Male
Urinary Catheterization
A male patient will lie on his back, with his
legs bent at the knees and flopping slightly to the side as
the nurse or doctor insert his foley catheter. His meatus (urethral
opening) and surrounding area will be cleaned with Betadine
before the foley catheter insertion by the nurse or doctor.
The meatus is at the tip of the penis. The nurse will hold and
lift the penis to a position perpendicular to patient's body
and apply light upward traction to insert the catheter.
This is a very invasive procedure and embarrassing
for many male patients. Keep in mind that urinary
catheterizations are often unnecessary. Do not allow a catheter
to be inserted unless it is absolutely necessary. There is usually
no need to have an urinary catheter inserted for most surgeries
that do not last longer than 3 hours. Prostatectomy is one surgery
that requires an urinary catheter because the prostate is located
so close to the bladder. A prostatectomy patient usually must
have a foley catheter in place for a week after surgery while
he heals. The prostatectomy patient's catheter is inserted by
an urologist with specific regard to the prostatectomy.
Concerns About Your Modesty
If you are required to have an urinary
catheter inserted and you are concerned about your modesty,
you should take the following steps:
1) Request that a male nurse
or doctor insert your catheter and that no female medical personnel
be present.
2) Request that your catheter
be inserted before they give you IV or medicine so you can make
sure that your wishes are honored. Once you are under anesthesia,
your wishes could easily be ignored unless you have an advocate
such as your wife who is not employed by the medical facility
present with you in the operating room.
3) It would be prudent to have
someone (if possible) present for your foley catheter insertion
to make sure that they do not give you any drugs especially
Versed against your wishes to make you become unable to speak
up or bring in female medical personnel against your wishes.
4) It would be prudent for
you to discuss your wishes about having a male staff member
doing your foley catheter insertion with your doctor and the
nursing department in advance. Talk to everyone you come in
contact about your wishes. Make sure you have your wishes in
writing.
5) Insist on wearing a cotton
underwear or boxer shorts with the foley catheter if you are
having surgery that does not involve the genitals such as brain
surgery.
How to Prevent Infection
& Pain
6) While being catheterized,
a topical analgesic should be applied to the catheter and urethral
opening to minimize the pain of being catheterized. Insist on
this to be done.
7) While they are catheterizing
you, ensure that sterile equipment and sterile techniques are
used. Usually, this comes in a catheterization kit, which comes
in either male or female. This has a set of sterile gloves,
a tube of sterile lubricant, a sterile catheter, and other sterile
equipment. This is usually done, but sometimes corners are cut.
If the nurse is using regular gloves out of the box, lubricant
out of a general-use tube uses a catheter which is not in a
sealed package, object and refuse. Using unsterile techniques
greatly increases the chances for a UTI, bladder, or kidney
infection - which may become very serious.
8) After the catheter is inserted, the tubing
must be secured to the thigh and upper leg. This is usually
done with 3 or 4 pieces of tape, possibly using a velcro strap
for one of the pieces of tape. Failing to have the catheter
secured may cause it to be pulled out, also known as "traumatic
removal".
9) The catheter bag must always be lower
than the bladder. To have it higher than the bladder allows
urine to flow back into the bladder from the tubing. This can
cause an infection.
10) When in bed, be sure that the bag is
hanging from the bed frame, not from a bed rail that raises
and lowers. This can be another reason that the catheter can
be pulled out, or "traumatic removal". Traumatic removal
of an indwelling catheter with the "balloon" inflated
can cause injury, tearing, infections, and long-term or permanent
incontinence. Of note, by agreeing to the catheter, this is
considered a "risk" of catheterization, a risk which
your signature almost always has you assume. You (or your insurance)
may have to pay for further treatments or surgery, you will
have to pay for incontinence supplies for years to come, and
you will have to endure the burden of both inconvenience and
embarrassment that goes along with it.
11) If you notice anyone or anything pulling
on the catheter so as to cause you discomfort, yell, scream,
and get them to stop so as to prevent it being pulled out or
"traumatic removal".
12) Ensure that the catheter is cleaned
at least twice a day, using soap and water, and a clean cloth
which has not been used to clean anything else - including other
parts of your body.
13) Ask your doctor every day whether the
catheter is still required. Each day of catheterization increases
your risk of UTI, bladder, or kidney infection by approximately
25%.
Make sure you check out our article about unnecessary
urinary catheterizations and missing informed patient consent
and do research to determine if a urinary catheter is really
necessary in your case.
Other Related Articles:
Unnecessary
Urinary Catheterizations and Missing Informed Patient Consent
Why
Consent For Urinary Catheters Should Be Mandatory By John H.
Fisher
Sources:
Post-Operative
Care | Robotic Prostatectomy | Thomas Ahlering, M.D.
|
