Catheterization of the bladder
Catheterization of the bladder is a medical manipulation that involves inserting a catheter into the bladder cavity. This manipulation is carried out with a diagnostic and therapeutic purpose.
Indications for catheterization:
- excretion of urine in acute urinary retention;
- washing or instillation of the bladder;
- treatment of diseases of the bladder by injecting drugs into its cavity;
- urine sampling for examination if it is impossible to obtain it in the usual way.
Bladder catheterization can be performed with a soft or hard catheter. A soft catheter is called an elastic rubber tube with a length of 25-30 cm and a diameter of 0.3 to 10 mm, which corresponds to sizes Nos. 1 to 30, corresponding to different widths of the urethra. On one side of the soft catheter is a blind rounded end with an oval hole on the side. With this end, the catheter is inserted into the opening of the urethra. On the other hand, the catheter has an oblique cut and a funnel-shaped extension designed to be easily connected to the syringe when it is necessary to introduce medications into the bladder.
The rigid metal catheter consists of a handle, a rod and a beak. One end of the rigid catheter is rounded, blind, with two holes of an oval shape. The length of the catheter for men is 30 cm, for women - 15 cm. Catheterization of the bladder, performed with the help of a metal catheter - is a complicated medical manipulation.
Catheterization is most often performed with a soft catheter. Catheterization of the bladder with a soft catheter is a nursing procedure. Before use, the catheter is sterilized by boiling. The introduction of the catheter is carried out after preliminary preparation, which consists in processing the hands of the nurse and the toilet of the external genitalia and the urethra of the patient. The rounded end of the soft catheter is lubricated with sterile vegetable oil and carefully introduced into the outer orifice of the urethra and then into the bladder. After insertion of the catheter from the outer end, urine is released, indicating that the catheter is inserted correctly and located in the bladder. When the urine stream decreases and starts to stand out slowly, it is necessary to slightly press on the area of the projection of the bladder. When the remains of urine are released, the catheter is slowly withdrawn from the urethra.
Catheterization of the bladder in men is more difficult than in women, since the urethra is long and forms two small physiological constrictions that interfere with the insertion of the catheter.
Conducting a catheterization can lead to complications, including:
- bleeding that develops during trauma to the urethral mucosa;
- infection of the urethra as a result of not following the rules of asepsis, which leads to the development of inflammatory diseases of the urinary system;
- urosepsis with rapid absorption of infected urine into the bloodstream through the injured urethral mucosa.
To prevent the possible development of bacterial complications after catheterization of the bladder, mainly when it is repeated, the bladder cavity is washed with a solution of furacilin or rivanol. Sometimes with a preventive purpose, antibacterial drugs are prescribed.
In some cases, it may be necessary to re-catheterize or insert a catheter that will remain in the bladder for a long time.
If bladder catheterization is not possible as a result of injuring the urethra or squeezing it with prostatic adenoma, suprapubic bladder puncture or artificial cystostomy for cystostomy tube insertion is performed.