other types of treatment havent worked

    The catheter will be used until its no longer needed. This may be for a short time and will be removed before leaving hospital, or it may be needed for longer or even permanently.

    When Urinary Catheters Are Used

    A urinary catheter is usually used when people have difficulty peeing naturally. It can also be used to empty the bladder before or after surgery and to help perform certain tests.

    Specific reasons a urinary catheter may be used include:

    • to allow urine to drain if you have an obstruction in the tube that carries urine out of your bladder . For example, because of scarring or prostate enlargement
    • to allow you to urinate if you have bladder weakness or nerve damage that affects your ability to pee
    • to drain your bladder during childbirth if you have an epidural anaesthetic
    • to drain your bladder before, during or after some types of surgery
    • to deliver medicine directly into the bladder, such as during chemotherapy for bladder cancer
    • as a last resort treatment for urinary incontinence when other types of treatment have been unsuccessful

    Depending on the type of catheter you have and why it’s being used, the catheter may be removed after a few minutes, hours or days, or it may be needed for the long term.

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    Looking After Your Catheter

    If you need a long-term urinary catheter, you’ll be given detailed advice about looking after it before you leave hospital.

    This will include advice about getting new catheter supplies, reducing the risk of complications such as infections, spotting signs of potential problems, and when you should get medical advice.

    You should be able to live a relatively normal life with a urinary catheter. The catheter and bag can be concealed under clothes, and you should be able to do most everyday activities, including working, exercising, swimming and having sex.

    Read more about living with a urinary catheter.

    Enhancing Healthcare Team Outcomes

    Catheterization Of Female Urinary Bladder

    A myriad of clinical conditions may require bladder catheterization. While a physician or a nurse can place the catheter in most cases, consultation with urology is necessary for specific patients. The nurses are essential members of the interprofessional group, as they will predominantly perform the procedure. They also monitor the catheter and assist with the education of the patient and family as needed. The pharmacist will ensure that the patient is not on any medication that can precipitate urinary retention. The physical therapist also plays a role in early mobilization, voiding exercises, and rehabilitation. Interprofessional communication and care coordination among health professionals are vital to enhancing patient-centered care and improve outcomes.

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    How Do I Catheterize Myself

    • Try to urinate before you catheterize yourself.
    • Gather all the items you will need: Ask your healthcare provider where to get the supplies to catheterize yourself.
    • A clean catheter
    • Bowl or container to collect urine
    • Bowl of warm water, soap, washcloth, and hand towel
    • Mirror and good lighting
    • Waterproof pad or bath towel
  • Wash your hands with warm water and soap.
  • Get into position to insert your catheter: Lie or sit down with your legs open and knees bent. Put a towel or waterproof pad under you. You may also sit on the toilet or stand with one foot on the edge of the toilet. Make sure the other end of the catheter is pointed into a container or down toward the toilet.
  • Use a mirror to find your urinary meatus: Find your meatus and vagina.
  • Clean yourself: Separate the outer skin folds around your urinary meatus. Wash from front to back with soap, warm water, and a washcloth. Do not scrub up and down. This could bring germs from your anus into the vagina and urethra and cause an infection. Rinse and dry.
  • Put water-based lubricating jelly on the first 3 inches of the catheter: This will help decrease discomfort during the procedure.
  • Insert the catheter:
  • Hold the labia apart with one hand. Slowly put the catheter into the meatus with your other hand.
  • Gently push the catheter about 3 inches into the urethra until urine begins to come out. Once urine starts to flow, push the catheter up 1 inch more and hold it in place until the urine stops.
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    How To Catheterize The Bladder In A Female Child

    , MD, Nemours/Alfred I. duPont Hospital for Children

    Bladder catheterization can be done for diagnosis and/or treatment.

    The main reason to insert a bladder catheter in female children is to

    • Collect a sterile urine sample for testing in very young children who cannot void on command

    Less common reasons include

    • Monitoring of urine output in certain hospitalized patients

    Complications Associated With Catheterisation

    Female Foley Insertion (Urinary Catheter)- Nursing Skills

    Catheterisation is associated with a number of complications including:

    • Catheter-associated urinary tract infection
    • Tissue damage

    The risk of complications means catheters should only be used after considering other continence management options, and should be removed as soon as clinically appropriate .

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    What To Expect At Home

    Urine will drain through your catheter into the toilet or a special container. Your health care provider will show you how to use your catheter. After some practice, it will get easier.

    Sometimes family members or other people you may know, such as a friend who is a nurse or medical assistant, may be able to help you use your catheter.

    You will get a prescription for the right catheter for you. Generally your catheter may be about 6 inches long, but there are different types and sizes. You can buy catheters at medical supply stores. You will also need small plastic bags and a gel such as K-Y jelly or Surgilube. Do not use Vaseline . Your provider can also submit a prescription to a mail order company to have your catheters and supplies delivered directly to your house.

    Ask how often you should empty your bladder with your catheter. In most cases, you empty your bladder every 4 to 6 hours, or 4 to 6 times a day. Always empty your bladder first thing in the morning and just before you go to bed at night. You may need to empty your bladder more frequently if you have had more fluids to drink.

    You can empty your bladder while sitting on a toilet. Your provider can show you how to do this correctly.

    Risks And Potential Problems

    The main problems caused by urinary catheters are infections in the urethra, bladder or, less commonly, the kidneys. These types of infection are known as urinary tract infections and usually need to be treated with antibiotics.

    You can get a UTI from using either a short-term or a long-term catheter. However, the longer a catheter is used, the greater the risk of infection. This is why it’s important that catheters are inserted correctly, maintained properly, and only used for as long as necessary.

    Catheters can also sometimes lead to other problems, such as bladder spasms , leakages, blockages, and damage to the urethra.

    Read more about the risks of urinary catheterisation.

    Page last reviewed: 26 February 2020 Next review due: 26 February 2023

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    What Is Intermittent Catheterization

    The body holds urine in the bladder, a muscular sac, and empties it through the urethra , a narrow passageway leading outside the body. A small tube called a catheter can be inserted through the urethra to help drain the urine. When this is done periodically, it is called “intermittent catheterization” .

    Catheterization promotes regular urine flow, protecting against overdistention . It also helps prevent infection.

    Removing A Urinary Catheter

    Catheter Model Set

    Patients require an order to have an indwelling catheter removed. Although an order is required, it remains the responsibility of the health care provider to evaluate if the indwelling catheter is necessary for the patients recovery.

    A urinary catheter should be removed as soon as possible when it is no longer needed. For post-operative patients who require an indwelling catheter, the catheter should be removed preferably within 24 hours. The following are appropriate uses of an indwelling catheter :

    • Improved comfort for end-of-life care
    • Assisting in the healing process of an open sacral or perineal pressure ulcer
    • Patients requiring prolonged immobilization
    • Select surgical procedures
    • Intra-operative monitoring of urinary output
    • Patients receiving large-volume infusions or diuretic intra-operatively

    When a urinary catheter is removed, the health care provider must assess if normal bladder function has returned. The health care provider should report any hematuria, inability or difficulty voiding, or any new incontinence after catheter removal. Prior to removing a urinary catheter, the patient requires education on the process of removal, and on expected and unexpected outcomes . The health care provider should instruct patients to

    Review the steps in Checklist 81 on how to remove an indwelling catheter.

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    When To Seek Medical Advice

    You should contact a district nurse or nurse practitioner or your GP if:

    • you develop severe or persistent bladder spasms
    • your catheter is blocked, or urine is leaking around the edges
    • you have persistent blood in your urine, or are passing large clots
    • you have symptoms of a UTI, such as pain, a high temperature and chills
    • your catheter falls out

    If your catheter falls out and you cant contact a doctor or nurse immediately, go to your nearest accident and emergency department.

    How To Insert The Catheter

  • With your right hand, pick up the catheter and hold it about one inch from the tip.
  • Gently insert the catheter into the urinary opening between your left fingers until urine begins to flow.
  • Hold the catheter in place until the urine stops flowing.Use your other hand to aim the end of the catheter into the toilet.
  • Gently insert the catheter about another 1/2 inch.Change your position a little and strain, grunt or cough a few times to help get all the urine out.
  • Slowly remove the catheter.Let any urine in the catheter drip into the toilet.Hold up both ends of the catheter in your hand to keep urine from spilling on your clothes.
  • Wipe your perineum with toilet tissue from front to back.
  • Read Also: How To Relieve Bladder Spasms With Catheter

    How Is A Catheterization Done

  • Clean your hands well, using one of the following methods:⢠Use an alcohol hand sanitizer according to directions.⢠If hands are dirty or alcohol is not available, wash your hands with soap and water for at least 15 seconds, rubbing all surfaces briskly, including under fingernails. Use a paper towel or clean hand towel to dry your hands, and then use the towel to turn off the faucet.
  • Gather equipment .
  • If the child is toilet trained, ask her to try to urinate.
  • Wash between the labia with soap and water. Use pre-moistened towelettes if soap and water are not available.
  • Have the child lie down on her back with legs apart and knees bent.
  • Open the catheter container and remove one catheter without touching the tip.
  • Lubricate the catheter tip.
  • With two fingers, hold the labia apart, pulling gently upward to expose the urethra. A mirror may be helpful when your child shows an interest in catheterizing herself.
  • Hold catheter two inches from the tip. Insert the catheter gently upward until the urine begins to flow into the container or toilet, then advance about ½ inch further.
  • Hold the catheter in place until urine stops flowing.
  • Remove the catheter slowly, pausing if the urine starts to flow again.
  • Discard the urine and rinse the container well.
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