External urinary catheter. Bladder catheterization - indications, algorithm. Equipment used for manipulation

In the practice of a urologist, quite often one has to deal with such a device as a urine catheter. It is a rubber tube or a system consisting of several tubes, necessary for insertion into the lumen of the bladder if the patient does not urinate for one reason or another or for other diagnostic purposes.

Most often, men who have diseases such as adenoma need catheterization prostate gland or her malignant degeneration(prostate cancer). Against this background, there is a violation of the patency of the urethra, which leads to urinary retention.

What is bladder catheterization?

The main goal of catheterization is to restore the normal outflow of urine from the lumen of the bladder, which normalizes all urodynamic processes and prevents a number of dangerous complications for the patient’s life.

The catheter is inserted into the external opening of the urethra, after which it gradually moves along the urethra and reaches the lumen of the bladder. The appearance of urine in the catheter is evidence that the procedure was performed correctly and successfully.

Catheterization should only be performed by a medically trained specialist (doctor or emergency medical technician).

Although the catheterization technique is quite simple to perform, it requires some skill to perform it correctly.

When performing bladder catheterization, it is important to observe a number of the following basic conditions:

insertion of a catheter into the urinary canal (urethra) should be done carefully, without the use of rudeness or violence;
the procedure begins with the use of elastic devices (Timann or Mercier type catheter);
in order to minimize possible damage to the walls of the urethra, it is necessary to use a large-diameter catheter;
a metal catheter is inserted into the patient only if the doctor performing the manipulation is fluent in this skill;
when any pain during catheterization, it must be stopped and the patient must be immediately hospitalized in a hospital;
if the patient has acute urinary retention, but inserting a catheter into the bladder is impossible (there are contraindications), then percutaneous cystostomy is used.

Types of catheters and their classification

Previously, only metal (rigid) catheters were used for catheterization, which led to frequent complications (trauma to the mucous membranes, ruptures, etc.). Currently, silicone (soft) and rubber (elastic) devices of different diameters have become widespread.

There are catheters for men (their length is approximately 30 cm) and for women (their length is 15-17 cm).

The following types of devices are used:

Nelaton catheter(used for catheterization for a short period of time, for the purpose of one-time drainage);
Foley catheter (inserted for a long period of time, has several passages through which the introduction is carried out simultaneously medicines and urine excretion);
Tieman stent (a device used by urologists for prostate diseases, it adapts well to the bends of the urethra).

The catheter is selected depending on the purpose of its use

Technique of the procedure

In order to carry out the catheterization procedure, in accordance with all the rules of asepsis and antisepsis, it is necessary to carry it out in conditions specialized hospital, using modern antiseptics, sterile devices, medical disposable gloves, etc.

Bladder catheterization in a woman

The manipulation algorithm is as follows:

The woman is placed on her back and asked to bend her knees and spread them apart.
Carry out thorough treatment of the female genital organs using antiseptic solutions, after which the vaginal opening is covered with sterile napkins.
With the right hand, a well-lubricated catheter for urine is inserted until urine appears (approximately 4-5 cm).
If urine suddenly stops flowing, this may indicate that the device has hit the wall of the bladder, so you need to pull the catheter back a little.
After the manipulation is completed and the urine has completely drained, it is necessary to carefully remove the catheter and treat the lumen of the urethra again with an antiseptic solution.
The patient is required to remain in a horizontal position for an hour.

The procedure is carried out only by qualified specialists

During pregnancy, situations arise when a woman requires catheterization, for example, when a stone is advancing and the lumen is blocked. urinary tract, which leads to acute urinary retention, as well as before an upcoming cesarean section.

The condition requires immediate hospitalization and observation of the woman only in a specialized hospital.

In men, catheterization becomes more difficult anatomical structure the urethra, namely its small diameter, significant length, tortuosity and the presence of physiological constrictions.

The procedure algorithm is as follows:

The man is placed on his back (there is no need to bend his legs at the knees).
Penis and groin area covered with sterile napkins around the entire perimeter.
With his left hand, the doctor pulls back the foreskin, exposing the lumen of the urethra, and at the same time extends the penis perpendicular to the surface of the patient’s torso. The head of the penis and other male genital organs are carefully treated with antiseptic solutions.
The pre-lubricated catheter is inserted right hand, all movements should be smooth and uniform, and the doctor should apply only a slight force in places of anatomical narrowing (the patient is asked to relax as much as possible).
Periodic palpation of the tip of the catheter is recommended, especially if there are obstacles in its path, until urine flows through it (evidence that it has reached the lumen of the bladder).
When the procedure is completed, the catheter is removed, and the lumen of the urethra is re-treated with an antiseptic solution. The patient is required to remain in a horizontal position for an hour.

Abducting the penis perpendicular to the male body allows you to maximally straighten the anterior urethra

Bladder catheterization in a child

In general, the technique of catheterization in children does not differ significantly from the procedure performed in adults. It is carried out with the aim of restoring normal urine flow and eliminating all signs of acute urine retention.

Inserting a catheter into a child requires special care and precision, since there is a high risk of damage to the mucous membranes, up to complete rupture of the wall of the urethra or bladder. That is why a smaller diameter device is used for catheterization of children, and if such a possibility exists, the procedure is carried out under ultrasound or x-ray control.

Indications and contraindications for performing the procedure

Main indications for bladder catheterization:

development of acute urinary retention in various pathological conditions;
chronic retention of urine in the lumen of the bladder;
the patient's state of shock, in which there is no possibility of spontaneous passage of urine;
the need to determine the exact volume of daily urine in patients in the intensive care unit or intensive care unit;
determining the volume of urine that remains in the patient after urination;
administration of contrast agents (required for cystourethrographic examination);
washing the lumen of the bladder with solutions of antiseptics or antibiotics;
for the purpose of removal blood clots from the bubble;
carrying out a series diagnostic procedures(for example, taking a urine test for further culture on nutrient media, when passing it naturally is impossible or difficult).

Most common cause development of urinary retention in men is prostate adenoma

The following may be contraindications for catheterization in men and women: pathological processes:

inflammatory process in the tissues of the prostate gland (acute prostatitis or exacerbation of its chronic form);
inflammatory process in the testicles or their appendages;
abscesses of the prostate or other space-occupying formations in it, leading to a sharp narrowing of the lumen of the urethra, when insertion of a catheter is impossible;
urethral infection ( acute urethritis or exacerbation chronic process when the edematous component is pronounced);
traumatic injury to the urethra or its sharp deformation due to strictures (insertion of a catheter can lead to rupture of the urethral wall);
pronounced spasm of the external sphincter of the bladder (for example, against the background of impaired innervation due to damage lumbar region spine);
contracture of the cervical part of the bladder.

Complications after manipulation

As a rule, if catheterization is performed by an experienced specialist, and the patient does not have any pathological processes that impede the advancement of the catheter through the urethra, then complications are quite rare.

The most common adverse outcomes from the procedure are:

damage to the walls of the urethra or bladder, which leads to blood in the urine (hematuria);
accidental rupture of the wall of the urethra or perforation of the bladder (this occurs when the catheter is roughly inserted);
infection of the urethra or bladder (cystitis or urethritis develops);
sharp decline in numbers blood pressure(hypotension due to manipulation).

The male urethra has several anatomical curves, so rough and incorrect manipulation can cause a number of complications

Replacing or removing the catheter

If bladder catheterization is performed for a long period of time, it often becomes necessary to replace the device. This occurs in the following situations:

initially incorrectly selected catheter size, as a result of which gradual “leakage” of urine is observed;
blockage of the device lumen;
the appearance of severe spasms in the patient or others discomfort requiring temporary removal of the catheter.

Removal of the device, as well as its insertion, should only be done by a specialist with a medical education in order to prevent any complications. The doctor disconnects the urine reservoir from the main tube. Using a large syringe attached to the outer hole of the tube, the residual volume of urine is removed, then the catheter is completely removed. All movements must be smooth and careful, and any “jerks” must be avoided.

After removing the catheter, you need to leave the patient in a horizontal position for 20-30 minutes. At the same time, it is important to ask him about the presence of unpleasant sensations, pain, etc.

If after catheterization the patient experiences bloating, blood from the urethra or other pathological symptoms, then it is necessary to find out their cause

Conclusion

Bladder catheterization is a manipulation that requires the intervention of only a specialist with a medical education.

Each patient who has a catheter requires constant monitoring. If any unpleasant symptoms appear, a diagnosis of this condition is necessary, and the issue of its removal can only be decided by a doctor.

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 are used to perform certain activities various shapes and size. 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 intended. 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.
Further bent legs it is necessary to move them apart in such a way 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 for 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 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.

Bladder catheterization is a necessary medical intervention performed for therapeutic or diagnostic purposes for certain diseases genitourinary system. It is necessary to understand specifically what are the indications for bladder catheterization, the types and methods of its implementation, and the process of removing the catheter.

With some diseases of the genitourinary system (prostate adenoma, oncological processes, various kidney pathologies), serious difficulties are observed with the removal of urine from the patient’s body.

Bladder catheterization is a medical procedure in which a special hollow device is inserted into the cavity of the urethra to force urine out. This manipulation requires the doctor performing it to have certain knowledge and skills. The procedure can be performed routinely or as an emergency.

The goals of bladder catheterization are:

medicinal;
diagnostic;
hygienic.

The diagnostic focus of using a catheter allows you to accurately determine the root cause of any genitourinary pathology. Sterile urine, directly taken from the specified organ, is considered the most reliable material for conducting certain types of tests. This technique allows you to carry out diagnostic measures with the introduction of a contrast agent into the bladder.

Catheterization, carried out for hygienic purposes, makes it possible to provide adequate care for seriously ill patients who cannot empty their bladder on their own.

For therapeutic purposes, to eliminate stagnation of urine, the following manipulations are carried out in the following cases:

for emergency forced excretion of urine when the process of urination is delayed for more than 12 hours due to various diseases genitourinary system;
V rehabilitation period postoperative intervention on the urinary organs;
for various pathologies of innervation of the bladder (urinary function disorders).

Timely and competent catheterization will allow the patient to avoid deterioration of health, and sometimes death.

Classification of catheters

The use of a catheter for catheterization of the bladder involves installation in urethra a curved or straight hollow tube with holes at the ends.

Such conductors can be intended for short-term or long-term use. When performing surgery on the urinary system, disposable short-term catheters are often used. In case of chronic urinary retention, the installation of the specified long-acting device connected to a urinal is required.

Depending on the material of manufacture in medical practice probes used:

hard;
elastic.

Rigid structures are made of non-ferrous alloys, are very traumatic and are used only in severe cases drainage. Metal structures due to physiological characteristics have different configurations for men and women. Their installation is the responsibility of only an experienced specialist.

Elastic catheters are more convenient to install and use. They can be made of modern silicone, flexible plastic, or special soft rubber.

Drainage devices can be:

urethral (internal);
suprapubic (external).

Each of these types of catheters has its pros and cons. The suprapubic conductor exits through abdominal wall bypassing the urethra. It is easier to install, less traumatic, and quality care is more accessible. A person retains sexual activity, which is important for long-term use of a catheter.

A urethral-type device can easily damage the walls of the bladder and neck during installation. When the device fails, the leaking urine infects the patient’s genitals, causing severe inflammation.

Based on their design features, the following types of catheters are distinguished:

disposable Nelaton (Robinson) device;
Thiemann stent;
the Foley system (which some people mistakenly call Phaleus);
Pezzer device.

Each of these drainages should be considered in detail.

Common types of drainage

The Nelaton (Robinson) device is presented in the form of a soft tube of small diameter with a rounded end and differs simple mechanism actions. Used for rapid catheterization of the bladder in men and women during surgery or for diagnostic urine collection.

For some diseases of the genitourinary system with a complicated course, a rigid Thiemann stent with an elastic curved tip is used, with which it is possible to reach the bladder through damaged and inflamed walls of the urethra.

In medical practice, it is most convenient to use a Foley catheter, designed for long-term installation. It is a multifunctional 2- or 3-way device, consisting of a flexible tube with several holes, a special reservoir, with the help of which the system is retained inside the body. This type of catheter can be used to administer medicines, flushing the bladder from pus and blood, freeing blood clots.

Less common catheters of the Pezzer system are used only for cystostomy drainage, most often in cases of kidney failure. Such systems are a flexible tube extending outward with 2–3 functional holes.

All of the listed types of drainage have different diameters. Depending on the prescription in each specific case, the specialist will select a catheter for the patient on an individual basis.

Drainage scheme for women

Indications and contraindications for the use of bladder catheters

Upon appointment medical procedure When installing a catheter, the doctor must take into account the indications and contraindications for its implementation. Frequent indications for installation of bladder drainage are:

any emergency conditions associated with forced diversion of urine due to disruption of the natural process of urination (bladder paresis, adenocarcinoma, prostate adenoma, etc.);
diagnostic measures, when to make the correct diagnosis and prescription effective treatment it is necessary to collect a portion of bladder urine;
specific diseases of the urethra and bladder, requiring the introduction of drugs into their cavity, washing from pus and blood.

Contraindications to bladder catheterization include:

urinary tract infections (acute and chronic urethritis);
injuries of the urethral canal and bladder;
spasm of the urethra;
lack of urine in the bladder (anuria).

Signs of contraindications to bladder catheterization may arise suddenly, during the illiterate implementation of this procedure due to injury to the urinary tract.

Preparing to install drainage

In order for bladder catheterization to proceed without complications, it is necessary to carefully prepare for it. Necessary conditions carrying out the procedure is:

attentive attitude to the patient;
maintaining sterility;
advanced bladder catheterization technique;
high-quality catheter materials.

Before the manipulation, the patient should be washed from front to back so as not to introduce intestinal flora into the urethral canal. To do this, you can use a weak solution of any antiseptic (Furacilin).

All catheterization equipment must be sterile

Bladder catheterization kit includes:

soft or hard catheter;
urine collection container;
anesthetic (lidocaine);
glycerin or Vaseline oil to facilitate the installation of a drainage device;
a set of consumables (cotton balls, napkins, diapers);
instruments (syringe for drug installation, tweezers, etc.).

To ensure the most convenient access to the site of insertion of the probe, the patient lies on his back, bends his knees and moves them slightly to the sides. To successfully complete the specified medical actions the patient must be in a relaxed and pain-free state, and the doctor and nurse must have the necessary experience.

It is worth noting that the male algorithm for carrying out this procedure is the same as the female one. But due to some physiological features of the body structure, catheterization of the bladder in men is much more difficult.

Catheter insertion technique

The difficulty of installing a bladder catheter in men is that their urethral canal is much longer than that of women and has some physiological narrowings. In most cases, a soft catheter is used for this procedure. The technique of performing this procedure requires certain skills and abilities of a doctor and nurse. After preparatory measures, bladder invasion includes the following main stages:

the surface of the patient’s penis is treated with an antiseptic, the head is especially carefully coated with a cotton swab and the pain is numbed;
a sterile lubricant is instilled into the opening of the urethra to facilitate the manipulations;
the inserted device is lubricated with glycerin or petroleum jelly;
an elastic drainage is inserted by a doctor using tweezers into the external urethral canal;
the catheter is gradually inserted deep into the man's urethra, slightly rotating the device around its axis;
The patient is considered fully catheterized when urine appears in the drainage tube.

Further actions are carried out depending on the doctor’s prescriptions, in accordance with the technique of catheterization of the bladder in men. After emptying the urinary organ, it is washed antiseptic by attaching a special syringe to the catheter. Often, permanent fixation of the tube of the installed device with a urine bag is carried out during long-term wear and recommendations for care are given.

Catheterization of the bladder with a metal catheter is carried out in a similar way, apart from some tricks of passing physiologically difficult areas.

Nelaton female catheters

Features of bladder drainage

The female urethra has a short and wide structure, thereby greatly facilitating the installation of a catheter. Stages of bladder catheterization in women include:

high-quality preparation for the procedure with sterile processing of instruments and surfaces of the genital organs;
an elastic catheter is inserted with tweezers into the external opening of the urethra to a depth of 5–6 cm;
the appearance of urine in the device will indicate that the goal has been achieved.

After carrying out this procedure, in order to avoid infection, all necessary requirements must be observed. hygiene rules. When wearing the catheter for a long time, its outer end is connected to a urine collection bag, which is securely attached to the thigh.

But catheterization of the bladder with a soft catheter in women is not always effective. In some rare cases, a metal drain is used.

Catheterization of a child requires special attention. This procedure is prescribed when absolutely necessary due to the difficulty of its implementation and the high risk of complications. The sizes of catheters for a child are selected according to age. Only soft elastic drainage devices are used.

The immune system in children is not sufficiently developed, so the risk of infectious inflammation is very high. Maintaining sterility when performing this bladder invasion is one of the main conditions for its success.

Complications during catheterization

The risk of complications during bladder catheterization, if performed ineptly, is quite high. The procedure is always performed without general anesthesia in order to promptly notice the occurrence of pain in the patient. You can list the frequent Negative consequences that appeared during the installation of the drainage device. These include:

damage or perforation of the urethra;
infection of the genitourinary organs in women and men (cystitis, urethritis, paraphimosis, pyelonephritis, etc.);
infection circulatory system through damage to the urethra;
various bleedings, fistulas, etc.

When using a catheter with a larger diameter than prescribed, the female sex may suffer from dilation of the urethra.

When constantly wearing a drainage device, you must strictly follow all the recommendations of the attending physician for its use. Bladder catheterization in women and men must be accompanied by careful hygiene of the perineum and catheter, otherwise serious complications may occur. If you detect urine leaks, blood in the urine collection bag, or discomfort in the genitourinary area, you should immediately contact a specialist.

The catheter is removed according to the doctor's instructions. Typically, this kind of manipulation is performed in a medical facility, but sometimes it can be performed at home. Correctly performed catheterization of the human urinary system will help in the treatment of many infectious and non-communicable diseases and will significantly improve his quality of life.

The catheter is made in the form of a drainage tube, which is installed into the person’s urinary canal by medical personnel. Depending on the gender of the patient and the material used to make the device, the installation procedure should be carried out by a qualified specialist and in accordance with the rules.

Catheterization is used in urology to treat patients suffering from diseases associated with impaired urine outflow.

What types of catheters are there?

Devices are classified according to several factors, divided into male and female, which differ in length, diameter and shape.

Based on the material used, the following types of urological tubes are distinguished:

elastic or rubber (Timman);
soft or latex, silicone (Foley, Pezzera);
hard - plastic (Mercier, Nelaton) and metal (brass or stainless steel). They are installed if the procedure is performed with other types of catheters.

Catheters can be made from various materials

Elastic and soft devices look like a transparent tube with a funnel at the end and have a small diameter.

Depending on the installation time, there are different types of devices:

permanent. When installing this type of device, it is necessary to perform hygienic washing of the external opening of the urethra every day, as well as to observe the toilet of the external genitalia after urination. All patients are taught the rules of flushing the urological system. Suprapubic catheters, which are installed through the abdominal wall, must be changed once every 4 weeks.
short-term or one-time. It is made of latex or metal (the attending physician is allowed to insert a catheter) and is used for a one-time need for catheterization.

Catheters differ in installation time

Depending on the location of installation, catheters are divided into:

internal - introduced into the human body;
external - one end remains outside;
single-channel, two-channel and three-channel.

Male and female devices are manufactured in accordance with anatomical features floors The first devices are made narrow, long (up to 30 cm) and flexible, while the second ones differ in diameter (caliber), length of 12-15 cm and lack of bends.

Based on the diagnosis, age and gender of the patient, the doctor selects a urological catheter.

Indications for testing

The catheter is inserted into the patient's body using therapeutic purpose in cases:

urinary retention;
blocking the urethral canal to prevent hydronephrosis;
introduction medications to the focus of the inflammatory process;
tumors in the urethral area;
lavage to remove pus and remaining stones from the bladder;
surgery and the use of epidural anesthesia.

A catheter is inserted into the patient's body for therapeutic purposes.

This manipulation is performed when identifying pathologies such as prostate adenoma, urolithiasis, glomerulonephritis, tuberculosis of the genitourinary system, urolithiasis disease, bladder paralysis.

For diagnostic purposes, catheterization is performed for:

taking a sample of clean urine, uncontaminated by external bacteria, which makes it possible to identify the cause and pathogenic causative agent of the disease;
visualization of the urinary organs by filling them with a certain contrast agent;
determining the residual volume of urine and diuresis in the postoperative period.

How hygiene product This urological system is used to care for bedridden patients.

Equipment for the procedure

In order for the installation of the device to be successful, you need to have medical materials and medicines:

catheter;
sterile gauze pads and cotton balls;
oilcloth and diapers;
tweezers (2 pcs.);
syringes 10 and 20 ml;
medical gloves;
vessel or pallet;
glycerin or petroleum jelly;
antiseptic - furatsilin solution (1:5000);
anesthetic - 2% lidocaine in gel form.

Before starting the treatment, the doctor explains the procedure to the patient. Then the genitals are disinfected using a bandage, tweezers and an antiseptic solution.

Carrying out manipulations in women

The female urethra, unlike the male urethra, is shorter and larger in diameter, so the catheterization process is quick and easy.

The manipulation algorithm includes the following steps:

Genital hygiene.
The woman is placed in a horizontal position on her back, her legs should be spread and tucked.
The nurse is positioned to the right of the patient and spreads her labia with her left hand.
The vulva is treated with an antiseptic solution.
The tip of the catheter is lubricated with emollient oil and inserted into the urethra 5-10 cm. If discharge is observed, then the insertion manipulation is carried out according to all the rules and the device is in in the right place. If you feel pain, you should immediately inform the medical staff performing the procedure.
The woman should remain in this position for at least 1 hour. A special container is placed between her legs to collect urine.

Carrying out manipulations in women

Usually, for representatives of the fairer sex, the procedure is painless, and only when urinating they may experience slight discomfort. This is due to the fact that the tube causes slight damage to the bladder mucosa during insertion, which causes a burning sensation when urinating.

At the end of the urine outflow process, the bladder is washed with furatsilin using a syringe attached to the catheter. Then the device is taken out by lightly twisting around its axis and the urethra is treated with an antiseptic to prevent infection.

Performing medical treatment for men

The urethra of the stronger sex is a narrow tube with its own constrictions, and is intended not only for the removal of urine, but also sperm. She is very sensitive to damage of various nature Therefore, catheterization is contraindicated in the presence of urethral injuries. The manipulation itself is more complex than that of the female sex and is performed in accordance with the following rules:

The outer part of the head and foreskin are disinfected with a solution of furatsilin, and it is important to hold the latter during the procedure to avoid injury.
The man lies down in the same position as the woman.
The medical staff is located to the right of the patient and inserts the device tube to a depth of 6 cm, which is pre-lubricated with an emollient, into the urethra using tweezers. The penis must be held with your left hand.
Advance the catheter slowly 4-5 cm, with extreme care, using rotational movements as needed.
At the moment when the device reaches the narrowing areas, the man takes 2 deep breaths, which will ensure relaxation of the smooth muscles and allow the tube to advance. If a spasm of the canal occurs, the procedure is suspended until the urethra becomes relaxed.
When the device is placed correctly, urine should be released from the tube. A vessel is placed between the patient’s legs to collect it.

When diagnosing a patient with prostate adenoma or urethral stricture, a metal system is used. The procedure has soybean features:

During insertion of the device, it is necessary to monitor the position of the rod, which should be positioned horizontally, with the beak facing down.
The tube is moved with the right hand and the penis is pulled onto it until the beak is hidden in the urethra.
Then the penis is lowered towards the abdomen, raising the free end of the device, and the device is inserted to the very base of the penis.
The catheter is placed vertically and the tube is pressed through the lower surface of the penis with the index finger.
As soon as the narrowing is passed, the device is tilted towards the perineum.
When the beak of the device is immersed in the bladder, an outflow of urine is observed.

At the end of the procedure, the same manipulations are performed as for women.

Possible complications

Like many types of treatment, this manipulation can lead to the development of some complications that arise as a result of an erroneous diagnosis, choosing the wrong catheter, carrying out the procedure without following the rules, which entails injury to the walls of the urethra and bladder, as well as various types of infections.

Cystitis is one of the possible complications

Main complications:

cystitis;
formation of fistulas due to urethral perforation;
bleeding;
pyelonephritis;
paraphimosis;
urethritis;
carbunculosis;
sepsis;
damage to mucous tissue.

This procedure greatly facilitates the treatment and diagnosis of diseases, but not every patient agrees to undergo it. This is due to a person’s misunderstanding and lack of complete information about how the catheterization process is carried out. Therapeutic effect This manipulation has an invaluable effect on the human body, improving its well-being and preventing the development of dangerous complications for various diseases.