Bladder catheterization is a medical procedure that involves the insertion of a catheter into the cavity of the bladder. This manipulation is carried out with a diagnostic and therapeutic purpose.
Indications for catheterization:
- excretion of urine with acute urinary retention;
- flushing or instillation of the bladder ;
- treatment of diseases of the bladder by introducing drugs into its cavity;
- urine sampling for examination if it is impossible to obtain it in the usual way.
Bladder catheterization can be performed with a soft or hard catheter. A soft catheter is an elastic rubber tube 25-30 cm long and 0.3 to 10 mm in diameter, which corresponds to sizes No. 1 from 1 to 30, corresponding to different widths of the urethra. On the one hand, the soft catheter has a blind rounded end with an oval hole on the side. At this end, a catheter is inserted into the urethral opening. On the other hand, the catheter has an oblique section and a funnel-shaped extension, so that it can be easily connected to a syringe if it is necessary to introduce drugs into the bladder.
A rigid metal catheter consists of a grip, a shaft and a beak. One end of the rigid catheter is rounded, blind, with two oval-shaped openings. The length of the catheter for men is 30 cm, for women - 15 cm. Catheterization of the bladder using a metal catheter is a complex medical procedure.
Most often, catheterization is performed with a soft catheter. Bladder catheterization with a soft catheter is a nursing procedure. Before use, the catheter is sterilized by boiling. The introduction of the catheter is carried out after preliminary preparation, which consists in processing the hands of a nurse and the toilet of the external genital organs and urethra of the patient. The rounded blind end of the soft catheter is lubricated with sterile vegetable oil and carefully inserted into the external opening of the urethra with careful movements and then into the bladder. After the introduction of the catheter, urine begins to flow from the external end, which indicates that the catheter is inserted correctly and is located in the bladder. When the urine stream decreases and begins to stand out slowly, you need to slightly press on the area of the projection of the bladder. When urine remains, the catheter is slowly removed from the urethra.
Catheterization of the bladder in men is more difficult than in women, since the urethra in them is long and forms two small physiological constrictions that interfere with the introduction of the catheter.
Catheterization can lead to the development of complications, which include:
- bleeding that develops when an injury to the mucous membrane of the urethra;
- infection of the urethra as a result of non-compliance with aseptic rules, which leads to the development of inflammatory diseases of the urinary system;
- urosepsis with the rapid absorption of infected urine into the bloodstream through the injured mucous membrane of the urethra.
To prevent the possible development of bacterial complications after catheterization of the bladder, mainly when it is repeated, the bladder cavity is washed with a solution of furatsilina or rivanol. Sometimes antibacterial drugs are prescribed for prophylactic purposes.
In some cases, there is a need for repeated catheterization or the introduction of a catheter that will be in the bladder for a long time.
If catheterization of the bladder is not possible as a result of trauma to the urethra or squeezing its adenoma of the prostate gland, suprapubic puncture of the bladder is carried out or an artificial cystostomy hole is formed to insert a cystostomy tube.