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Bladder catheterisation

Urinary catheterization
Intervention
Urinary catheterization with a doll.jpg
Urinary catheterization with a dummy
ICD-9-CM 57.94
MeSH D014546
MedlinePlus 003981
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In urinary catheterization a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into a patient's bladder via the urethra. Catheterization allows the patient's urine to drain freely from the bladder for collection. It may be used to inject liquids used for treatment or diagnosis of bladder conditions. A clinician, often a nurse, usually performs the procedure, but self-catheterization is also possible. The catheter may be a permanent one (indwelling catheter), or an intermittent catheter removed after each catheterization.

Catheters come in several basic designs:

Catheter diameters are sized by the French catheter scale (F). The most common sizes are 10 F (3.3mm) to 28 F (9.3mm). The clinician selects a size large enough to allow free flow of urine, and large enough to control leakage of urine around the catheter. A larger size is necessary when the urine is thick, bloody, or contains large amounts of sediment. Larger catheters, however, are more likely to damage the urethra. Some people develop allergies or sensitivities to latex after long-term latex catheter use making it necessary to use silicone or Teflon types.

Evidence does not support an important decrease in the risk of urinary tract infections when silver-alloy catheters are used.

In males, the catheter tube is inserted into the urinary tract through the penis. A condom-type catheter (also known as a 'Texas catheter'), if used, fits around the tip of the penis, rather than being inserted. In females, the catheter is inserted into the urethral meatus, after a cleansing using povidone-iodine. The procedure can be complicated in females due to varying layouts of the genitalia (due to age, obesity, female genital cutting, childbirth, or other factors), but a good clinician would rely on anatomical landmarks and patience when dealing with such a patient. In the UK it is generally accepted that cleaning the area surrounding the urethral meatus with 0.9% sodium chloride solution is sufficient for both male and female patients as there is no reliable evidence to suggest that the use of antiseptic agents reduces the risk of urinary tract infection.


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