Indwelling Catheter: Foley Type, Two-Way Latex with Coating (Teflon, Silicone, Silicone Elastomer, or Hydrophilic, etc.), Each (A4338)

Name of the Procedure:

• Common Names: Foley Catheter, Urinary Catheter, Bladder Catheter
• Medical Terms: Indwelling Catheterization, Two-Way Foley Catheterization

Summary

An indwelling catheter, commonly known as a Foley catheter, is a flexible tube inserted into the bladder to drain urine. This type of catheter remains in place for an extended period and is equipped with a coating (Teflon, silicone, silicone elastomer, or hydrophilic) to reduce friction and potential infection.

Purpose

• Medical Conditions/Problems: Urinary retention, post-surgical drainage, monitoring urine output in critically ill patients, managing patients with bladder obstruction, and ensuring urine drainage in those with certain conditions like spinal cord injuries.
• Goals/Outcomes: To provide continuous urine drainage, reduce the risk of urinary tract infections (UTIs), and ensure patient comfort and hygiene.

Indications

• Severe urinary retention or obstruction
• Need for precise urine output monitoring
• Post-operative urine drainage
• Long-term management of chronic conditions affecting bladder function
• Patient criteria include men and women who are unable to naturally void urine due to various medical conditions or surgeries.

Preparation

• Pre-Procedure Instructions: No special fasting or medication adjustments typically required. The patient may need to empty their bladder if capable.
• Diagnostic Tests: Possibly a bladder scan or ultrasound to assess the need for catheterization.

Procedure Description

1. Insertion:

   • Sterile gloves and antiseptic are used to clean the genital area.
   • The catheter, coated with a lubricant, is gently inserted through the urethra into the bladder.
   • Once urine begins to flow, the catheter is advanced a few more centimeters.
   • A balloon at the tip of the catheter is then inflated to keep it in place.

2. Equipment:

   • Foley catheter (latex with Teflon, silicone, silicone elastomer, or hydrophilic coating).
   • Lubricant, antiseptic solution, sterile gloves, and a collection bag.

3. Anesthesia/Sedation: Usually not required, although local anesthetic gel may be used for patient comfort.

Duration

• The catheter insertion typically takes about 10-15 minutes.

Setting

• The procedure is performed in various healthcare settings, including hospitals, outpatient clinics, and surgical centers.

Personnel

• Typically performed by nurses, but can also be done by other healthcare professionals such as physicians or medical assistants.

Risks and Complications

• Common Risks: Discomfort or pain during insertion, minor bleeding, and risk of urinary tract infections.
• Rare Risks: Bladder spasms, urethral injury, and accidental removal of the catheter.

Benefits

• Provides continuous and effective urine drainage.
• Decreases the risk of bladder and kidney damage due to urine retention.
• Symptoms of urinary retention are typically relieved immediately after catheterization.

Recovery

• Post-Procedure Care: Regular catheter care and hygiene to prevent infection, monitoring for signs of complications.
• Expected Recovery: Immediate relief from symptoms; patients can often return to normal activities shortly after insertion, with some activity restrictions.
• Follow-up: Regular follow-ups for catheter maintenance and timely replacement.

Alternatives

• Intermittent Catheterization: Periodic insertion and removal of a catheter.
• Suprapubic Catheterization: A catheter inserted through an incision in the abdomen directly into the bladder.
• Medication: For some conditions managing symptoms without catheterization.
• Pros and Cons: Intermittent catheterization reduces the risk of infection but requires more frequent insertions. Suprapubic catheters decrease urethral injury risk but involve surgical procedure.

Patient Experience

• During the Procedure: Mild discomfort or a feeling of pressure during insertion.
• After the Procedure: Initial discomfort, which typically subsides. Pain management can include over-the-counter pain relievers as needed.
• Comfort Measures: Regular hygiene, adequate fluid intake, timely catheter maintenance, and monitoring for potential complications enhance patient comfort and safety.