male catheterization

male catheterization,

the passage of a catheter through the male urethra for the purpose of draining the urinary bladder or instilling a medication. A French size 14 catheter is usually determined for adult men unless the physician orders a larger size. The male patient is placed in a supine position with the legs extended. The catheter is inserted 17.5 to 22.5 cm, or until urine flows. Sterile technique is important throughout the procedure to prevent the introduction of infectious organisms into the bladder.

method Equipment is assembled, including a bath blanket, waterproof underpad, and a prepackaged sterile catheter kit (drape, gloves, disinfectant, lubricant, cotton swabs, forceps, catheter, and urine collection container and bowl). A sterile catheter may be packaged separately. Appropriate catheter type (nonindwelling or indwelling) and size (usually French 14 gauge for adult males) are selected. The bladder is assessed for fullness, the individual is prepared for the procedure, and the male is positioned in a supine position with legs slightly abducted. A waterproof pad is placed under the hips, a bath blanket over the chest, and bed covers placed on the legs, leaving only the genitalia exposed. The perineal area is washed with soap and water and patted dry. Lidocaine gel is often inserted and allowed to set for a few minutes before the procedure is performed. The catheter kit is then opened, gloves are donned, sterile technique is used to organize kit supplies, and the catheter tip is lubricated. The sterile drape is applied below the penis. The penis is grasped with the nondominant hand, and the foreskin is retracted if the male is uncircumcised. Cotton balls soaked in disinfectant are picked up with tweezers in the dominant hand and used to clean the penis, using a circular motion from the urethral meatus to the base of the glans. The cleaning procedure is repeated three times. The penis is then lifted into a perpendicular position, and light traction is applied with the nondominant hand while the catheter is picked up with the dominant hand and the catheter tip is inserted through the urethral meatus as the individual is asked to bear down as if to void. The catheter is then advanced 7 to 9 inches or until urine flows. Once urine flow is established, the catheter is advanced another 1 to 2 inches. The penis is then lowered as the urine drains into the bowl. If the catheter is a straight catheter, it remains in place until urine ceases to drain. The catheter is then removed. If the catheter is indwelling, the balloon is inflated with fluid and the catheter is attached to a drainage bag and taped to the top of the thigh or the lower abdomen. There should be no tension in the catheter when it is taped. The urine is measured, samples are labeled and sent to the lab, and supplies are disposed of. The bladder is palpated to assess adequacy of emptying and results, and urine characteristics are charted. The individual is assessed for comfort level.

outcomes The expected outcome is drainage of urine from the bladder and relief of bladder distension and discomfort. Unexpected outcomes include the absence of urine because of an inability to advance the catheter through the urethra to the bladder. Catheter insertion should never be forced. The male may also experience ongoing discomfort despite catheter patency, which may be a result of urethral spasm, bladder infection, or balloon inflation when the balloon is not entirely in the bladder. Leakage of urine around the catheter may indicate that the catheter size is too small or that the balloon is inadequately inflated.