Bladder catheter for relief and delay: what are they for and risks

Bladder catheterization is a technique that consists of introducing a catheter, also known as a bladder catheter, through the urethra to the bladder in order to allow urine to escape in people who are unable to control this act, due to obstructions such as hypertrophy of the prostate, urethral dilation or even in cases where it is intended to perform tests on sterile urine or prepare the person for surgery, for example.

This technique should only be performed if necessary and ideally it should be done by a health professional, as the risk of developing infections, injuries and bleeding is very high. However, there are also some cases in which the introduction of the probe can be indicated to do at home, but in these cases the correct technique needs to be taught by a nurse.

What is it for

Due to the risks of the technique, catheterization should only be used if necessary, in the following cases:

Relief of acute or chronic urinary retention; Control of urine production by the kidney; Post-renal renal failure, due to infra-bladder obstruction; Loss of blood through urine; Collection of sterile urine for exams; Measurement of residual volume; Control of urinary incontinence; Ureteral dilation; Assessment of the dynamics of the lower urinary tract; Emptying of the bladder before, during and after surgery and examinations;

In addition, bladder catheterization can also be used to administer medication directly to the bladder, in cases of serious infections, for example.

What material is needed

Generally, the material used to perform this technique consists of a sterile bladder catheterization package with:

Pean forceps; Gauze packet; Small round tub; Slotted fenestrated field; Bladder catheter; Collection bag; Liquid aseptic solution, such as povidone-iodine; 20 mL syringe; Anesthetic gel, such as lidocaine; Distilled water ampoule; Gloves.

The bladder probe should be as small as possible capable of providing adequate urine drainage in order to minimize damage to the urethra. The collection bag must be long enough to allow mobility and not cause tension in the catheter and consequent urethral injury.

What is the procedure

This procedure must always be performed by a health professional and before performing it, the person must be explained how the technique will be performed, which usually consists of the following:

Gather all the necessary material; Put on gloves and wash the person's intimate region; Wash hands; Sterile open the catheterization package with the person; Open the indicated probe package and place it next to the tub, without contaminating; Place the lubricant over one of the gauzes in the package; ask the person to lie on their backs, in the gynecological position for the female and legs together, for the male; put on the sterile gloves of the catheterization package; lubricate the tip of the probe; for females, perform antisepsis with the forceps fitted, separating the small lips with the thumb and forefinger, pass a wet gauze of antiseptic between the large and small lips and over the urinary meatus; male, perform antisepsis on the glans with the forceps assembled with gauze moistened with the antiseptic, removing with the thumb and forefinger of the left hand the foreskin covering the glans and the urinary meatus; take the probe with the hand that does not en brought in contact with the intimate region and introduce into the urethra, and leave the other end inside the vat, checking the urine outlet; inflate the probe balloon with 10 to 20 mL of distilled water.

At the end of the procedure, the catheter should be fixed, which in men is placed in the supra pubic region and in women it is applied to the inner thigh.

Types of bladder catheterization

There are two types of bladder catheterization:

1. Bladder catheterization

Bladder indwelling catheterization is used when the catheter remains for longer for continuous drainage and a Foley or Owen catheter is used for this.

In this technique, the catheter remains for continuous drainage, allowing gradual bladder decompression and is indicated to promote emptying of the bladder, monitor urine output, perform surgical preparation, perform bladder irrigation or to reduce urine contact with injuries skin close to the genital region.

2. Relief or intermittent bladder catheterization

In vesical relief catheterization, the catheter does not remain in the person for a long time and the most used is the Nelaton probe.

This technique is generally used to drain the urine present in the bladder before medical procedures or for immediate relief in people with paralysis and urinary retention, for example. It can also be used in people with neurogenic bladder, to obtain a sterile urine sample or to examine residual urine after spontaneous emptying of the bladder.

What are the risks

Bladder catheterization should only be performed if it is really necessary, because it presents risks such as urinary tract infection, which is more frequent in females, the elderly and people with renal failure, which can occur due to inadequate preparation of the peri-urethral area before insertion of the catheter, inadequate technique in the installation of the catheter, trauma to the urethra by pressure of the catheter, contamination in the connection region of the catheter tube or contamination of the collection bags with reflux into the bladder.

Other risks of the technique are hemorrhage, which can be caused by the use of a probe of a caliber inappropriate for the size of the urethra, incorrect passage of the catheter or existence of previous diseases, formation of bladder stones due to a long stay of the probe and injuries to the device urinary, due to the application of excessive force during the passage or use of a catheter of caliber greater than the recommended.

Learn how to care for the bladder tube in order to minimize the risk of infection.