Attention
- Do not force catheter into urethra
- Aseptic procedure
- Check for latex allergy
- Male practitioner should do this procedure, if possible
- Tell person that inserting catheter will cause discomfort
What you need
- Sterile and non-sterile gloves
- Blueys
- Sterile catheterisation or dressing pack
- Normal saline for cleaning
- Urinary catheter with a balloon, or in/out catheter
- Smaller the urethra, smaller the catheter
- 14G or 16G for most men, 12G or less for younger boys
- For enlarged prostates — a bigger catheter will be easier to put in than a smaller
one (which is likely to turn back on itself and come back out the urethra)
- Clean dish to catch urine
- 2 x Sterile lignocaine anaesthetic catheterisation gel in pre-filled syringes, water-based
lubricant (can help dilate the urethra)
- Sterile specimen jar, if needed
- Kelly Forceps or similar (ones in dressing pack usually too small)
- If indwelling catheter — 10mL syringe filled with sterile water, and catheter drainage
bag
What you do
- Lie man on bed, put blueys under bottom, keep upper body covered
- Put on unsterile gloves, mask, goggles
- Lay out dressing pack and prepare equipment using aseptic technique
- Open catheter outer packet, drop catheter onto sterile area. Do not open inner plastic covering yet
- Put clean dish between man's legs
- Remove gloves, wash hands, put on sterile gloves
- Clean penis with cotton balls soaked in normal saline
- Retract foreskin if needed
- Clean glans (top of penis) in a circular motion, then wipe from top to base
- Drape with sterile towels
- Hold penis upright and gently squirt lignocaine gel into urethra x 2. Wait about 5 minutes for it to work before doing next step
- Open end of inner plastic cover to expose tip of catheter. Do not touch tip
- Hold catheter with forceps or by plastic cover so you don’t touch it. Put into urethra
— Figure 9.28
- Start with the penis at 90° and gently push catheter in until you meet resistance,
then lower penis to 45° and continue until urine flows into collection dish
- Aboriginal men may be sub-incised along their urethra — so the urethral opening is
ventral (underside of the penis) and the distance to the bladder is less
- Let about 500mL urine flow into dish, then clamp or kink catheter
- After 5–10 minutes release and let flow finish
- Acute retention is a much more common presentation in men — be aware of potential
for post-obstructive diuresis
- Collect urine specimen if needed, do U/A
- If catheter indwelling (to stay in)
- Fill balloon with sterile water from syringe — amount needed is written on side of
catheter
- Withdraw catheter slightly until resistance felt
- Connect urine drainage bag
- Secure catheter — check it is not stretched tight when person moves