Equipment
A typical commercial single-use urethral catheterization tray (see the first, second, and third images below) includes the following:
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Preparatory solution (eg, povidone-iodine or chlorhexidine)
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Sterile cotton balls
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Water-soluble lubrication gel
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Sterile drapes
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Sterile gloves
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Urethral catheter
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Prefilled saline syringe, 10 mL
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Urinometer connected to a collection bag (see the fourth image below)
Urinary catheterization kit. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Urinary catheterization supplies. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Urinary catheter urine collection bag. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Sterile anesthetic lubricant (eg, 2% lidocaine gel) with a blunt-tipped urethral applicator or a plastic syringe (5-10 mL) is indicated if topical anesthesia is desired.
Catheter sizes are as follows:
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Adults - Foley catheter (16-18 French)
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Children - Foley catheter (5-12 French)
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Infants younger than 6 months - Feeding tube (5 French) with tape
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Adults with gross hematuria - Catheter (20-24 French)
Catheter types are as follows [5] :
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Latex
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Silastic (pure silicone or silicone-coated)
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Silver alloy
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Antibiotic-impregnated
Patient Preparation
The steps in the procedure, along with its benefits, risks, complications, and alternatives, must be explained to the patient or the patient’s representative.
Topical anesthesia is provided with 2% lidocaine gel. This and other viscous water-based lubricants facilitate the insertion of urethral catheters. Lidocaine gel has the added benefit of providing urethral anesthesia. [6, 7] When topical anesthesia is being used, the tip of the gel applicator should be inserted into the meatus and the gel pushed into the urethra before the Foley catheter is inserted.
The patient should be supine, in the frog-leg position, with knees flexed and genitalia uncovered.
Monitoring and Follow-up
The timing of long-term indwelling urinary catheter changes should be individualized. Indications for changing the catheter include obstruction (eg, by encrustation or mucus), symptomatic infection, or leakage around the catheter. Latex catheters are prone to encrustation and require more frequent changes than silicone or hydrogel-coated latex catheters do but are cheaper than nonlatex catheters. [8]
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Commercial urinary catheterization kit.
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Preparatory solution in commercial urinary catheterization kit.
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Urinary catheterization kit. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
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Urinary catheterization supplies. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
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Urinary catheter tip. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
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Urinary catheter urine collection bag. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
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Urinary catheterization. Video courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
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Taping of urinary catheter. Video courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
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Female urinary organs, anterior view.
