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Male Urinary Catheterization

A male patient will lie on his back, with his legs bent at the knees and flopping slightly to the side as the nurse or doctor insert his foley catheter. His meatus (urethral opening) and surrounding area will be cleaned with Betadine before the foley catheter insertion by the nurse or doctor. The meatus is at the tip of the penis. The nurse will hold and lift the penis to a position perpendicular to patient's body and apply light upward traction to insert the catheter.

This is a very invasive procedure and embarrassing for many male patients. Keep in mind that urinary catheterizations are often unnecessary. Do not allow a catheter to be inserted unless it is absolutely necessary. There is usually no need to have an urinary catheter inserted for most surgeries that do not last longer than 3 hours. Prostatectomy is one surgery that requires an urinary catheter because the prostate is located so close to the bladder. A prostatectomy patient usually must have a foley catheter in place for a week after surgery while he heals. The prostatectomy patient's catheter is inserted by an urologist with specific regard to the prostatectomy.

Concerns About Your Modesty

If you are required to have an urinary catheter inserted and you are concerned about your modesty, you should take the following steps:

1.) Request that a male nurse or doctor insert your catheter and that no female medical personnel be present.

2.) Request that your catheter be inserted before they give you IV or medicine so you can make sure that your wishes are honored. Once you are under anesthesia, your wishes could easily be ignored unless you have an advocate such as your wife who is not employed by the medical facility present with you in the operating room.

3.) It would be prudent to have someone (if possible) present for your foley catheter insertion to make sure that they do not give you any drugs especially Versed against your wishes to make you become unable to speak up or bring in female medical personnel against your wishes.

4.) It would be prudent for you to discuss your wishes about having a male staff member doing your foley catheter insertion with your doctor and the nursing department in advance. Talk to everyone you come in contact about your wishes. Make sure you have your wishes in writing.

5.) Insist on wearing a cotton underwear or boxer shorts with the foley catheter if you are having surgery that does not involve the genitals such as brain surgery.

How to Prevent Infection & Pain

6.) While being catheterized, a topical analgesic should be applied to the catheter and urethral opening to minimize the pain of being catheterized. Insist on this to be done.

7.) While they are catheterizing you, ensure that sterile equipment and sterile techniques are used. Usually, this comes in a catheterization kit, which comes in either male or female. This has a set of sterile gloves, a tube of sterile lubricant, a sterile catheter, and other sterile equipment. This is usually done, but sometimes corners are cut. If the nurse is using regular gloves out of the box, lubricant out of a general-use tube uses a catheter which is not in a sealed package, object and refuse. Using unsterile techniques greatly increases the chances for a UTI, bladder, or kidney infection - which may become very serious.

8.) After the catheter is inserted, the tubing must be secured to the thigh and upper leg. This is usually done with 3 or 4 pieces of tape, possibly using a velcro strap for one of the pieces of tape. Failing to have the catheter secured may cause it to be pulled out, also known as "traumatic removal".

9.) The catheter bag must always be lower than the bladder. To have it higher than the bladder allows urine to flow back into the bladder from the tubing. This can cause an infection.

10.) When in bed, be sure that the bag is hanging from the bed frame, not from a bed rail that raises and lowers. This can be another reason that the catheter can be pulled out, or "traumatic removal". Traumatic removal of an indwelling catheter with the "balloon" inflated can cause injury, tearing, infections, and long-term or permanent incontinence. Of note, by agreeing to the catheter, this is considered a "risk" of catheterization, a risk which your signature almost always has you assume. You (or your insurance) may have to pay for further treatments or surgery, you will have to pay for incontinence supplies for years to come, and you will have to endure the burden of both inconvenience and embarrassment that goes along with it.

11.) If you notice anyone or anything pulling on the catheter so as to cause you discomfort, yell, scream, and get them to stop so as to prevent it being pulled out or "traumatic removal".

12.) Ensure that the catheter is cleaned at least twice a day, using soap and water, and a clean cloth which has not been used to clean anything else - including other parts of your body.

13.) Ask your doctor every day whether the catheter is still required. Each day of catheterization increases your risk of UTI, bladder, or kidney infection by approximately 25%.

Make sure you check out our article about unnecessary urinary catheterizations and missing informed patient consent and do research to determine if a urinary catheter is really necessary in your case.

Other Related Articles:

Unnecessary Urinary Catheterizations and Missing Informed Patient Consent

Why Consent For Urinary Catheters Should Be Mandatory By John H. Fisher

Sources:

How Is A Urinary Catheter Inserted? | LIVESTRONG.COM

How to Insert a Foley Catheter | EHow

Post-Operative Care | Robotic Prostatectomy | Thomas Ahlering, M.D.

 

 
     
   
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