Types, devices and methods of placing urinary catheters

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A urinary catheter refers to medical instruments that are intended to connect the internal cavities and natural channels of a person with the external environment when problems arise with the functioning of the urinary system or after operations. This device is used as a means of combating incontinence or, conversely, retention of urine, for rinsing, and administering medications.

This article will be useful to those who have encountered similar problems in practice, so that they can understand in general what types of urinary catheters there are, how they are designed, how many stages the catheterization process consists of, the secrets of caring for them and other questions that naturally arise in during their use.

Main indications for catheterization

The main therapeutic indications may be:

chronic or acute forms of urinary retention as a result of constrictions, stones, tumors, pathologies (hyperplasia, nephrotuberculosis, glomerulonephritis);
comatose or other helpless state of the patient;
for the purpose of recovery after operations (patient rehabilitation);
for disinfecting rinses, removal of blood or pus.

Common diagnostic uses of catheters include:

installation for the purpose of monitoring the total amount of urine;
to assess the general condition of the bladder, urethra;
for the purpose of collecting urine during special studies;
in preparation for examinations for administration of contrast agents.

Bladder catheterization is widely used in urological practice both to make the patient’s life easier and to obtain reliable data during examinations.

Solving emerging problems.

If the catheter is leaking.

A leak can be caused by kinking both the catheter itself and the drive tube of the urinal. Make sure that all components of the drainage system are secure and that there are no kinks throughout. Leakage may be caused by constipation. Eat a balanced diet and drink enough fluids. If the problem cannot be solved, contact your doctor or nurse.

There is no outflow of urine.

Possible reasons:

Kink in the area of the catheter or urinal tube - fix the problem.
Insufficient fluid intake into the body - increase the amount of fluid consumed.
Constipation - Eat a balanced diet and drink plenty of fluids.
The urinal is fixed too high - make sure that the urinal is below the level of the bladder.

If you develop a catheter blockage or bladder spasm, contact your doctor or nurse.

The urine is cloudy and has an unpleasant odor. There is pain and discomfort in the catheter area. There is bleeding, increased sensitivity, itching...

Possible causes: urinary tract infection, bladder or urethral irritation. Drink enough fluids, contact your doctor or nurse.

The catheter fell out.

The likely cause is premature deflation of the catheter balloon or bladder spasm. Tell your doctor or nurse immediately.

Types of catheters

Depending on the duration of installation, they are divided into two types:

intended for permanent use;
temporary use (disposable or reusable).

According to their external characteristics they are:

hard (rigid), often represented by metal versions;
soft bladder catheters (mostly made of rubber);
semi-rigid (made using synthetic polymer materials: latex, polyvinyl chloride, silicone).

Latex products have the shortest service life (no more than one week), silicone catheters can be worn for up to one month, and silver-plated options are used for up to 3 months continuously.

Departure is paid separately - from 550 rubles

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Depending on the number of channels in the device itself:

single-channel catheters;
There are also two-channel devices;
with the presence of three channels at once.

The catheters themselves can be placed in various organs, which may become a condition for identifying their individual varieties:

directly urethral;
placed in the renal pelvis;
used in the ureter;
catheters into the bladder.

In addition to all of the above, these devices can also be external (external) and internal (inserted through the abdomen, for cystoma, for example), as well as female (shorter and wider, but straight, 12-15 cm long), male (curved and more long, up to 30 cm) and children's.

The drainage tube can be inserted either through the urinary canal or through a special puncture (suprapubic).

When choosing a particular type of catheter, the diagnosis, installation site and individual characteristics are taken into account. Most often in their practice, urologists use the following types of bladder catheters:

Foley catheter device

It is considered the most popular and more common type. It is used when long-term catheterization is needed for pathologies (inflammations) in the genitourinary system, for tumors, and obstruction. In addition to diverting urine, they can remove blood clots or rinse the bladder.

All its varieties (two-way, three-way or with a Timman tip, etc.) are distinguished by the presence of a blind end with 2 holes. There is also an additional channel, which is intended for inflating the rubber balloon. It is thanks to the balloon that reliable fixation is ensured. Three-way options allow for medication administration.

Nelaton catheter device

Such a urinary catheter can be used as a means of intermittent catheterization when independent urination is not possible. After the invention of a variation of the Foley catheter, it was no longer used as a permanent option.

These versions have a straight rubber or polymer structure, a rounded end, two drainage holes on the side and small diameters. Different sizes have different colors.

Features of the Tiemann (Mercier) catheter

It has a curved atraumatic tip with two holes, as well as one outlet channel. Most often used for prostate adenoma. It has optimal rigidity for passing the narrowed part, and is able to soften in the body (reducing the risk of injury).

Departure is paid separately - from 550 rubles

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+7 (499) 455-08-05

Pizzera catheter device

These are rubber catheters that have a dish-shaped tip (retainer) and two or three holes. They are used when continuous catheterization is required.

In addition to the listed options, many more varieties of such devices are used in medical practice (Malekota, Mazbitsa, Davola, Pousson, etc.)

Possible complications

When monitoring a catheterized patient, they carefully monitor adverse events:

The catheter falls out or is pulled out by the patient himself.
Increased body temperature over 370C.
A sharp change in color, smell, transparency, volume of urine discharge.
Stopping urine output.
Pain in the abdomen, back below the waist.

If you observe one of these signs, you should call a doctor. If all is well, then the doctor is scheduled to be contacted after 3 months of continuous wearing of the catheter to replace it.

When caring for a person with a urine drainage device, do not forget about the sensitivity of the problem. Such people are in dire need of tactful, restrained, skillful and respectful treatment.

Features of installing a urinary catheter

Bladder catheterization is usually performed in a hospital setting by a nurse or urologist, or by calling a specialist at home.

During long-term installation, the catheter will be worn permanently, and during short-term installation of the device, it will be used for several hours or days in the hospital.

Next we will look at how to place a urinary catheter.

Preliminary preparation

Immediately before the procedure, the patient washes, shave, and the medical worker prepares the necessary tools and materials:

Disposable sterile gloves.
Oilcloth or diaper.
Gauze napkins.
Sterile instrument tray.
Tweezers, clamp.
Furacilin solution is used as an antiseptic.
To soften Vaseline (glycerin).
Special syringe Janet.
Catheters in sterile packaging.

Methodology of the procedure itself

The algorithm for catheterization of the bladder with a urinary catheter includes several stages:

preparation of equipment;
washing hands, putting on gloves;
correct position (on your back, bending and spreading your knees, placing a vessel, tray, oilcloth);
hygienic treatment of the external genitalia with an antiseptic, using a clamp with a napkin;
then the tray is removed, the gloves are removed;
2nd hand treatment, including antiseptic, putting on sterile gloves;
the insertion procedure itself: the catheter is taken from the package with sterile tweezers, the tip is lubricated with Vaseline; the catheter is inserted into the man’s bladder slowly (rotational) until the obstacle is overcome; the other end is fixed in the urinal;
When finished, urine should appear.

A catheter is placed in a woman's bladder in the same way. The procedure is much easier, because here the length and diameter of the urethra are smaller. The release of urine will indicate the correctness of the manipulation.

In case of constant use, the urine container is secured to the thigh with fixing straps, and for bedridden patients, the container is attached to the bed.

Catheterization of the bladder in women is much easier to tolerate due to the peculiarities of their physiology.

If the placement is done correctly, there is practically no pain. There may simply be minor difficulties in areas of natural constriction. If an obstacle occurs, it is recommended to wait until the muscle spasms disappear and then continue as usual.

Advantages of the model

Urological Foley catheters are sterilized with ethylene oxide, therefore, with one-time use, infection is excluded. The packaging is designed in such a way that you do not have to remove the catheter before insertion. In the line you can choose options with different lengths and sizes of the cylinder, and in order to quickly determine the size, they are equipped with multi-colored caps.

The smooth surface makes insertion easy and the large lateral openings ensure efficient drainage. The cylinder is durable, and the connector connects to urinals of various designs.

Rules for proper care of an indwelling catheter

To avoid complications and infections, you need to follow certain rules for caring for a permanent urinary catheter:

the drainage fluid is drained and the device is carefully removed;
Urine is drained from the bag, rinsed with water, treated with an antiseptic (Chlorhexidine, boric acid solution or Dioxidine);
the catheter itself is washed using a syringe with a volume of 50, 100 ml, first filled with an antiseptic, then under running water;
in the presence of inflammation, the catheter is treated with Furacilin solution.

How to rinse a urinary catheter correctly and how often? The urinal itself is emptied up to 5-6 times during the day, washed with antiseptics at least once a day. The catheter should be cleaned no more than once or twice a week.

Performing a catheter replacement procedure at home is a dangerous procedure that can lead to severe injury to the urethra. It is better to trust certified specialists with experience who comply with all aseptic measures and take into account individual factors and possible contraindications.

How to attach a night urine bag?

When using a night urine bag simultaneously with a foot bag, do not disconnect the foot bag from the catheter.

Place the urine bag below the level of the bladder.

Select a night bag.
Attach the ribbed connector of the night bag to the silicone tube in the area of the drain valve of the foot bag.
Open the drain valve, ensuring the flow of urine from the foot bag into the night bag.
Loosen the fastening straps so that the maximum comfort is achieved while minimizing the risk of components coming apart.
Fix the night urine bag with a hook, ensuring the optimal position of the product and the unimpeded outflow of urine.