Catheterization of the urinary bladder in men: procedure algorithm, tools
Catheterization is a procedure for inserting a catheter( for men and women) into the bladder through the urethral canal. Catheterization is often used and is used for diagnosis and therapy.
Catheter installation guidelines
The catheter can be installed for a short period of time, for example, a short-term catheter installation is necessary for surgical intervention, and for a long time if the patient experiences difficulty with the act of urinating. The latter can be caused by certain diseases.
Male urethra can be affected by various pathological processes that result from infection, trauma, and neoplastic syndrome. Violation of urination can provoke the development of such unpleasant consequences as renal failure and infertility. In this article, we will consider in detail the algorithm of catheterization of the urinary bladder in men.
procedure The catheter can be administered for diagnostic purposes:
- For urine specimens in the bladder cavity. Samples are further used in laboratory testing, for example, to determine the bladder microflora.
- In order to determine the amount of urine that is released, observations of its organoleptic characteristics.
- To determine the level of patency of the urinary tract.
In the treatment of
In addition, catheterization may be performed in the treatment of:
- When restoring the urethra after the operation.
- In the presence of decompression of the bladder.
- In the presence of acute urinary retention delay, which may occur against the background of urethritis, changes in the pathological nature of the prostate gland.
- For the treatment of the walls of the bladder with drug solutions.
- With chronic obstruction, which can be caused by hydronephrosis.
- In order to excrete urine, if the patient is unable to perform an act of urination. For example, if the patient is in a coma.
The algorithm of catheterization of the urinary bladder in men is quite complicated, but it should not cause any concern for one's health, as this procedure is trusted by experienced specialists.
Contraindications to catheterization of
Despite the fact that there are many indications, catheterization can be performed not always. There are some contraindications:
- Presence of blood in the scrotum.
- The presence of bruising in the perineal region.
- Presence in the urethra.
- Trauma of the bladder.
- Injured urethra.
- Prostatitis in acute form.
- Some diseases of the genitourinary system, for example, gonorrhea.
- Spasm of the urethral sphincter.
- Acute inflammatory processes occurring in the bladder or in the urethra.
- Fracture of the penis.
Features of catheterization in men
Due to the anatomical features of the urethra in men, the procedure of catheterization must be performed exclusively by experienced specialists. Difficulties in conducting catheterization arise due to the fact that the male urethra is relatively long, about 25 centimeters. In addition, there are two physiological constrictions in the urethra that prevent the free introduction of the catheter. And also it is very narrow.
The greatest care is required if the procedure is carried out using a metal catheter. If excessive force is applied during the manipulation, then the walls of the urinary system can be damaged, as a result of which the occurrence of false moves is not ruled out.
The algorithm of catheterization of the urinary bladder in men should be strictly observed.
Instruments used in catheterization
For the procedure of catheterization the following tools will be needed:
- Reservoir for urine. If the study is intended to be sterile, the reservoir will be sterile.
- Syringe to Jean.
- Furacilin solution.
- Rubber gloves.
- The tweezers are sterile.
- Vaseline oil( or glycerin).
- Sterile gauze wipes, two pieces.
- Sterile cotton balls, two pieces.
- Catheters of different sizes, sterile, two pieces. The introduction of a urinary catheter is a simple process, but requires caution.
Bladder catheterization algorithm for men
If the procedure is performed using a soft catheter, the specialist should perform the following actions:
- The medical worker should preliminarily prepare hands, wash them thoroughly, treat them with a disinfectant solution.
- The patient is laid on his back, his legs slightly apart, while the knees should be bent. Between the legs it is required to install the tray, and to put a diaper under the pelvic area.
- The health care provider should wear sterile gloves, wrap the sterile napkin below the head with a sterile napkin. This will open the outer aperture of the urethra.
- Next, it is necessary to treat the head with a cotton swab dipped in furacilin. The treatment should be carried out in the direction from the urethra to the edge of the head.
- It is necessary to open the external urethral opening by squeezing the glans penis. After the opening has opened, a few drops of sterile glycerin are poured into it.
Using a forceps, a catheter is caught, and its rounded hole is wetted with petrolatum oil or glycerin. The catheter is then inserted into an open urethral opening. Using the sterile tweezers, the first five centimeters of the catheter are inserted, while holding the head.
The catheter should be immersed in the urethra slowly, intercepting it with tweezers. The penis should be pushed onto the catheter with a free hand. This technique will allow the catheter to be moved more easily through the urethra. In the region at the junction of the membranous part and spongy part, a slight resistance may appear. If it occurs, then you need to pause in two to three minutes to wait for the disappearance of muscle spasm, and then continue the introduction of the catheter.
Physiological constriction is also present at the entrance of the urethra into the bladder. In this area, the re-introduction of the catheter is not excluded.
After the first portion of urine appears, the opposite tip of the catheter must be lowered into the urine collection.
Before the end of urination, the bladder should be rinsed. After this, following the safety measures, the catheter is carefully removed.
After the end of urine extraction, a Janae syringe filled with a furacilin solution is added to the catheter, which is poured very slowly into the bladder cavity. The volume of the injected solution should be about 150 milliliters. The catheter is then guided into the tray to remove the liquid. The washing procedure should be carried out until the contents of the bladder becomes transparent.
After the rinsing is completed, the catheter from the urethra is removed, performing neat rotational movements. After that, the outer opening of the urethra is re-treated with a cotton ball, previously moistened in a furacilin solution. At the end of the catheterization procedure, all instruments should be placed in a disinfectant solution.
If the use of a soft catheter does not allow the procedure, then the use of a metal catheter is required. A similar procedure for the introduction of a urinary catheter should be carried out exclusively by a qualified doctor, as the technique is very complex, requiring special care and attention.
The patient is placed on his back, the hole of the urethra is treated. The catheter is turned down with a "beak" and propels it up the urethra until it reaches the bladder. To overcome the area of the sphincter, you should direct the penis along the median line. The catheter is inserted further, slowly moving the urethra in the direction of the instrument.
If the procedure is performed correctly, then there are discharges in the urine tank, and the patient does not experience painful sensations. Due to the fact that catheterization with a metal catheter is quite painful and traumatic, it is seldom performed.
Complications of catheterization of
In some cases, some complications may occur, for example:
- Urinary system infection. As a result, pyelonephritis, cystitis, urethritis can develop.
- Damage to the urethra, sometimes considerable, up to perforation.
Complications can occur due to errors made during the insertion of a catheter, especially a metal catheter, or due to a lack of preliminary examination of the patient. More often complications arise as a result of violation of asepticity.