Urinary Bladder
Catheterization
Definition
• Invasive aseptic or sterile procedure where a flexible
draining tube (catheter) is placed through the urethra
into the bladder to empty the patient’s bladder of
urine
Considerations
• Patient may be asked to urinate prior to procedure
• Patient may arrive to the OR with a catheter in place
• Catheter may be left in or changed
• Will be placed pre-operatively and remain in place
post-operatively
Types of Catheters
• Robinson or Rob-nel (Red Rubber)
used for one time emptying prior to
procedure
is a straight less flexible catheter
• Indwelling Foley used if surgeon wants
bladder to be drained continuously during
surgery
• Carson-Coude tip of catheter slightly bent to
aid in passing through an obstructed urethra
(BPH or prostate surgery history)
• Supra-pubic/Mushroom catheter
Cath Kit
Standard Latex Foley
Red Rubber
Coude Tip
Supra-pubic/Mushroom catheter
Catheter Materials
• Consider types of materials catheters
are made of:
• Latex rubber
• Polyvinyl chloride (PVC)
• Silicone
Types of Drainage Systems
• Gravity bag
• Urimeter
• Sterile container
Purpose
• To empty or decompress the bladder
during a surgical procedure
• Drain urine from the bladder
• Obtain a sterile urine specimen for lab
analysis
Reasons for Catheterization
• Pelvic surgery
• Genitourinary system surgery
• Spinal or epidural anesthesia
• Surgery expected to last more than 2
hours
• Patient having difficulty urinating
• Patient unconscious
Procedure
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Basic handwash
Gather supplies:
catheter kit (catheter & drainage system)
sterile water in a 5 or 10cc syringe (know balloon capacity)
PPE (sterile gloves)
Cleaning solution (betadine solution, other, & cotton balls
gauze sponges)
OR
Water soluble sterile lubricant
Positioning aides if needed (tape, blanket, assistant)
Trash
Clean surface available that allows use of dominant hand for inserter
Good Lighting
Procedure
• Identify self if patient alert/awake
• Identify patient
• Explain procedure if patient
awake/alert
• KNOW allergy status (betadine, latex)
• Know where alternatives are (gloves,
catheters, solutions)
Procedure
• Expose external genitalia
• Maintain privacy as much as possible
• Male: Supine
• Female: “frog-legged”
• Catheter set opened aseptically creating
a sterile field
• Open glove technique
Procedure
• Prepare set
• Pour sterile betadine solution or have
other poured over gauze or cotton balls
• Prepare lubricant
• Test catheter balloon with sterile water
leaving connected
• Attach urinary drainage system to
catheter)
Procedure For Males
• Place sterile drape or towel over thighs under penis
(extends sterile field)
• Place towel above penis
• Two towels should meet
OR
• Place fenestrated towel over penis
• Move catheter system closer to target area
• Use nondominant hand to grasp and pull the penis
up
*Note: this hand is contaminated and will remain
where it is until the catheter is inserted and the
balloon is inflated
Procedure For Males
• Antiseptic solution soaked sponge is grasped with forceps from
set or dominant hand
• Urethral meatus is cleansed from urethra out times two in a
circular motion, removing sponge away from sterile field, after
each cleansing
• Grasp catheter about three inches from the tip with your sterile
dominant hand and put into the urethral meatus until the end of
the catheter is buried or until urine drains
• May need to press on the bladder to get urine to drain
• Securing catheter with nondominant hand, inflate the balloon
with sterile water of the appropriate amount
• Gently pull catheter until resistance is felt
• Secure to patient’s thigh
• Place drainage bag below the level of the OR bed
Procedure For Males
• Clean patient prn
• Clean up supplies
• Remove soiled gloves using proper
technique
• Reposition and cover patient prn
• Wash your hands
• Record or note abnormalities to
circulator
• Note color and clarity of urine
Procedure For Females
• Sterile drape is placed between the thighs
• Fenestrated drape placed over pubis exposing
urethral meatus
• Move catheter system closer to target area
• Spread labia with nondominant hand
*Note: this hand is contaminated and will
remain where it is until the catheter is
inserted and the balloon is inflated
Procedure For Females
• Antiseptic solution soaked sponge is grasped with forceps from
set or dominant hand
• Urethral meatus is cleansed anterior to posterior times two,
removing sponge from sterile field, after each cleansing
• Grasp catheter about three inches from the tip with your sterile
dominant hand and put into the urethral meatus until urine
drains
• May need to press on the bladder to get urine to drain
• Securing catheter with nondominant hand, inflate the balloon
with sterile water of the appropriate amount
• Gently pull catheter until resistance is felt
• Secure to patient’s thigh
• Place drainage bag below the level of the OR bed
Procedure For Females
• Clean patient prn
• Clean up supplies
• Remove soiled gloves using proper
technique
• Reposition and cover patient prn
• Wash your hands
• Record or note abnormalities to
circulator
• Note color and clarity of urine
Summary
• Catheterization
• Purpose
• Considerations
• Male
• Female