Male Catheterisation 💦

Step-by-step guide for male urinary catheterisation. Technique, indications, complications, and troubleshooting for NCHDs.

🧠 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

Male Catheterisation 💦 - BetterCall.ie