How to operate male indwelling urinary catheter

The operation methods of male indwelling catheterization mainly include steps such as disinfection preparation, catheter insertion, fixation of the catheter, connection of drainage devices, and postoperative care.

1. Disinfection preparation

Before the operation, the perineum and urethral opening need to be disinfected in a circular manner with iodophor solution, covering the base of the penis to the glans. The disinfection sequence is from the inside to the outside and repeated 2-3 times. Operators need to wear sterile gloves and lay out sterile drape to establish a sterile area. Incomplete disinfection may increase the risk of urinary tract infection.

2. Insertion of urinary catheter

Apply lubricant to the front end of the sterile catheter, lift the penis with your left hand at a 60-degree angle to the abdominal wall, hold the catheter in your right hand and gently insert it into the urethra. When encountering resistance, pause briefly and ask the patient to take a deep breath and relax. The insertion depth is about 20-22 cm. After urine flows out, advance 5 cm to ensure that the balloon completely enters the bladder.

3. Fixed urinary catheter

After confirming that the urinary catheter is in the correct position, inject 10 ml of sterile saline into the balloon. Gently pull on the catheter to feel for resistance and make sure the balloon is stuck in the neck of the bladder. The outer end of the urinary catheter is fixed to the inner thigh with tape to avoid pulling or twisting. Improper fixation may result in catheter slippage or urethral damage.

4. Connect the drainage device

Connect the end of the catheter to the sterile drainage bag, keeping the drainage bag below the level of the bladder. Check whether each interface is tight to prevent urine from flowing back. The drainage bag should be changed every day, and the urine output and characteristics should be recorded. Incorrect device connection may cause urine leakage or retrograde infection.

5. Postoperative care

Clean the urethral opening with normal saline every day and observe whether there is redness, swelling or exudation. Keep the urinary catheter unobstructed and avoid folding due to pressure. Patients are encouraged to drink more water and maintain a daily urine output of more than 1500 ml. Those with long-term indwelling urinary catheters need to be replaced regularly. Generally, silicone urinary catheters are replaced once a month.

During indwelling catheterization, strenuous exercise should be avoided to prevent the catheter from shifting. Pay attention to changes in urine color and seek medical attention promptly if symptoms such as hematuria, pyuria or fever occur. Eat a light diet and limit caffeine and alcohol intake to help prevent urinary tract infections. Carry out bladder function exercises regularly to shorten the time of indwelling urinary catheterization.