Name of the Procedure:

Insertion Tray without Drainage Bag with Indwelling Catheter, Foley Type, Two-Way, All Silicone (HCPCS Code: A4312)

Summary

This procedure involves the insertion of a silicone Foley catheter using a sterile insertion tray. A Foley catheter is a flexible tube inserted into the bladder to drain urine. This specific procedure does not include a drainage bag and utilizes a two-way Foley catheter, which has a balloon at one end to keep it in place.

Purpose

The procedure addresses urinary retention, incontinence, and the need for continuous bladder drainage. It helps patients who cannot empty their bladder naturally or require monitoring of urine output. The goal is to ensure efficient urine drainage, monitor kidney function, and prevent bladder distention or damage.

Indications

• Acute or chronic urinary retention
• Severe urinary incontinence
• Pre and post-operative management in urological surgeries
• Neurological disorders affecting bladder function
• Need for accurate urine output measurement

Preparation

• Follow any pre-procedure fasting or medication adjustment instructions provided by your healthcare provider.
• Patients may need to undergo a urinalysis or bladder scan.
• Ensure the genital area is clean to reduce the risk of infection.

Procedure Description

1. The patient will be positioned comfortably, usually lying on their back.
2. A healthcare provider will don sterile gloves and prepare the sterile field using the insertion tray.
3. The patient’s genital area will be cleansed with antiseptic solution.
4. The Foley catheter will be lubricated and carefully inserted into the urethra until it reaches the bladder.
5. Once urine flow is observed, the balloon at the catheter's end is inflated with sterile water to secure it in place.
6. The catheter will then be connected to a drainage system, if needed, though in this case, a drainage bag is not included with the tray.

Duration

The procedure typically takes about 10-15 minutes.

Setting

The procedure is usually performed in a hospital setting, outpatient clinic, or in some cases, a nursing home.

Personnel

• Nurse or trained healthcare provider for insertion
• Possible oversight by a urologist or other specialized physician if complications or special conditions exist

Risks and Complications

• Urinary tract infection (UTI)
• Bladder spasms
• Pain or discomfort during insertion
• Bleeding or trauma to the urethra
• Blockage or kinking of the catheter

Benefits

• Immediate relief from urinary retention
• Accurate monitoring and measurement of urine output
• Prevention of bladder overdistention
• Reduced risk of pressure sores in bedridden patients due to incontinence management

Recovery

• Patients should drink plenty of fluids to help prevent infection.
• Report any signs of infection, such as fever, chills, or cloudy urine, to the healthcare provider immediately.
• The catheter will usually need to be changed periodically, as instructed by the healthcare provider.
• Follow-up appointments may be necessary to monitor progress and make adjustments.

Alternatives

• Intermittent catheterization: Periodic insertion and removal of a catheter multiple times a day.
• Suprapubic catheter: A catheter inserted directly into the bladder through the lower abdomen.
• Medications to manage urinary retention or incontinence.
• Behavioral therapies such as bladder training exercises.

Patient Experience

During the procedure, the patient may feel some initial discomfort or pressure when the catheter is inserted and the balloon is inflated. After the procedure, slight discomfort might persist but can be managed with pain relievers if necessary. Proper hygiene and care can help minimize discomfort and the risk of complications, ensuring a smoother recovery experience.