Who is a candidate for
the procedure?
The most common reason for urinary catheterization is to monitor the output of
urine. This may be needed during surgery or a hospital stay for severe illness. For the
long term, it is better to have people catheterize themselves when needed, if possible.
Short-term urinary catheterization has few risks or side effects.
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How is the procedure
performed?
Catheters that are placed through the urethra have a smooth tapered tip and two
outlet ports. The larger port drains the urine, and the other is for inflating the balloon
that keeps the catheter from slipping out. Catheters are made of several materials, which
vary in slipperiness. Some catheters have the tip curved upward, for use in men with large
prostates. Other catheters have an extra hole so they can be placed over a wire to guide
placement in the bladder.
The genital area is first cleansed with a sterile solution. The catheter is then
lubricated and passed gently through the urethra into the bladder. Its proper placement is
indicated when urine is returned to the catheter. The balloon is inflated with a small
amount of fluid. The catheter is then taped or strapped into place. When the person is in
bed, a large bag is used to collect the urine. If a person is walking around, bags that
are smaller and easier to use are strapped to the leg.
Sometimes it is better to go directly through the skin of the lower abdomen into the
bladder. This might be done when the urethra is damaged, infected, or blocked by cancer.
The catheter is placed with a needle and wire through the skin, or a very small incision
over the bladder is made. This might be performed under local, regional, or general
anesthesia.
The catheter is held in place with a balloon or by the shape of the catheter. The catheter
is often sewn into place on the skin, as well. This kind of tube through the lower abdomen
is more commonly used when people need long-term catheterization and cannot catheterize
themselves when necessary.
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What happens later at home?
Care should be taken to avoid pulling the catheter out accidentally. It is
important to be aware of the tubes and straps. Careful cleansing of the site where the
tube exits the body, either at the urethra or at the skin of the abdomen, helps to prevent
infection and irritation.
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What
are the potential complications after the procedure?
Catheterization for less than 3 to 4 days rarely causes problems. If a catheter
is left in longer than a week, bacteria are likely to grow in the bladder. In these cases,
antibiotics may be given when the catheter is removed to help clear the infection.
Catheterization for years may result in skin erosions where the catheter exits. Chronic
inflammatory changes in the bladder, which rarely can induce a form of cancer, and chronic
urinary tract infections are also possible.
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