Catheterisation

Why catheterisation?

Catheterisation is understood to mean the insertion of a catheter into the urinary bladder via the urethra (= transurethral). Catheterisation may be required for the following reasons:

  • Emptying the bladder in cases of urinary retention
  • Irrigation of the bladder
  • Insertion of drugs (e.g. local chemotherapy)
  • Bladder function examination (urodynamics)
  • Urine drainage following surgery
  • Urine drainage in cases of pronounced inflammations of the urinary organs

What sorts of catheters are there?

There are various kinds of catheters: Single-use catheters, indwelling catheters and measuring catheters.

  • Single-use catheters are narrow plastic tubes that are inserted into the urinary bladder and immediately removed following completion of the necessary measure.
  • Indwelling catheters have an inflatable balloon at the tip that prevents the catheter from coming out. Indwelling catheters remain in the bladder for prolonged periods in order to drain the urine, e.g. following surgery or in the case of urinary retention.
  • Measuring catheters have multiple fine internal channels to measure the pressure in the bladder and urethra. These enable important diagnostic information to be obtained concerning a bladder disorder. Measuring catheters are removed following the examination.

How is catheterisation performed in women?

The patient lies in the gynaecological position during catheterisation. After spreading the labia, the external urethral opening is cleaned with a disinfectant that does not cause any burning sensation on the mucosa. The urethra is then locally anaesthetised and lubricated for the instillation in advance with a sterile lubricant with local anaesthetic and disinfecting properties, such as Instillagel®.

First, a drop of Instillagel® is applied to the urethral opening in order to enable the blunt and fully rounded cone of the syringe to be easy inserted. Instillagel® is then slowly injected into the urethra. The injection of Instillagel® opens and expands the urethra, enabling the catheter to be inserted considerably more easily than would be the case if the lubricant were simply applied to the catheter. It is important to wait 5 - 10 minutes following instillation of Instillagel® in order to allow the anaesthetic to take full effect. Once it has taken effect, the physician inserts the catheter into the bladder with sterile gloves and forceps. Draining urine indicates that the tip of the catheter has reached the bladder. The patient may assist catheterisation by remaining calm and relaxed (with the pelvic floor relaxed).

How is catheterisation performed in men?

The patient lies in the supine position during catheterisation. After pulling back the foreskin, the external urethral opening is cleaned with a disinfectant that does not cause any burning sensation on the mucosa. The urethra is then locally anaesthetised and lubricated for the instillation in advance with a sterile lubricant with local anaesthetic and disinfecting properties, such as Instillagel®. First, a drop of Instillagel® is applied to the urethral opening in order to enable the blunt and fully rounded cone of the syringe to be readily inserted. Instillagel® is then slowly injected into the urethra. Some patients experience a brief sticking or burning sensation, which then clears up immediately. The injection of Instillagel® opens and expands the urethra, enabling the catheter to be inserted considerably more easily than would be the case if the lubricant were simply applied to the catheter. It is important to wait 5 - 10 minutes following instillation of Instillagel® in order to allow the anaesthetic to take full effect. A FARCO penile clamp may be secured to the penis during this period to prevent Instillagel® from running out. Once the anaesthetic has taken effect, the physician inserts the catheter into the bladder with sterile gloves and forceps. Draining urine indicates that the tip of the catheter has reached the bladder. The patient may assist catheterisation by remaining calm and relaxed and taking deep breaths as the catheter is advanced.

Is catheterisation painful?

Catheterisation is normally not painful. As the catheter is carefully advanced, some patients may experience brief discomfort at most, such as a sticking or burning sensation in the urethra. Tell your physician if you continue to experience this sensation for a more prolonged period.

Are there any potential complications?

Catheterisation is performed under sterile conditions, such that infections are very rare. A mild burning sensation or initially frequent urination are possible following catheterisation and will clear up on their own in a little while. Similarly, small amounts of blood may be present in the urine or in your underwear following catheterisation. But this is no cause for alarm. The risk of injury to the urethra during catheterisation is extremely low and is able to be reduced by proceeding carefully and using a suitable lubricant, such as Instillagel®.