Bladder catheterization (urinary catheterization) has various indications and is a common technique, but the recognition of the high incidence of urinary infections with this practice has led to it being used only in cases of absolute necessity. In the event of difficulties with urinary evacuation, nursing measures that promote physiological bladder emptying should be used first (warm wedge, intimacy, comfortable position…), and only when all these actions fail may catheterization be necessary.
Equipment:
There are sterile probing equipment that includes all the necessary material to perform it. You should have a second piece of equipment and a second set of gloves in case it is necessary. When catheterization is performed to determine residual volume, it must be verified that the person has urinated before.
The most common probes are:
-French or Robison. They are usually used in momentary probing.
-Foley. It is a probe with two lights (one for the inflatable balloon) or three lights (the third is for irrigation). It is the most used probe.
-Coude. It is a rigid probe with a curved end, especially useful in cases of retention caused by prostatic hypertrophy.
Probing technique:
-The equipment’s instructions or the hospital’s normal instructions in this regard must be followed.
-It is essential to respect sterile technique.
-In women: The lateral position is the most comfortable for the patient and allows the probe to be introduced more easily. Before opening the equipment, sterile gloves must be put on and the anatomical reference points must be found: the urinary meatus, the clitoris and the vagina. Check that the urinary meatus is clearly visible.
-In men: Hold the penis firmly (if done too gently, an erection may be stimulated). With the patient’s legs bent, hold the penis at about 60-90º, slightly inclined toward the legs. Using scrupulously sterile technique, insert the well-lubricated catheter into the urethra. When the probe passes through the internal urethral sphincter, slight resistance may be felt. The pressure should be constant and gentle. The probe should never be forced. Bladder decompression should be done gradually. The maximum amount of urine to be extracted at a time is 300 ml, unless the doctor has indicated otherwise. After 15 minutes another 300 ml can be released. Continue with this pattern until the bladder is completely emptied.