Technique for catheterization in men and women. Indications and methods of urinary catheterization in men, possible complications How to correctly insert a catheter into the bladder

Excluding the area of professional interest, people with a urethral catheter encounter serious problems with health in the genitourinary area.

A urethral catheter is a system of tubes placed in the body and one end coming out; its purpose is to drain and remove urine (empty the bladder) if the body for some reason cannot cope with this physiological need on its own.

The medical term "catheterization" refers to the insertion of a catheter into a hollow organ, respectively, a urethral catheter is inserted through the urethra into the bladder.

Today, the market offers a large assortment of these medical instruments, both imported and domestic, of various sizes.

Urethral catheters, intended for the removal of urine, are distinguished by the composition of the material:

hard (metal; they look like a curved tube, its inner end has a smooth curve, it is also equipped with a handle, a rod and a beak);
semi-rigid (also called elastic catheters);
soft (they are made of polymers (Teflon, silicone, latex and other materials), less often - of rubber, the length of this type of catheter is 25-30 cm).

Urethral catheters vary in terms of use:

short-term (periodic);
long-term (permanent).

They also differ in type:

Nelaton (Robinson) - a straight tube with a blind end, used for short-term catheterization.
Timmana is a straight tube with a blind end in the form of a curved beak.
Foley is a straight tube equipped with a 5-70 ml cartridge.
Pezzera is a curved rubber tube with an extension and two holes at the end.

The length of the urinary catheter intended for women is from 12 cm. The length of the instrument intended for men is 30 cm.

The difference in the length of catheters is due to the physiological characteristics of female and male urinary tract.

Indications

Catheters are placed for diagnostic and/or therapeutic purposes. The goal is to detect the presence of urine in the bladder if this cannot be done by other means or if a sterile portion of urine is required. A urethral catheter is also inserted if a study with a contrast agent is to be administered.

Therapeutic catheterization is used for diseases such as prostate adenoma, oncology (prostate cancer). Because with these diseases there is urinary retention (acute or chronic).

Foley catheter

The instrument is also placed in the postoperative period, when surgery on the urinary organs was performed. If urinary tract diseases are being treated, this may also be a reason for installing this type of catheter.

In modern urology, therapeutic catheterization is used if urine is not excreted from the body naturally.

How is a urethral catheter installed?

The procedure for installing a catheter is accompanied by discomfort and pain.

Everyone’s pain threshold is individual, so patients give different assessments of this manipulation.

In the postoperative period, after surgery on the urinary organs, the painful sensation is more severe.

It is important to understand that catheterization Bladder– this is one of the stages of treatment, a step towards recovery or maintaining quality of life.

Installation of a urinary catheter in men is considered a more complex manipulation than a similar procedure in women, since the length of the male urethra is 20-25 cm and there are narrowings in it (this is the male physiological feature). A male urethral catheter is used for the procedure.

Sterility is one of the most important conditions for installing a urinary catheter, otherwise there is a high risk of sepsis. The instrument is pre-treated with an antiseptic and sterile lubricant, which facilitates its insertion. Painkillers are also used - for example, lidochlor gel and others.

The genitals and the exact place where the hollow tube will be installed must be treated and disinfected.

Catheter installation for men

The patient lies on his back with his knees slightly bent; it is advisable to be in a relaxed state, this will facilitate the insertion of the hollow tube.

The doctor performs the manipulation by slowly and smoothly inserting the catheter into the urethra.

Index correct installation– the appearance of urine in the catheter means that fluid will flow out.

If the tube is difficult to advance, it is possible that the doctor will select a catheter of a smaller diameter. But in the vast majority of cases, replacement is not required, since its size corresponds to the urethra. Do not be alarmed by the appearance of a small amount of blood; this happens quite often during this medical procedure.

The final stage of installation - the catheter is washed with sterile water; if it is correctly installed in the bladder, then it quickly returns.

Upon completion of the manipulation, the urinal is attached to the patient’s thigh or at the bedside (the second option is more often used for urine drainage in bedridden patients).

When conducting surgical interventions, and also if it is necessary to administer medications directly into the bladder, a catheterization procedure is used. It is carried out easily and painlessly, since the urethra in women is short. Read more about the procedure on our website.

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Urethral catheterization for women

The patient lies on her back, legs bent at the knees and spread to the side.

The genitals and external opening are treated with a disinfectant solution urethra.

Using smooth rotational movements, a female urethral catheter, pre-treated with an antiseptic, is inserted into the urethra to a depth of approximately 4-6 centimeters.

The outer end of the catheter is placed in a urine bag; if urine begins to come out, it means that the manipulation was successful and the hollow tube is in the bladder.

After installing the catheter, in order to avoid injury, you should not twist it or try to push it deeper inside.

Instrument care

During urethral catheterization of a patient, key moment, – ensure a tight connection of the hollow tube with the adapter and the urinal; this is where special clamps come to the rescue.

Due to this, urine leakage is eliminated, and the patient feels more comfortable not only physically, but also mentally.

Another important nuance– convenient location of the urinal on the human body. It should be below the level of the bladder.

The urinal should not be positioned higher; in this case, urine may flow back and this can lead to infection. Most often, the urinal is attached to the thigh using special elastic straps.

For prophylaxis, antiseptic solutions (for example, chlorhexidine) must be periodically injected into the bladder through the urinary catheter; it does not irritate the mucous membrane, and disinfection is quite effective.

With urethral catheterization, a possible complication is pressure sores of the urethra. To avoid this, you must constantly change the position of the drainage tube in the urethra. This manipulation is painful, but vital.

Nelaton catheter

It is recommended to change the urinary catheter tube at least once a week, as it tends to take the shape of the urethra, which can cause bedsores in the urethral mucosa. To replace it, it is recommended to contact a doctor (this procedure is usually performed by a nurse), but, as practice shows, patients who for a long time live with a urethral catheter, learn to carry out this manipulation independently.

If you manipulate a catheter or urinal, then your hands must first be treated with a disinfectant solution.

Unlike female catheterization, this procedure in men requires more qualified training of medical personnel, since the urethra in men is long and the catheter must be installed with great care. : indications and technique of the procedure.

About preparing for an ultrasound abdominal cavity read the topic. Colon cleansing and diet before the study.

Video on the topic

In this article we will look at how to place a urinary catheter in a woman.

People very often have to get acquainted with a wide arsenal of all kinds of medical instruments. And one of them is a urinary catheter for women and men. What is it and why is it used at all?

Main purpose

Why is a urinary catheter required for women and men? In urology, catheters of various shapes and sizes are used to perform certain activities. The device is selected individually for each patient. At the outlet, such a probe is usually connected to a drainage bag, that is, directly to a collector designed to collect urine.

The bag is fixed on the patient's leg so that he can move freely and the collector can be used throughout the day. Containers are used at night bigger size hanging from the bed.

Indications for the procedure are:

The need to obtain bladder urine for analysis.
Availability inflammatory diseases bladder in women.
The appearance of acute or chronic urinary retention.

Description

A catheter is a tube designed to create a kind of passage between the internal cavities of the body and external environment. An instrument is used to inject medicinal solutions, and, in addition, to rinse the organ and perform surgical procedures.

Catheter urinary women and men require it to achieve forced emptying of the organ. For example, catheterization may be required immediately after childbirth, when the woman in labor is unable to urinate on her own for the first time. Sometimes the procedure is performed due to damage to the bladder. For example, due to injury, the lumen often closes, and urine from human body is not excreted naturally. In a number of situations, the use of female urological catheters is required during the examination to make a diagnosis. It is often necessary:

Determination of the volume of urine present in the bladder.
Obtaining a sterile portion of urine for analysis.
Performing X-rays of the urethra and bladder by injecting a contrast component into the organs.

Types of catheters

There are many types of urinary catheters today. The type of medical instrument chosen directly depends on the specific case, for example:

A device called a Foley catheter is used for long-term catheterization (when patients are in a coma). It is also suitable for short-term manipulation. It is used for washing, eliminating blood clots, draining urine, and so on.
The Nelaton Catheter is designed for periodic catheterization in situations where the patient cannot independently urinate. Until the invention of the Foley catheter, this device was intended for continuous use.
A device called a Pezzer Catheter is well suited for maintaining continuous catheterization and drainage of urine through a cystostomy. This tool, unfortunately, has quite a lot of shortcomings; therefore, they work with it only in the absence of other possibilities.

Which ones are used more often?

Urinary catheters are currently predominantly flexible. Metal models are used extremely rarely. The fact is that they are less comfortable for the patient and are not very convenient to use. Catheters must be fixed after insertion; the doctor chooses the method for this and is guided by the characteristics of a particular situation.

Difference between female and male models

The difference between a female and a male urological catheter is determined by the anatomical features of the body. Although the purpose of the devices can be said to be the same, they still differ in structure:

Male models are intended for insertion into narrow and curved urethra, which is why the tube is made thin and long.
Urinary catheters for women are made with a short, wide and straight urethra in mind, so such an instrument is endowed with the appropriate characteristics, that is, a relatively large diameter, short length and the complete absence of any bends.

Today, urological catheters are available in most medical stores. Usually in the description of each such product it is indicated for which gender of the patient this or that instrument is designed. The approximate cost of the product ranges from nine to two and a half thousand rubles. The price largely depends on the type of catheter, and at the same time on the place of purchase and the material of manufacture.

How is a urinary catheter placed in a woman?

Installation Features

This procedure in itself is not at all difficult, since female body is very convenient for inserting the tube. For example, in a man, in order to be able to get to the bladder, you will need to overcome the genital organ. But in women, the urethra is located directly behind the labia.

Let’s take a closer look at how a catheter is placed in a woman’s bladder.

Before the catheterization procedure, the patient must take a shower, wash thoroughly and come to the room for manipulation. If the procedure is carried out to collect urine, then at first the doctor or nurse may try to do without inserting an instrument into the urethra. For this:

The patient needs to lie down on a couch on which a diaper or oilcloth has been previously spread.
Next, the bent legs must be spread apart so that a bedpan can be placed between them in order to accumulate urine.
Patients are placed on the lower abdomen warm heating pad. This helps stimulate reflex urination. For similar purposes, the genitals can be watered with slightly heated water.

Stages of catheterization

How to insert a urinary catheter into a woman, what are the stages of the procedure? In cases where urination cannot be provoked, doctors proceed to the catheterization procedure. It includes the following main steps:

Carrying out disinfection of the urethra.
Carefully insert the catheter into the urethra at a distance of five to seven centimeters. In this case, the doctor will need to keep the patient’s labia apart.
Collecting urine, which flows through the tube into a container prepared for this purpose.
Then, if necessary, perform the following procedure (that is, wash the bladder, administer medications, etc.).

Every specialist with the appropriate qualifications knows how to place a catheter in a woman’s bladder.

What are the inconveniences?

Despite the fact that catheterization is much less unpleasant for women than for men, this kind of manipulation is still quite stressful. Many patients do not experience any particular pain or any other physical discomfort, but they absolutely always have to experience obvious psychological inconvenience. A good doctor manages to create a trusting and at the same time calm atmosphere in which women feel relaxed. It is very important that the patient is not afraid or embarrassed, then the procedure will be very easy, painless and fairly quick.

In simple situations, catheterization can be performed by a nurse, for example when a diagnosis needs to be confirmed. In the event that the manipulation is performed in medicinal purposes, then only a qualified doctor should work. It is important to do catheterization very carefully, since a sharp or too fast movement can damage the urethra, causing an inflammatory process (such as cystitis or urethritis).

The female urinary catheter is one of the medical achievements whose importance is very great and cannot be overestimated. Thanks to this simple device, diseases of the urinary system simply cease to be difficult for people: they are easier to recognize and treat. It would be superfluous to recall patients suffering from severe brain or back injuries, when the use of a catheter is one of the main conditions for providing comprehensive care for the patient. How to insert a catheter into a woman’s bladder is now clear.

For what pathologies is catheterization necessary?

So, catheterization of an organ such as the bladder in women is a procedure necessary in a number of cases with the development of pathologies of this organ. The procedure itself involves inserting a catheter in the form of a flexible latex tube, which can also be made of silicone or Teflon. Such a tube can pass through the urethra directly to the bladder.

Often, the need for the described event in women arises in the postoperative periods against the background of gynecological or diseases. Catheterization is done to control the volume of urine produced. In addition, it can promote the healing of postoperative wounds.

In some situations, the procedure is required for patients to rinse in case of bleeding, administration of medications, detection of general obstruction, urine output due to neurological pathologies (paralysis), incontinence or retention in a number of certain diseases.

For cancer

Bladder cancer, which is often diagnosed in women, often requires the insertion of a catheter. Typically, this disease can develop against the background of papillomas. In this case, as a rule, patients have an excessive amount of blood in their urine, which is very easily detected even with the naked eye.

Cancer is often diagnosed in smokers and those who work with aniline dyes. Often this pathology is formed against the background chronic inflammation of this organ, after irradiation and in those who often do not urinate on demand. Various sweeteners and a number of medications also have an effect.

We looked at how to place a urinary catheter in a woman. This procedure is very useful, necessary for carrying out in the presence of pathologies of the bladder.

Delayed urination without timely medical care threatens a person with serious complications and intoxication. Complications in addition to pyelonephritis and cystitis can result in irreversible processes in the urinary system. It can also cause kidney dysfunction and lead to kidney failure.

To remove urine from the bladder in urology, I use catheterization of the organ cavity through the urethra.

Indications for catheterization are divided into two categories by urology specialists:

Medicinal. They imply the presence of diseases and complications in which the procedure is vital and is often carried out urgently.
Diagnostic. They arise when it is necessary to confirm the diagnosis with laboratory, ultrasound, and contrast studies.

A complete list of indications for the procedure of placing a catheter in the bladder is shown in the table.

Table No. 1. List of indications for catheterization.

Treatment indications	Diagnostic indications
(acute/chronic)	The need to collect urine for laboratory research
Comas and other physical limitations	Integrity confirmation urinary tract for pelvic fractures/injuries
Removing blood clots	Contrast-retrograde studies of the urinary tract
Restoration of the lumen of the urethra	Filling the bladder cavity with ultrasound fluid
Intravesical chemotherapy, introduction medicines	Detection of urethral obstruction for subsequent elimination
Transurethral interventions	Checking the urodynamics of the organ (capacity, residual urine volume, urination)

Catheterization concept

The term catheterization implies a complex of manipulations using special medical instruments that allow connecting vessels, natural channels, cavities of the human body with the external environment.

Depending on the disease, the patient’s condition, individual characteristics body procedure can be carried out for the following purposes:

drainage of accumulated fluid;
administration of medications;
washing with liquid solutions;
facilitating the insertion of surgical instruments.

Bladder catheterization in men and women is performed to remove urine in case of illness genitourinary system, as well as if it is necessary for the patient to remain in a supine position for a long time. Most often, a catheter is installed after surgery, comatose conditions, or pathologies that make it impossible to naturally excrete urine.

Urinary retention is the result of manifestations and complications of diseases of the genitourinary system. Specialists in the field of urology may recommend bladder catheterization in the presence of the diseases listed in the table.

Table No. 2. List of pathologies of the genitourinary system.

Note. Bladder dysfunction may be a consequence of diseases of the central nervous system. Such manifestations are caused by tumor processes of the brain and spinal cord, inflammatory processes, hernias, injuries.

Types and differences

Bladder catheterization in urology is the most important step in stabilizing the patient’s condition during urinary stagnation.

Depending on the need for frequency of the catheter installation procedure, there are two types:

Permanent catheterization. Produced for long-term drainage of fluid from the cavity. Prescribed after surgical interventions using anesthesia or while in an unconscious state, with physical limitations, or the need for the patient to remain in a horizontal position for a long time. Allows you to track the amount of urine during catheter installation.
Periodic. With this method of removing fluid, a disposable catheter is inserted at a time and removed immediately after the result is achieved. The advantage of this method is that there is no need to constantly wear and monitor the fluid accumulator. However, if urination is delayed again, the procedure must be performed again.

The choice of type of manipulation depends on the severity of the disease, the general condition of the body and physical features patient.

Depending on the conditions of the catheter installation procedure, the following are distinguished:

sterile (carried out under hospital conditions with complete sterility);
clean (carried out by the patient independently at home).

The second method does not at all imply neglecting the rules of disinfection. However, it is not possible to achieve complete sterility at home.

Attention. Improper handling of instruments, hands and materials necessary for manipulation can lead to infection in the bladder and urethra.

Required Tools

The very name of the procedure indicates the need to use a special catheter inserted into the cavity to carry it out.

Cavity catheters are divided depending on the installation site:

for an introduction to gallbladder(with cholecystostomy);
installations in the renal pelvis (for nephrostomy);
for drainage of cysts, hydatid cysts, abscesses;
for insertion into the bladder (urethral, used for cystostomy).

To remove stagnation of urine and introduce fluid into the bladder cavity through the urethra, urethral types of devices are used. Types of catheters used short description are presented in the table.

Table No. 3. Types of catheters for emptying the bladder cavity.

Name	a brief description of
	Most often, this device is installed for long-term use. The balloon located at the distal end of the latex tube allows it to be securely held inside the cavity. This design is especially convenient for mobile patients. The length of the product allows you to place the urinal in a place convenient for the patient. Considering the specifics of use and installation, the assistance of medical personnel is required to carry out the urine removal procedure.
	A device with a simpler design and method of use. Suitable for short-term and self-catheterization. Using such a device 4-6 times a day imitates the natural process, which medical professionals consider a positive thing. Removed immediately after emptying is completed.

Important. For self-catheterization through the urethra at home, catheters with special lubricant are used. Its action is activated when interacting with water and ensures atraumatic administration without discomfort.

The procedure requires additional devices, materials, antiseptics, and emollients.

The complete list includes the following:

gloves;
oilcloth;
clamp or tweezers;
sterile materials for processing (cotton wool, napkins);
trays (for tools, materials, waste materials);
Vaseline oil;
disinfectants;
syringe;
urinal (if necessary).

Note. When purchasing a catheter, you need to consider the features physiological structure genitourinary system. There are catheters for men and women, due to the different lengths of the urinary canal. Information on the use of the device is specified in the instructions supplied with it.

Where and how bladder catheterization is performed, technique

It is safest to carry out the procedure in a specialized medical facility with experienced staff. Sterile hospital conditions and many years of staff practice minimize the possibility of injury and infection of the canal and organ.

As mentioned earlier, the structure of the genitourinary organs and the length of the natural urine excretion channel in women differs from that in men, therefore, the technique of performing the manipulation will vary slightly.

Catheter installation algorithm for women:

Before starting manipulations, you must wear sterile gloves. The patient's legs are bent at the knees.
The waste tray is located between the woman’s thighs for ease of use.
The patient's labia majora and minora are hygienically treated by wiping them with a napkin or cotton swab moistened with an antiseptic.
Spread the labia with two fingers (thumb and index) to open access to the external opening of the urination channel for processing.
Using tweezers or a clamp, the external opening of the urethra is treated with an antiseptic. The vaginal and anal openings are closed with sterile cotton or gauze swabs.
One end of the catheter is grabbed with tweezers at a distance of 3-4 cm from the balloon (4-6 cm from the end), the rest of the catheter is bent in an arc and grabbed with the little finger of the hand.
The inserted end is treated with oil to ensure sliding along the urethral canal, then gently inserted until urine appears.
If a balloon is available, after successful insertion of the device, it is filled with sodium chloride solution.
If necessary, a urinal bag is attached to the outer end of the catheter. Otherwise, the urine is collected using a pan, then the tube is removed in a smooth motion.

Important. Due to the proximity of the anus and vaginal openings to the urethra, there is a risk of infection. That is why the holes are blocked with cotton or gauze swabs, which are removed only after the procedure is completely completed.

Technique for performing the procedure in men:

Using gloved hands, the external genitalia are treated with an antiseptic. Then it is dried with a sterile swab. The waste material is dumped into a tray pre-positioned between the patient’s thighs.
Replace the gloves you are using with sterile ones, grab the penis, middle and ring finger left hand to retract the foreskin. Big and index finger using a squeezing motion, expand the opening of the urethra.
Treat the head of the penis with a cotton swab with an antiseptic, moving from the opening to the body of the organ.
Position the organ perpendicular to the body to straighten the urethra and, by analogy with the previous technique, grab the catheter with tweezers and the little finger of your hand.
The oiled front end of the catheter is inserted into the opening of the urethra and gradually, intercepting the tube with tweezers, it is advanced to the bladder.
Stop when urine appears to fill the balloon, attach a urine bag, and then foreskin returned to natural position.
The catheter is removed using smooth rotational movements.

Possible complications, errors and negative consequences

When performing catheterization at home or by inexperienced young specialists, mistakes are often made. Despite their apparent insignificance when carrying out this manipulation, in most cases, compliance with these rules helps to avoid complications.

Complete emptying of the bladder. Urine passing through the channels in a natural way is a kind of washing and disinfection. Therefore, during the process of removing it, it is necessary to leave a small portion of urine (20-250 ml) inside the bladder by clamping the tube and removing the catheter.

Important. When washing the walls of the bladder or delayed removal of the catheter, it is required to be washed with sterile furatsilin at room temperature. When the tube is removed, 150-200 ml of solution should remain in the cavity.

Infection

Placing a catheter in violation of the rules of sterility and processing can lead to infection in the organ cavity and urethra and the development of complications. This is why catheterization at home is always riskier and requires careful preparation.

Depending on the pathogenic microorganism that caused the infection and its ability to spread to other organs of the genitourinary system, the following diseases may develop:

Infection will complicate general state the patient, taking into account that most often the procedure is prescribed for stagnation of urine or existing pathologies of the urinary organs. Pregnant women should be especially careful about observing all precautions. Infections are a threat to both the baby and reproductive system future mother.

Damage to the urethral mucosa

Any foreign body Even rubber can damage the delicate mucous membranes of human natural canals. When wearing a catheter for a long time side effect is inflammation of the urethra.

It is to prevent such problems that a furatsilin solution is injected into the cavity of the storage organ before removing the catheter. Passing through natural channels, it disinfects them and promotes restoration processes mucous membrane.

Trauma can also be caused by improper procedure technique, which is quite rare in a hospital setting. If you experience pain or discomfort after the procedure for a long time, you should consult a doctor.

Contraindications for catheter placement

Interfering with the natural processes of the body without preliminary diagnosis and observation by a specialist threatens the patient with serious problems. Not all of us know hidden pathologies of your body, which can only be identified by undergoing a full examination.

This caution is associated with a number of contraindications for the use of catheters:

inflammation in the urethra;
prostatitis in acute form;
sphincter injury/spasm;
anomalies of the canal lumen (narrowing).

An experienced urologist will prescribe catheterization only if there is laboratory tests and examinations of the bladder using an ultrasound machine.

With pathologies of the genitourinary system, a situation may arise in which the use of catheters for a person becomes a daily necessity. The article contains information to familiarize yourself with the procedure for installing them.

For a more visual presentation and practical application of the material, the article presents photo and video materials, viewing of which will not leave readers with questions.

Carrying out diagnostics and a therapeutic course in some cases requires installing a catheter in the patient’s bladder. Most often the tube is inserted through the urethra, but it can also be placed through abdominal wall, located in front. The catheter performs such important functions:

removes urine;
flushes the bladder;
helps administer the medicine.

Read also: How is bladder instillation done?

When a catheter can and cannot be used

Catheterization is used in the following cases:

If urine does not come out or comes out very weakly, not in full. This is observed with prostate adenoma, if you are concerned about blockage of the urethra with stones, paralysis or paresis of the bladder has been diagnosed due to lesions in spinal cord, after operations.
It is necessary to examine the vesicular urine.
The patient is unable to urinate on his own, for example, if he is experiencing a coma.
If the patient is concerned about cystitis, it is more effective to prescribe lavage of the bladder using a catheter.

Do not rush to insert a catheter, even if there are indications for it. First, check the contraindications when inserting a catheter is dangerous:

suffers from an acute inflammatory process affecting the urethra caused by gonorrhea;
there is an injury to the urinary sphincter.

That is why experts advise patients to be extremely frank with their doctor. Otherwise, you can invite big trouble.

How to choose a catheter for a specific patient

Catheters are sold in pharmacies in two types:

soft instrument - equipped with a flexible tube with thick walls, 25 to 30 cm long;
hard, containing metal. The tube is curved, for women it is 12-15 cm long, and for men it is 30 cm. The instrument has a rod, a beak and a handle.

The use of a rigid catheter is gradually becoming a thing of the past. A soft catheter does not injure the urethra and performs the same functions. The one who inserts the tube applies a disinfectant to his hands, otherwise an infection can be introduced into the genitals of a sick man or woman. The tube is inserted as carefully as possible; the nurse’s task is not to disrupt the integrity of the walls of the urethra. Make sure that the catheter packaging is sealed!

How to correctly insert a catheter into a woman

Due to the short length of the urethra, it is not difficult to insert a catheter into a woman. The process consists of the following manipulations:

The nurse comes in to the patient's right.
Spreads the woman's labia with his hand.
Apply water to the vulva and then add antiseptic.
Next, an instrument pre-treated at the inner end with petroleum jelly is inserted into the opening of the urethra, located externally.
Liquid should flow out of the tube; if the discharge does not drain, the procedure must be repeated. If the patient experiences pain, the nurse should take this into account.

Subtleties of installing a catheter in a man’s bladder

In men, the urethra is longer and narrower. Not everyone may be able to insert the tube freely from the first eye. Follow these instructions:

The nurse should get away from the patient with right side.
The health worker treats the head of the penis with an antiseptic; the external opening of the urethra should be well smeared.
Glycerin or petroleum jelly is applied to the tube, then grabbed with tweezers and distributed in the urethra. The penis is supported with the left hand.
Push the tool little by little, you can resort to progressive rotational movements. At the supposed site of narrowing of the urethra, the man is asked to take a deep breath, this will relax the smooth muscle muscles, and the catheter will pass longer easily.
If the patient complains of tenderness in the urethra, stop and wait for the urethra to relax. Use a deep breath technique. The fact that the object has reached its final destination is indicated by the appearance of discharge.

If the soft tube is ineffective

This happens if a man suffers from urethral strictures or is bothered by prostate adenoma. If it is impossible to do without a tube that will bring the discharge out, they resort to using a metal instrument.

Movements must be careful; haste can harm the patient:

The nurse takes a position to the left of the patient.
After treatment of the head and urethral opening antiseptic the penis is positioned vertically.
With your free hand, insert the tube so that it takes a horizontal direction, the beak should look at the floor.
Advance the catheter right hand as if you were pulling the penis onto the instrument until the beak disappears into the urethra.
Point the penis towards the stomach, lift the free edge of the tube and, taking this position into account, insert it to the base of the penis.
Next, the tube should be placed vertically.
Lightly, with little force, press the end of the instrument, grasping the lower part of the genital organ.
When the anatomical narrowing of the urethra is behind, the catheter is tilted towards the perineum.
When it enters the bladder, the resistance disappears and urine flows out of the tube.

Leave the handset in this position. You cannot rotate or move the instrument further, as this will lead to injury to the patient’s bladder.

A visual video instruction for bladder catheterization is presented below:

pochkiguru.ru

Conducting bladder catheterization in men

Bladder catheterization is the installation of a special medical device that ensures the outflow of urine directly into the cavity of the specified organ. The measure is used in cases where the option of a person’s independent urination is excluded - it is impossible due to various factors or is unacceptable according to the algorithm of specific manipulations. If in women the procedure can be performed by both a nurse and a doctor, then only a specialist with higher education and mastering the relevant practice perfectly.

Bladder catheterization in men to remove urine.

Indications

The catheter used in urological practice can be flexible (rubber, silicone) or metal. A silicone product is installed in the urinary organ when it is necessary to ensure a prolonged outflow of urine (during the operation and after it, when the man is unable to get out of bed to urinate on his own). The metal device is used only for one-time manipulation - it is not installed for a long time.

The main indication for catheterization is acute urinary retention.

In each case, the catheter is used in cases where the patient:

acute urinary retention (more often with adenoma prostate gland);
there is a need to donate urine for subsequent bacteriological or other research;
complications due to an existing infectious process.

Violation of the outflow of urine, which can lead to the development of hydrocele of the kidney, occurs as a result of the following reasons:

emerging prostate adenoma;
urethral stenosis ( pathological condition, in which there is a narrowing of the lumen of the urethra);
the presence of stone-like deposits inside the urethra (rare case);
glomerulonephritis (an inflammatory process involving the glomerular system of the kidneys);
blockage of the urethra due to a tumor process;
tuberculosis of renal tissue and organs of the urinary system.

Also, the use of a catheter is necessary for administering medications directly into the bladder cavity: the catheter, crossing the urethra, reaches the bladder cavity. Insert into a flexible tube previously attached to the catheter drug(usually an antibiotic or disinfectant solution) to wash the organ, gradually eliminating inflammation of its tissue.

A long-term catheter (silicone) is installed for a period of no longer than 5 days. If the patient's condition still does not allow him to urinate on his own, the catheter is replaced (to avoid the development of an inflammatory process).

Catheterization algorithm

When performing the procedure, it is important to maintain sterility in the office. Therefore, the staff works in masks and disposable gloves. There is a specific algorithm for bladder catheterization. All actions need to be performed only after psychological preparation the patient, explaining the features and order of the stages, as well as the sensations that he will notice during the procedure.

The patient is invited to dressing room, where he is laid on a table located here with a previously laid diaper and oilcloth.
Taking off underwear and, remaining only in a special operating shirt (or a disposable one), the man lies on his back, with his legs bent and spread apart. By this time the nurse has already prepared everything necessary tools and consumables.
Before inserting the catheter, the doctor carefully cleans the patient’s genitals with an antiseptic solution, using wipes and tweezers. This stage is necessary to eliminate pathogens from the surface mucous membrane penis so that they do not move along with the catheter into the bladder, causing inflammation.
Then the doctor lubricates the surface of the instrument with glycerin (to ensure gliding) and carefully inserts the catheter so as not to damage the internal structures. The male urethra has a special structure, and the doctor, using an instrument, has to overcome two physiological bends. If you apply force at this stage, injury cannot be avoided. Therefore, the doctor performs the procedure very carefully. The success of the intervention is determined by the appearance of urine in the catheter.
If the main goal is to release urine, place a pre-prepared tray and fill it until the bladder is completely emptied. To make sure that the organ is completely emptied, the doctor presses on the suprapubic area.
If the purpose of the procedure is to enter medicine, then the staff uses a syringe and a rubber catheter. The drug is injected into the bladder through a tube, then the lumen of the adapter is closed with a clamp so that the injected medicine does not flow back.

Correctly performed manipulation causes slight discomfort to the patient, which is only due to the presence of a foreign object inside the urethra. Under no circumstances should there be pain, pain or burning due to the installation of a catheter!

Possible complications

Potential complications that may arise during bladder catheterization in men are associated with non-compliance with the rules of asepsis and antisepsis, as well as inept handling of the catheter.

Cystitis, pyelonephritis, urethritis - the inflammatory process may be preceded by insufficient hygiene of the genital organ before insertion of the catheter.
Damage to the internal structures of the penis, urethra, bladder.

Complications also arise in cases where the preliminary diagnosis was made incorrectly or the rigid catheter was inserted incorrectly.

Inflammation of the urinary canal (urethra) is a contraindication to bladder catheterization.

Contraindications

Bladder catheterization should not be performed if the patient:

acute urethritis(including gonorrheal type);
damage to the structures of the urethra or suspicion of such;
if the sphincter (physiological valve) is contracted.

At the end of the procedure, the patient is moved to the ward, and a urine sample taken is sent to the laboratory.

Read also: Bougienage of the urethra in men - indications, procedure

menquestions.ru

Catheter into the bladder

A urinary catheter is a device that is often inserted for urological diseases, problems with urinary system and after surgery. To drain the organ, several tubes are installed in the bladder through the urethra, through which urine will be excreted. Catheters help restore urination in case of urinary dysfunction and make life easier for the patient.

Types and sizes

The catheter in the bladder can differ not only in the main material, but also in the type of device and location in the body. Catheterization of the bladder in both men and women is carried out taking into account the channels and characteristics of the organs where the device is placed. The size of the tube is also selected taking into account individual characteristics (for women the ideal length is 14 cm, for men - more than 25 cm)

The urinary catheter may differ in the material of manufacture:

made of special rubber;
latex and silicone;
solid (main material is plastic).

The device for urination also differs in the length of time it remains in the ureter:

constant. This type of urine catheter can be placed on long term;
disposable. Placement is carried out in emergency situations (in case of injury to the urinary organs or infection).

The catheter placed in the bladder in men and women differs in the type of insertion and location. The internal urinary device is completely located inside the organ, and the external one is only partially located. Also, catheters through which urine is excreted are divided into single-channel, double-channel and triple-channel.

Whether it is painful to insert a catheter into the bladder and how long you will have to walk with it depends on what pathology the patient is faced with. Adaptations various types They cost differently, they also need to be cared for in a certain way, and it is not recommended to take ideas out of thin air without consulting a doctor.

Most popular types

The device for catheterization of the bladder may vary depending on what function it will perform. The price of the device also varies depending on this factor and the material used. If the catheters are made of poor quality material, the patient may develop allergies or rejection.

The most common types of catheters:

Foley. It is permanent and includes one blind end and two holes. A Foley catheter can be used to flush out the organ and drain urine and accumulated blood.
Nelaton. It has a smaller diameter than the previous version, is more elastic and has a rounded end. Installation of this type of catheter to remove urine is only temporary.
Timann. Insertion of the catheter and after removal of the catheter into the bladder is used only for pathologies of the prostate gland.
Pizzeria. Made of rubber, has 3 holes and a bowl-shaped tip. The technique of bladder catheterization with a soft catheter is used to drain the kidneys when they are dysfunctional.
Poisson. Installation is carried out using a metal probe. This placement technique is extremely rarely used to treat the genitourinary system.

Each of these products has its own strengths and weak sides. If catheterization of the bladder in women and men is carried out for a short time, best option- Nelaton device, it is quite easy to install and remove. But if the urinary product is placed for a long period of time, and the patient must remove not only urine, but also the breakdown products of medications, a Foley catheter will be optimal.

If the patient is unable to independently excrete urine, it is recommended to install a Pizzera product for excretion.

How does the installation work?

How to properly place an indwelling urinary catheter?

the physician will need to prepare everything necessary in advance. To do this, take: a syringe with a blunt tip, anesthetic, napkins, gauze, cotton wool, a container for collecting urine, an antiseptic;
All instruments must be disinfected, otherwise not only will the restorative effect not be achieved, but it may also cause harm to health.

But in any case, no matter what installation technique is used, patients say that the procedure is very painful. After urine is collected by the device, the patient needs to use painkillers to help relieve the sensation.

Catheterization of the bladder with a metal catheter or a soft one is much more difficult for representatives of the stronger sex. If the patient does not relax when installing the bladder product, the procedure will take longer and the patient will suffer from severe pain. The device is installed very slowly; if the installation is completed correctly, urine will immediately begin to flow into the container, which means that it will be successfully catheterized.

It is much easier to catheterize the bladder with a soft catheter in women; the insertion is carried out while lying on your back, you cannot lie on your stomach. If the doctor follows the algorithm of actions, the patient will not experience severe pain, and complications will not arise.

How to care for an indwelling catheter

Care urinary catheter is not difficult, the main rule is that the patient needs to keep it clean at all times.

It is also necessary to comply following rules:

If the organ is catheterized, after each bowel movement it is necessary to wash the genitals.
Male and female catheters should be cleaned daily with soap. Such procedures remove germs and bacteria, which promotes a speedy recovery.
Catheterized patients should also be monitored for tube changes. Replacement should be carried out once a week, and the product should also be moved periodically.
To prevent the occurrence of urinary diseases, the patient must be administered antiseptic drugs (prescribed by a doctor).

If you properly care for the catheter, the patient will be able to avoid possible complications. The main thing is to ensure that urine flows steadily (if it does not flow crookedly, but evenly, without delays, then the device is working correctly).

If the device is not installed correctly, it may become clogged, in which case doctors will remove it. If it is not possible to completely remove urine with a catheter, there will be no positive effect, and health will not be restored either.

Possible complications

In order for urine output to be restored, the doctor must strictly follow the installation algorithm, but the patient must also adhere to the care recommendations.

If you do not follow these rules, you may encounter the following complications:

Introduction of infections.
The occurrence of inflammatory processes (pulling out the catheter will be very problematic and painful).
Formation of fistulas.
Heavy bleeding.
Accidental pulling out (the risk increases especially if you use the wrong device for installation).

The catheterization process is quite complex and painful and should only be performed by an experienced physician. It is also not recommended to purchase the device yourself. If the patient bought the wrong catheter, it may simply not fit anatomical features and doctors will not diagnose it.

pochki2.ru

Bladder catheterization algorithm

There are many diseases that require bladder catheterization. Among them are stroke, heart attack, and inflammatory processes of the genitourinary system. This therapeutic method can save a person’s life and also eliminate discomfort. With some diseases it hurts very much. It is important that healing method carried out by a specialist. We must not forget that this method of removing urine has contraindications.

Bladder catheterization - necessary procedure in case of organ pathology, with the need to remove urine through a tube.

Indications and contraindications

Bladder catheterization is the removal of urine through a catheter.

Due to the fact that this technique is used quite often among patients with diseases of the genitourinary system, the following indications for catheterization can be distinguished:

inability to remove urine on your own (due to urinary retention) and pain when urinating;
the need to take liquid for analysis directly from the bladder;
the need to introduce liquid into the bladder;
damage to the urinary canals.

All indications and purposes of catheterization are individual and depend on the patient’s diagnosis. They are mandatory for people in a coma or kamatosis who cannot urinate on their own. As for contraindications, they include: inflammation of the urethra, gonorrhea, bladder injury. Before the procedure, the patient must inform the doctor about changes in his condition. The first time should always be done medical worker, after careful instruction, a person can try to perform the operation himself under the supervision of a doctor. Only after several such attempts can the patient try to do catheterization on his own. If the smallest ones appear painful sensations You should consult a doctor immediately.

Bladder catheterization is performed once, periodically or on an ongoing basis. Return to contents

Types of catheterization

There are several options for the procedure. They depend on the purpose, diagnosis and the person’s ability to move independently. The technique includes several types of catheterization:

one-time;
intermittent (periodic);
constant.