A Practical Approach to Difficult Urinary Catheterizations (original) (raw)
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Review Article: Urethral Catheters and Catheterization Techniques
2022
Review Article IntroductIon Urinary catheters are one of the most commonly used medical devices in clinical practice. [1] They have been used for over 3500 years to drain the urinary bladder when it fails to empty or for other indications. [2] In the United States of America alone, an estimated 30 million indwelling urethral catheters are sold yearly, and about 20% of hospitalized patients have a urethral catheter inserted at any given moment. [3] A urinary catheter is a tube inserted from the external urethral meatus to the bladder to drain urine from the bladder. [4] It can be used for the short term, especially in the perioperative period. Still, it can also be used long term, especially when managing people with urinary incontinence or chronic urine retention. [4] Globally, the commonly used catheter is the Foley catheter invented by an American urologist named Frederic Foley. [5] However, there are several types of urinary catheters, and their use is determined primarily by the indication for urinary catheterization. Under ideal conditions, a urinary catheter that is 100% silicone can remain in situ for up to about 12 weeks. This, however, is often not feasible due to encrustation and bacterial infection that can block the catheter or result in a medical complication. [5] Although urethral catheterization is a standard procedure performed by many cadres of health workers, it may be associated with some complications and thus may be the cause of litigations and medical malpractice consequent on certain complications that may arise such as urethral stricture, urinary tract infection, urethral erosion, sepsis, and urethral injuries. [6] MaterIals and Methods A review of the international literature was conducted using PubMed database and Google Search, using keywords such as "urethral catheter materials and types," "catheterisation techniques and complications," "difficult urethral catheterizations," "retained urethral catheter," "catheter-associated urethral Background: The urethral catheter is an essential medical device that is used in everyday medical practice worldwide. The urethral catheter has evolved over the years with several modifications and improvements to overcome the shortcomings of previous productions. With several indications, it remains one of the most commonly used devices traversing almost all specialties in the field of medicine; however, the process of urethral catheterization is occasionally challenging and may result in injury to the urethra. The attendant complications following its passage far outweigh its cost and the required skills to necessitate appropriate insertion. Knowledge of the type of urethral catheter, training with regard to its insertion, care while in situ, and competency of the attendant caregivers are required for safe catheterization. Aim: This review aims to disseminate knowledge on urethral catheter types, insertion procedures, and its attendant complications so that doctors and other health-care professionals may safely perform this necessary procedure. Materials and Methods: A review of internatinal literature was conducted using PubMed database and goggle search using key words such as urethral catheter materials and types. Result: 105 articles were identified and found suitable for the study.
Series of Endocrinology, Diabetes and Metabolism, 2020
The physiologic process of micturition plays an essential role in the ability of the human body to regulate homeostasis. When the urinary system encounters an obstruction such as a foreign body within the bladder or other prostatic diseases like benign prostatic hyperplasia (BPH), alternative measures to drain the bladder is required, this birthed the use of urethral catheters & the catheterization procedure. Urethral catheterization dates to the early days of medicine and while it is mostly a routine procedure in this era, the total understanding of its indications, proper techniques, and associated complications remains an essential tool in the arsenal of a practicing physician.
IATROGENIC URETHRAL INJURY FROM IMPROPER CATHETERIZATION; A PRACTICAL WAY OUT
TIJER, 2024
Urethral catheterisation is one of the most common bedside procedures performed on hospitalized patients. Compliance with ethical standard Conflict of interest. The authors declare that they have no conflict of interest. Ethical approval Ethical approval was obtained from the ethical board of Abubakar Tafawa-Balewa University Teaching hospital, Bauchi to conduct the study.
An audit of suprapubic catheter insertion performed by a urological nurse specialist
Indian Journal of Urology, 2013
Aims: Aims: To introduce the concept that a urological Nurse Specialist can perform Suprapubic Catheter (SPC) insertions independently without signifi cant complications, if systematic training is given. Settings and Design: Settings and Design: Retrospective study. Materials and Methods: Materials and Methods: A retrospective audit of Suprapubic Catheter insertions performed by a Urological Nurse Specialist was conducted between April 2009 and April 2011. Results: Results: Of the total 53 patients, in 49 (92.45%) the procedure was successful. Out of the remaining four, two (3.77%) were done by a urologist. One patient's (1.89 %) SPC did not drain after placement and ultrasonography reported that the Foley balloon was lying within the abdominal wall. The other patient's SPC drained well for a month and failed to drain after the fi rst scheduled change in a month. Since the ultrasonography showed the Foley balloon to be anterior to the distended bladder, an exploration was performed and this revealed that the SPC tract had gone through a fold of peritoneum before reaching the bladder. None had bowel injury. Conclusions: Conclusions: If systematic training is given, a urological Nurse Specialist can perform SPC insertions independently without signifi cant complications.
Urinary catheterization from benefits to hapless situations and a call for preventive measures
Journal of Family Medicine and Primary Care, 2016
Catheter-associated complications are common, expensive, and often preventable by reducing unnecessary catheter usage. These complications range from most common nosocomial infection to uncommon conditions such as urethral diverticula and ischemic necrosis of the penis. Often, removal of a single known essential cause may be sufficient to prevent a disease. This review raises issues associated with urinary catheterization and emphasizes on the need of preventive measures a physician should take to reduce disappointing situations. The main objective of this literature review is to intercept or oppose unwanted catheter use and thereby, the disease processes associated with urinary catheterization. There is well-described literature available on catheter-associated urinary tract infection, but little is known about noninfectious complications resulting from catheter use; therefore, we also tried to draw attention on these unusual complications.
Retained Urethral Catheter: Novel Method of Removal Using Trans-rectal Ultrasound Guidance
2019
Background: Urethral catheterization is a common procedure in medical practice. Retention of urethral catheter due to inability to deflate the balloon can be a distressing complication for the patient on prolonged indwelling urethral catheter. Several techniques have been devised for removal of such retained urethral catheters. Objective: The aim of this study is to present our experience in the management of retained urethral catheters using trans-rectal ultrasound-guided balloon puncture at the Urology unit of Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria. Methods: This was a prospective case series of five men referred to the unit with non–deflatable urethral catheters between July 2013 and January, 2014. Results: Five men were referred with retained urethral catheters. The mean age of the patients was 46.4 years with a range of 25-80 years. Indications for catheterization were benign prostatic hyperplasia, burns, and paraplegia. All had successful catheter remova...
Flow characteristics of urethral foley catheters
Urological Research, 1980
The flow, which reflects the effective internal diameter of the catheter, was measured in urethral catheters. Water immersion did not reduce the flow. Siliconized Latex catheters had a high frequency of function failure and the lowest flow. The siliconized Latex and PVC catheters showed an overlapping in flow for catheters of different sizes. A linear increase in flow with increasing size was found with the smaller sizes. The flow in this system represents the internal catheter diameter, which does not always paralel the Charriere number. Silicone catheters were found to have the highest flow with a linear relationship between flow and size. On the basis of this study a catheter with Charriere 24 is recommended for the relief of obstruction, whereas Charriere 12-14 is adequate when the indication is simple urinary drainage.
Management of Catheter-Associated Urethral Strictures
Orient Journal of Medicine, 2020
Background: Urethral stricture is an abnormal narrowing or loss of distensibility of any segment of the urethra surrounded by corpus spongiosum. In the last two decades, there has been a change in the pattern of aetiology of urethral stricture in urban centres in Nigeria with a shift away from post-infective strictures to the emergence of traumatic and iatrogenic causes.Objective: This study aims to present our observation of the occurrence of long-segment urethral strictures in patients after urethral catheter placement for various indications.Methodology: This is a descriptive, cross sectional report of patients who presented to and were managed at the Urology Unit of a tertiary hospital in North-Western Nigeria. Relevant information were retrieved from patients’ case notes and the data was entered into a proforma and analysed using the SPSS 20 software.Results: The mean age of the patients was 45.4 ± 19.4 years, with a range of 11-80 years. Indications for urethral catheterizatio...