Female Urethral

4 Catheterization
MIN CHEN
Geriatric Department
ZHONGNAN Hospital

LEARNING

OBJECTIVES

Know indications and contraindications

for Urethral catheterization
Know the procedures of Urethral
catheterization
Command the skill of insertion Urethral
catheterization

Definition- Female urethra

catheterization
The insertion of a catheter through the
urethra into the urinary bladder to
permit drainage of urine
A fundamental skill for the practicing
health care professional

Indications
Diagnostic indications include the following:

Collection of uncontaminated urine specimen

Monitoring of urine output

Imaging of the urinary tract

Therapeutic indications include the following[2j:

Acute & Chronic urinary retention

Instilling medication
Intermittent decompression for neurogenic bladder

Hygienic care of bedridden patients

Contraindication
Urethral injury
(most commonly result from pelvic
fractures)

Equipment
- urinary catheterization kit
U

iodine
Sterile cotton balls
Water-soluble lubrication gel
Sterile drapes
Sterile gloves
a preconnected closed Foley system
a specimen container
a 10-cc syringe filled with sterile water for
balloon inflation
Urinometer connected to a collection bag

1 .1

V.

CT

JU

Anatomy

Clitoris

gin by inspecting the

genital area to identify
the urethral meatus
The female urethra is a
fibromuscular tube

Urethra
Vagina
Labium
majora

Anus

Labium
minor

PreparationConsent
inform the patient of the reasons and
necessity for the procedure
Explain the procedure to the patient
including possible complications
Address any specific questions or
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Positioning
With the bed flat, the patient should lie
supine in a frog-legged position, with
legs apart and feet together

Procedure
i Ask the patient to clean perinaeum
with soap water or the hygienic towelette
i Place the patient supine
i Prepare equipments
i Wash hands

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Six steps hands washing

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Procedure-lst sterilization
UTclh

sterile conditions
ral catheterization should be performed under
Inspect the sterile catheterization kit and remove
it from its outer packaging
separate labia using left hand with a plastic glove
Using right hand to handle forceps, cleanse peri
urethral mucosa with betadine
Cleanse the mons pubisthe left labia majorathe right labia majoraleft in between of labia
majora and minor- righter in between of labia
majora and minor- - left labia minor right labia
minor- urethral meatus , one swipe per swab

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Procedure -drape
Open the inner paper
wrapping to form a
sterile field.
Put the gloves on
Cover the patient's
abdomen and superior
pubic region with the

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Procedure-lubricate
Check the contents of the tray or
the sterile field
lubricate the tip & distal end of
catheter( 2-5 cm)
Connect the catheter with urine
collection bag

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Procedure-2nd sterilization
Sterilize the meatus labia minors (both sides) ~
meatus again
before its insertion into the urethra,using your
nondominant hand, identify the urethra by spreading
the labia majora and minora;
Dlace the thumb and index finger medial to the inner
abia
spreading the fingers slightly and with gentle traction
and pulling upward toward the head of the patient
(This hand is no longer sterile and should not be
removedhand
from position
this position.)
Maintain
until preparing to inflate
balloon
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Procedure-insertion

Holding the catheter in the dominant

hand, gently insert the catheter tip into
the meatus
slowly advance it through the urethra
into the bladder (6-8cm) (insert until 2
to 3cm beyond where urine is noted
)

If the catheter is accidentally

contaminated, discard it and obtain a

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Procedure-evaluation
Evaluate catheter function and amount,
color, odor, and quality of urine
If the flow of urine is slow or nonexistent,
the catheter may be obstructed or in the
wrong site, or the bladder may be empty.
Flush the catheter with saline
If saline or urine freely returns, the
catheter is properly inserted.
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Procedure-inflate balloon
Inject the entire contents of the
10-cc syringe of sterile water to
Gently
pull catheter
until inflation
Inflate
balloon
completely
balloon is snug against bladder
neck

Secure catheter to abdomen or thigh,

without tension on tubing

Inflated Balloon

Document
Remove gloves, dispose of equipment
appropriately, wash hands
Document size of catheter inserted,
amount of water in balloon, patient's
response to procedure, and
assessment of urine
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Complications
The main complications are tissue trauma
and infection

Traumatic injury may cause strictures, narrowing,

and scarring of the urethra.

After 48 hours of dwelling catheterization, most

Removing the Catheter

First, deflate the balloon
Re-attach the syringe as you did before,
Exert a bit of suction with the syringe:
be sure you have taken out as much
water
as
you
put
in;
the
balloon
must
be deflated
Now slowly withdraw the catheter
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Th* NEW ENGLAND JOURNAL of MEDICINE

Female Urethral Catheterization

Rafael Ortega, M.D., Linda Ng, M.D., Pavan Sekhar, B.S,, and Michael Song, MA

N EnglJ Med 2008;358:el5.

Copyright 200$ Masiaciwsttts Medical Society

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Key point
using an aseptic technique

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Opening of urethra

Shaft of clitoris
Glans of clitoris

Opening of
na

ulbsof
clitoris

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