Urethral catheterisation technique

Table of Contents

1. Introduction
2. A skilled procedure
3. The full process
4. Preparing the trolley
5. Inserting the catheter
6. Gloves
7. Key points
8. Male urethral catheterisation
   1. Sterile field and gauze
   2. Cleaning the urethral meatus
   3. What position?
   4. Balloon
9. Summary
10. References

What position?

Once the urethral meatus has been cleaned, the lubricating/local anaesthetic gel should be inserted into the urethra as shown in the image.

Task 7

1	What position should the penis be held in for insertion of the gel, and why? Enter your answer in the box here and then select Check answer. This should be elevated at 45-90o to the abdomen, so that gravity will aid the movement of gel down towards the prostatic urethra.

Task 8

2	Some practitioners advocated 'massaging' the gel down the shaft of the penis (Yates, 2008). Why is this not recommended? Enter your answer in the box here and then select Check answer. The patient is likely to develop an erection, causing them embarrassment and preventing catheterisation.

Task 9

3

If using a local anaesthetic lubricant, this should be left for three to five minutes to take effect prior to inserting the catheter. What should the nurse do during this time? Enter your answer in the box here and then select Check answer. The nurse should continue to hold the penis in an upright position. If this is let go, the gel will drain out of the urethra and onto the sterile field. This can be an embarrassing time for both the patient and possibly the nurse. It is helpful, therefore, to have a 'script' prepared and to converse with the patient about the procedure and catheter care, which can help to occupy the time and minimise embarrassment as well as using the time for patient education.

After the gel has taken effect, the catheter can be inserted after changing gloves and the piece of sterile gauze. This separates the 'dirty' from the 'clean' part of the procedure.

Again, it is important to hold the penis in an upright position for catheterisation to straighten out the first bend of the urethra and ease the passage of the catheter.

Task 10

4

What complication may occur if the penis is not held upright while the catheter is passed? Enter your answer in the box here and then select Check answer. Urethral perforation. The catheter may pass through the wall of the urethra and create a false tract. The catheter should never be forced through against resistance.

Task 11

5

Slight resistance may be encountered at the external urethral sphincter. What should the nurse ask the patient to do in order to help overcome this resistance? Enter your answer in the box here and then select Check answer. Ask the patient to cough or 'bear down' as if trying to pass urine. This can help the urethral sphincter to relax and ease catheterisation if the catheter is advanced as the patient performs these manoeuvres.