In this article we will address the topic of urinary catheterization, its indicators, possible difficulties, measurements and control methods. Urinary catheterization is a standard medical procedure employed to control malfunctions with the urinary tract which can carry dangerous consequences and difficulties. Health professionals and/or medical practitioners at home should put this into practice so as to acquire the best results possible and decrease potential complications.
Nowadays, many patients utilize urine catheterization for different reasons. One of them is to facilitate drawing off urine from the bladder. Specialists can do this in two different ways:
– By introducing a catheter through the urethra into the bladder
– By introducing a catheter above the pubic bone into the bladder
In 1779, the antecedent of the new-age catheter, which was manufactured using gum elastic, was introduced. Then, in the 1800’s the latex catheter came into being. The urinary catheterization procedure might go back to 300 AD or even before this time. The first indwelling catheter was created by Jean Francois Reybard in 1853. This catheter was designed with an inflated balloon to make sure that it would remain inside the bladder. Years later in 1932, Frederick Foley changed the design of the indwelling catheter and since then, this catheter continues to be the most frequently used item when it comes to managing urinary tract malfunctions.
Materials employed in the manufacturing of catheters have greatly improved with the passage of time, but so have the caregiving and the control that the process encompasses. Being informed about catheter caregiving is fundamental for a health professional and/or medical practitioner. This will guarantee better results and less difficulties for the patient.
According to research, it is estimated that millions of Americans have to go through catheterization every year. Over 500,000 catheterizations include the employment of indwelling catheters which are positioned for a certain period of time. Approximately 20% of patients are likely to experience the insertion of an indwelling catheter while being hospitalized. Whereas in long term care (LTC) facilities, the frequency of catheter employment is of 7% to 10% approximately. Recent studies have also demonstrated that out of 4,010 in home caregiving, an estimated 5% has employed the insertion of indwelling catheters. Despite all the information available on how to properly carry out a catheterization procedure and care for the patient undergoing this, studies have yielded more than 20% of improper employment of catheters.
Urinary catheters are mainly used to control problems in the urinary tract, specifically urinary incontinence and urinary retention (inability to void urine). Employment of either short or long period catheterizations and the method to be utilized, mainly depend on what generated the urinary dysfunction. Catheterization methods comprise the following:
– Indwelling (this can be inserted through the urethra or by inserting the catheter above the pubis)
Employing indwelling urethral catheterization entails the insertion of a catheter via the urethra and into the bladder. The catheter is kept in a specific position by means of a retention balloon.Then, it is attached to a drainage bag which forms a closed urinary system. Specialists have provided a set of directions which should be followed so as to obtain the best outcome possible while managing catheters, these include the following:
∎ Precise checking in severely sick patients when urine is passed.
∎ Provide comfort to terminally or extremely sick patients.
∎ Try to monitor and take good care of any harm caused to the skin due to incontinence if all resources to control it have been exhausted.
∎ In patients who have not yet undergone a surgical intervention or those who have problems passing urine out due to neurological conditions, it is of utmost importance to keep a constant flow of urine.
∎ For sudden onset pain (acute pain), prompt treatment needs to be given.
Utilizing intermittent catheterization enconpasses the insertion (for a short period of time) of a catheter via the urethra and into the bladder. This is done to draw off urine on a periodic basis.
The following are some of the situations where intermittent catheterization may be used:
∎ To void urine and obtain urine tests.
∎ To calculate residual volume.
∎ To deliver medicines drop by drop.
∎ To deliver contrast material drop by drop into the bladder so as to analyze the urethra and bladder.
Intermittent catheters have become the best of their kind when it comes to managing urine voiding problems and subsequent operative procedures. Employing the insertion of intermittent catheters offers many advantages including the prevention of suffering from urinary tract infections related to catheterization. This makes them a better alternative to indwelling catheters. It is important to mention that patients who suffer from sight problems, lack of adroitness or motion should get the help from someone (family member or carer) who is knowledgeable on how to carry out the catheterization process.
Suprapubic catheterization is a process through which a catheter is inserted above the pubic bone and into the bladder. An inflated balloon inside the bladder keeps the suprapubic catheter secure in its place . This is then attached to a drainage bag so as to draw off urine from the bladder.
Performing a suprapubic catheterization requires the administration of local or general anesthesia. The following are some of the situations when using suprapubic catheters is advisable:
∎ Physical problems in the lower urinary tract and urethra.
∎ Urethral catheters coming out of the bladder due to weakened pelvic floor muscles.
∎ Complicated urethral/abdominal operation.
∎ For wheelchair patients or those patients who wish to remain sexually active.
∎ For those patients who suffer from fecal incontinence and do not want to get the catheter dirty.
∎ For patients suffering from blockage or abnormal narrowing of the urethra hence making it difficult to introduce a urethral catheter. .
Despite being a standard procedure in hospitals and sometimes at home, special attention should be paid to potential dangers arising from catheterization, for example:
∎ Unintentional detachment of the catheter
∎ Puncturing of the urethra
∎ Catheter obstruction
∎ Entrance of bacteria into the urinary bladder which may cause serious infections, blood poisoning (septicemia) and even death.
∎ Injury caused to the urethra or bladder due to inappropriate introduction or removal of the catheter and balloon not being deflated.
∎ Urine overpasses the bladder
∎ Kidney stones
∎ Long term inflammation in the kidneys
∎ Patients can experience a great impact on their work, social and psychological wellness
According to specialists, catheterization must only be carried out if all other resources to control urinary system dysfunctions have been exhausted or have not been successful. By following all the right directions, healthcare providers will be able to deliver a better process of catheterization hence giving the patient a better experience, positive results and less difficulties.