Insertion of temporary indwelling bladder catheter; simple (eg, Foley)
CPT4 code
Name of the Procedure:
Insertion of Temporary Indwelling Bladder Catheter (Simple) Commonly known as Foley catheter insertion.
Summary
Inserting a temporary indwelling bladder catheter involves placing a thin, flexible tube through the urethra into the bladder to drain urine. It is typically a short, straightforward procedure often performed without the need for extensive anesthesia.
Purpose
This procedure addresses urinary retention, helps monitor urine output in critically ill patients, provides a means for collecting a sterile urine sample, and assists in bladder management for surgical patients. The goal is to relieve urinary retention, ensure accurate monitoring of urine output, and collect uncontaminated urine specimens.
Indications
- Urinary retention
- Need for accurate urine output measurement
- Sterile urine sample collection
- Pre- or post-operative bladder management
- Severe skin breakdown due to incontinence
Patient criteria:
- Inability to void naturally
- Patients undergoing certain surgical procedures
- Need for sterile urine sample assessment
- Patients at risk of skin damage due to incontinence
Preparation
- No special fasting required
- Patients may need to adjust certain medications as advised by their healthcare provider
- Basic diagnostic tests, like a urine analysis, may be performed beforehand
Procedure Description
- The patient is positioned comfortably, typically lying flat on their back.
- The area around the urethral opening is cleaned with an antiseptic solution.
- A sterile lubricated Foley catheter is inserted gently into the urethra until it reaches the bladder.
- Once urine flows through the catheter, a small balloon at the tip of the catheter is inflated with sterile water to keep it in place.
- The catheter is connected to a drainage bag to collect urine.
Equipment used:
- Sterile Foley catheter kit
- Antiseptic solution
- Sterile gloves
- Drainage bag
Anesthesia or sedation:
- Usually not required; local numbing gel may be used.
Duration
The procedure typically takes about 10 to 15 minutes.
Setting
Performed in various healthcare settings:
- Hospitals
- Outpatient clinics
- Surgical centers
Personnel
- Registered Nurse (RN)
- Medical Doctor (MD) or Physician Assistant (PA), if specialized care is needed
Risks and Complications
Common risks:
- Discomfort during insertion
- Urinary tract infections (UTIs)
Rare complications:
- Urethral injury
- Bladder spasms
Complication management:
- Antibiotics for infections
- Removal or repositioning of the catheter for injuries
Benefits
- Immediate relief from urinary retention
- Accurate urine output measurement
- Obtaining clean urine specimens
- Improved patient comfort in certain conditions
Recovery
- Minimal recovery time
- Keep the catheter and collection bag clean to prevent infections
- Follow-up appointments as scheduled by the healthcare provider
Alternatives
- Intermittent catheterization
- Urethral stents
- Suprapubic catheters
- Medications to improve bladder function
Pros and Cons:
- Intermittent catheterization avoids a constant foreign body but requires frequent self-catheterization.
- Suprapubic catheters reduce the risk of urethral trauma but involve a minor surgical procedure.
Patient Experience
During the procedure, patients might experience mild discomfort, pressure, or a slight burning sensation. Pain management includes the use of a local anesthetic gel. After insertion, there might be initial discomfort, but it typically subsides quickly. Proper care and hygiene can prevent complications and ensure comfort.