Urinary Catheterization

Urinary catheterization is a relatively common procedure performed in hospitalized patients. It includes introduction an elastic tube into the urethra and through the urethra into the bladder. Even such simple intervention can be very important and in some cases it can even save the kidneys.


Why is the catheterization performed? We usually catheterize patients with disruption of urine outflow. There are numerous possible causes - unconsciousness, spinal cord injury with spinal shock, benign prostate enlargement, prostate cancer, urinary tract infections, some cancers of the urinary bladder, overall deterioration of the patient's condition, etc.


Whatever is the cause of the urine accumulation, its flow must be restored as quickly as possible. Accumulating urine may be dangerous as it can cause urinary infections, the bladder may burst due to overpressure and even kidneys may be threatened when the urine begins to accumulate not only in the bladder, but also in ureters and renal pelvises – this condition is known as hydronephrosis. Unsolved hydronephrosis causes compression of the kidney tissue by the urine and this may lead to acute renal failure. All these complications can be avoided by early catheterization.


The second reason for the introduction of a urinary catheter may be urinary incontinence. Severely incontinent patient can have diapers, which is not exactly sanitary, or a urinary catheter.


The procedure should be strictly sterile. The outlet of the urethra is disinfected; the person performing catheterization puts on sterile gloves and takes the catheter with a sterile tweezers. The catheter is usually covered with numbing gel and then it is introduced into the urethra. This part is sometimes uncomfortable for the patient, but most people do not complain. When the catheter reaches the bladder, urine will usually flow out. The end of the catheter is equipped with a deflated balloon, which can be filled with fluid from an outside port. The filled balloon prevents the catheter from leaving the bladder. The bladder outlet is connected to a tube with a bag for collecting urine.


Urinary catheterisation
Schema - established catheter into the bladder at men



The main disadvantage is presence of foreign material in the body and direct connection of the urinary bladder with the external environment. In addition, the urinary sphincter is bypassed by the catheter and does not work. All these factor increase risk of urinary tract infections. Therefore, it is necessary to periodically change the catheter (usually at least once per month). The catheter may cause temporary decrease or loss of the sphincter function and after the removal of the catheter, the person may suffer from urinary incontinence. mVery unpleasant complication may occur in old patients who suffer from dementia and confusion. Patients with dementia may pull the catheter out, which is accompanied with local injury of urethra and bleeding (blood in urine).


The catheter is a great way how to ensure free outflow of urine from the bladder. This prevents urine accumulation and its consequences. In addition, the collected urine can be sent for microbiological examination.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources