Urinary Catheter

General Description

Urinary catheterization is a urological technique used to extract urine from the bladder using a catheter, a thin and flexible plastic tube connected to a collection bag.

Depending on how long the catheter stays in place, two main types are distinguished:

• Permanent urinary catheter: The catheter is left in place in the bladder for an extended period. It is usually used for therapeutic purposes.
• Intermittent urinary catheter: The catheter is removed once the bladder is emptied. It is typically used for diagnostic procedures.

When is it indicated?

As a diagnostic tool, the primary purpose of the urinary catheter is to obtain a urine sample for later examination (when natural urination is not possible), as well as to monitor urine production or determine the volume of residual urine after urination. It is also used in imaging diagnostic tests when it is necessary to administer contrast agents into the bladder.

Additionally, urinary catheterization is a therapeutic technique used to relieve urinary incontinence or retention or to administer medication directly into the bladder.

How is it performed?

The urinary catheter can be placed via two routes: the urethra or the suprapubic route.

The urethral catheter is introduced through the urinary meatus (the opening connecting the urethra to the outside) and gently guided into the bladder.

The suprapubic catheter is placed through an incision in the lower abdomen. The procedure is typically guided by ultrasound images. This technique is used when urethral drainage cannot be performed or is contraindicated, such as in cases of urethral injuries or strictures, recent urinary tract surgery, or current urinary tract infections.

Risks

The most common complication of urethral urinary catheterization is urinary tract infection. Urethral injuries, prostate or bladder damage, and corresponding bleeding are also common. In rare cases, bladder or urethral wall perforation may occur, or scar tissue may form, eventually causing urethral stricture.

For the suprapubic urinary catheter, possible complications include urinary infections and intestinal injury.

What to expect from a urinary catheter

Before the procedure begins, the patient should undress and wear the gown provided by the medical center.

If it is a urethral urinary catheter, the patient lies on their back on the examination table, with their legs extended in men and with legs apart and knees bent in women. The doctor then proceeds to clean and disinfect the entire genital-urinary area with gauze and an antiseptic solution. Before inserting the catheter into the urethra, lubricating gel is applied to the tip of the catheter.

For a male urinary catheter, lidocaine gel is inserted into the urinary meatus with a syringe, as it helps dilate the urethra and has an anesthetic effect. The insertion of the catheter is usually uncomfortable or even painful, especially for male patients. It is advisable for the patient to try to relax with slow and deep breaths. When the urine flow stops, the collection bag is removed, and the catheter is extracted.

To place a suprapubic urinary catheter, the patient lies on their back on the table. Before making the incision, the area is disinfected, and a local anesthetic is applied. If the procedure is guided by ultrasound, a conductive gel is spread over the abdomen, and the ultrasound probe is moved over it to locate the bladder and identify the appropriate area for the incision. Then, a thick needle is inserted into the bladder, and the catheter is placed through the opening. A sharp or pressure-like sensation may be felt during the insertion. After removing the collection bag and catheter, pressure is applied to the puncture site, and a dressing is placed to prevent bleeding.

Specialties in which the urinary catheter is requested

The urinary catheter is requested in the field of urology.