URETHRAL CATHETERIZATION

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Indications . Urethral catheterization is performed for diagnosis and treatment of urologic disease.. Indications. Diagnosis:collection of urine for culture.Measurement of the postvoid residual urine.Cystourethrography.Urodynamic studies.. Indications. Treatment:Relief of infravesical obstr

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URETHRAL CATHETERIZATION

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1. URETHRAL CATHETERIZATION Ali Rashad, FEBU Assistant Consultant, Urology Department of Surgical Specialties KFMC

2. Indications Urethral catheterization is performed for diagnosis and treatment of urologic disease.

3. Indications Diagnosis: collection of urine for culture. Measurement of the postvoid residual urine. Cystourethrography. Urodynamic studies.

4. Indications Treatment: Relief of infravesical obstruction. drain the bladder after surgical procedures involving the lower urinary tract. monitor urinary output.

5. Indications Treatment: Clean intermittent catheterization. urinary incontinence. urethral catheters are often used as stents after surgery to allow healing of an anastomosis or incision involving the bladder neck or urethra.

6. Indications Treatment: Administration of intravesical therapy such as with bacillus Calmette-Guérin (BCG) or mitomycin-C for bladder cancer also requires temporary catheterization.

7. Types of Catheters

8. Types of Catheters Catheter size is usually referred to using the French (Fr) scale (circumference is in millimeters), in which 1 Fr = 0.33 mm in diameter. each millimeter in diameter is approximately 3 Fr. a No. 18 Fr catheter is about 6 mm in diameter.

9. Types of Catheters Catheter sizes refer to the outside circumference of the catheter, not the luminal diameter.

10. Types of Catheters

11. Types of Catheters

12. Types of Catheters

13. Types of Catheters Two-way catheters . Three-way catheters.

14. Frederic Eugene Basil Foley, MD 1891 - 1966

15. Types of Catheters

16. Patient Preparation the patient should be informed of the reason for catheterization . discomfort. it is essential to prepare and drape the urethra and surrounding area as for a surgical procedure.

17. Patient Preparation In the male, retrograde injection of 10 to 15 mL of a water-soluble lubricant-anesthetic (e.g., 2% lidocaine hydrochloride jelly) and placement of a urethral clamp for 5 to 10 minutes to allow the anesthetic to contact the mucosal surfaces are recommended before any urethral instrumentation.

18. Patient Preparation In the female, the lubricant-anesthetic can be placed directly on the catheter or a cotton-tipped applicator coated with lubricant-anesthetic can be placed in the urethra before catheterization.

19. Technique In the male patient, the penis is placed on stretch perpendicular to the body (pointing slightly toward the umbilicus) without compressing the urethra and then the catheter is placed in the urethral meatus by holding the catheter at the tip. Gentle advancement of the catheter causes the least amount of discomfort.

20. Technique As one approaches the bulbomembranous urethra (i.e., level of external sphincter), asking the patient to take slow, deep breaths will help relax the patient and often allow easier catheter passage. one should not attempt forceful catheter insertion .

21. Technique

22. Technique After spreading the labia, one can usually identify the urethral meatus easily, and the catheter is placed gently into the bladder.

23. Technique Catheters made of silicone are, in general, better tolerated over the long-term than those made of materials such as latex and polyurethane. choose the smallest urethral catheter that will accomplish the purpose of catheterization. adult, catheters of No. 16 to 18 Fr . pediatric s, feeding tubes of No. 3 to 5 Fr.

24. COMPLICATIONS

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