Name of the Procedure:

Indwelling Catheter, Foley Type, Three-Way for Continuous Irrigation (A4346)

Summary

This procedure involves the insertion of a special type of urinary catheter known as a three-way Foley catheter. It is designed to continuously irrigate the bladder, which helps to prevent the buildup of clots and debris, particularly after urinary tract surgeries.

Purpose

The three-way Foley catheter is commonly used to manage post-surgical UTI patients, those with severe hematuria (blood in urine), or individuals requiring continuous bladder irrigation. The goal is to maintain clear urine flow, avoid blockage, and facilitate healing or additional medical evaluations.

Indications

• Severe hematuria
• Postoperative urinary tract surgeries
• Patients with an existing high risk of urinary blockages
• Management of bladder irrigation in certain medical conditions

Preparation

• Patients may be advised to fast for a few hours prior to the procedure.
• Necessary adjustments to medications, particularly anticoagulants, might be required.
• Pre-procedure urinalysis or imaging studies may be conducted to assess the bladder and urinary tract.

Procedure Description

1. Preparation: The patient is positioned comfortably, usually lying flat. The genital area is cleaned with an antiseptic solution to maintain sterility.
2. Insertion: A sterile lubricated three-way Foley catheter is gently inserted through the urethra into the bladder.
3. Balloon Inflation: Once inside the bladder, a small balloon at the catheter's tip is inflated with sterile water to hold the catheter in place.
4. Irrigation Setup: The third lumen of the catheter is connected to an irrigation solution to continuously flush the bladder.
5. Monitoring: The patient is observed for any signs of discomfort, leakage, or blockages.

Tools used include a sterile Foley catheter, irrigation solution, and a collection bag. Local anesthesia or mild sedation may be provided to minimize discomfort.

Duration

The entire procedure usually takes about 15 to 30 minutes to complete.

Setting

The procedure is typically performed in a hospital setting or outpatient clinic.

Personnel

A trained nurse or a urologist usually performs the insertion of the catheter. Support personnel may include nursing assistants and potentially an anesthesiologist if sedation is used.

Risks and Complications

• Infection at the insertion site
• Difficulty in inserting the catheter
• Bladder or urethral injury
• Persistent leakage around the catheter
• Rarely, allergic reactions to materials

Benefits

• Continuous bladder irrigation reduces the risk of clots and blockages.
• Helps in maintaining urinary tract health following surgery.
• Enhances patient comfort by preventing urinary retention.

Recovery

• Patients will receive instructions on proper catheter care at home.
• Regular monitoring and follow-up appointments are essential to prevent complications.
• Expected recovery time varies, with normal activities usually resuming shortly, but avoiding strenuous activities until cleared by the physician.

Alternatives

• Intermittent self-catheterization might be an alternative for less severe conditions.
• Medications to manage symptoms without catheter use.

• Lifestyle and dietary changes to reduce risks of urinary complications.

  Comparison:

• Alternatives may be less invasive but might not be as effective for severe conditions requiring continuous irrigation.

Patient Experience

Patients may initially experience mild discomfort during the insertion process. Post-procedure, minor pain and sensations of fullness or urgency in the bladder are typical. Pain management can include over-the-counter pain relievers and prescribed medications if needed. Most patients acclimate quickly to having the catheter in place, and continuous medical support helps mitigate any discomfort.