# Urinary Catheterisation

## Overview

This module describes how to insert a catheter through the urethra and into the urinary bladder.

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“I need to place a thin tube in your bladder to drain urine into a bag. I will either strap it to your leg, or it will be placed on a bag stand.”

### What can my patient expect?

“It may feel slightly uncomfortable when I pass the tube.”

### What is my patient’s role?

“Tell me if you have any allergies. Stay still and try to remain relaxed while I insert the tube; it’ll help it to pass more easily. Let me know if you experience any pain. Afterwards, keep the bag lower than the level of your bladder, and tell the nursing staff if there are any problems with your catheter such as leaking or the plaster coming loose.”

## Preparation

Prepare a trolley with equipment.

### Documentation

### Equipment

## Site & Positioning

The patient should be positioned supine. Females should bring their heels to their buttocks with their legs separated.

## Procedure

Wash the perineal area with soap and water, using unsterile gloves.

Follow medical asepsis with sterile gloves.

## Troubleshooting

I inserted the catheter into the vagina.

Leave that catheter in place for the moment, so you know where not to insert on your next try. Get a new catheter. Look for the urethral meatus just above the vagina. Remove the incorrectly placed catheter after placing one successfully.

I’m encountering resistance.

This may be at the level of the external sphincter. Ask the patient to cough to help you to pass the catheter. In men, the prostate may interfere with catheter insertion. Do not use force to pass the prostate. Try gently re-angling the catheter as you insert it. Try using gentle traction on the penis. In some cases, the obstruction may be due to strictures. If you are unable to pass the catheter, attempt a smaller size. If unsuccessful, call a senior clinician for advice.

I inserted the catheter, but there is no urine drainage.

If the patient experiences pain with balloon inflation, you are probably in the urethra. Deflate the balloon and re-insert or advance the catheter until you see urine drainage.

If the patient did not experience pain during inflation, it is likely that you have reached the bladder. There may be lubricant jelly temporarily obstructing urine flow, or the bladder may be empty. Press gently on the suprapubic area to encourage urine flow.

Evaluate for urine drainage after 30 minutes if no urine was seen initially.

## Risks

## References