Male Catheterisation 💦
🧠 Indications
- Urinary retention (acute/chronic)
- Accurate fluid balance monitoring
- Pre/post-op bladder drainage
- Neurogenic bladder dysfunction
- Bladder irrigation (e.g. haematuria)
🚫 Contraindications
- Suspected urethral injury (e.g. blood at meatus, pelvic fracture)
- Known urethral stricture (relative)
- Recent urological surgery – seek senior advice
🧰 Equipment
- Sterile catheterisation pack
- Sterile gloves, drapes
- 14–16Fr Foley catheter (usually)
- Sterile water (10ml for balloon)
- Lubricant with lidocaine (e.g. Instillagel)
- Sterile urine drainage bag
- Apron + appropriate PPE
- Consent form (verbal or written if needed)
📝 Procedure
- Always ask a nurse to assist
- Explain procedure & gain consent
- Wash hands & prepare sterile field
- Position patient supine; expose genitalia with privacy
- Clean glans with sterile saline or iodine solution
- Lubricate urethra using Instillagel – wait 2–3 minutes
- Gently insert catheter until urine flows
- Advance catheter fully to the bifurcation before inflating balloon
- Inflate balloon with 10ml sterile water
- Gently pull back until resistance felt
- Secure catheter & connect to drainage bag
- Replace foreskin if uncircumcised (risk of paraphimosis)
- Document date/time, size, balloon volume, residual volume (if relevant)
❗ Tips & Troubleshooting
- If resistance is met — stop, do not force; consider senior help or urology
- Use smaller size (12Fr) in elderly or those with strictures
- Use coude (curved tip) catheter in BPH if trained
- If unable after 2 attempts → escalate
🧼 Aftercare
- Monitor output and colour of urine
- Maintain closed drainage system
- Review daily for ongoing need
- Document clearly in the notes
✅ Actions for Interns
- Ensure consent + chaperone if needed
- Check for contraindications before attempting
- Gather all equipment beforehand
- Ask for help early if unsure
- Document full procedure in notes