What Are the Most Common Complications of Catheterization?

A urinary catheter is a tube that is inserted into the bladder from the urethra to drain urine. It is a tube made of natural rubber, silicone rubber or polyvinyl chloride (PVC). It can be inserted into the bladder through the urethra to drain urine. After the catheter is inserted into the bladder, a balloon is fixed near the end of the catheter to fix the catheter. The tube remains in the bladder, and it is not easy to come out, and the drainage tube is connected to a urine bag to collect urine.

Chinese name: Urinary catheter
Foreign name: Catheter

Management category: Class II
Category Name: Catheters, drainage tubes

Catheter model

According to the perimeter of the outer diameter, it is usually divided into 13 specifications and models, from 6F to 30F. There are four types of catheters commonly used by adults: 12F, 14F, 16F, and 18F. (F is the abbreviation of French, which means the number of millimeters of the outer circumference. Conversion formula: F = 2r, rough conversion: F (mm) = 3 times the outer diameter (mm)).

Catheterization indication

1. Patients with urinary retention or bladder outlet obstruction.

2. Urinary incontinence.

3. Precise monitoring of urine output.

4. The patient is unable or unwilling to collect urine.

5. Patients who require prolonged bed rest or forced posture.

6. Perioperative use during surgery.

Catheter preparation materials

1. Polyvinyl chloride (PVC): The product is harder, more irritating, has a strong foreign body sensation, is cheap, and is mostly an airbag-free product.

2. Dry glue (raw rubber): The product is soft and irritating. It can easily cause inflammation of the urethral mucosa for a long time. The price is low, and most of them are airbag-free products.

3. Silicone rubber: The product is soft, has good biocompatibility, and the patient has no foreign body sensation. However, the surface of the molding process is difficult to keep smooth and clean, and the cost is high. Most of them are airbag-free products.

4. Natural rubber latex: The product is soft, good biocompatibility, comfortable to the patient, high surface finish, little irritation, reasonable price, mostly for airbag products, and convenient for indwelling operation.

Catheter classification

According to the structure, it can be divided into the following types:

1. Single-lumen urethral catheter: usually without a balloon, only one channel, difficult to fix, and short indwelling time.

1) Single-chamber children-type urinary catheter: commonly used models F6-F10, mainly used for urinary catheterization.

2) Single-cavity standard urinary catheter: commonly used models F12-F26, mainly for temporary catheterization.

3) Single-lumen plum-head urethral catheter: commonly used models F12-F28, mainly used to drain urine after bladder or kidney fistula. As shown in Figure 1.

Figure 1 Single-lumen plum-head catheter

4) Single-cavity elbow-type urethral catheter: commonly used models F12-F26, the head is pointed, mainly used for male prostatic hypertrophy. as shown in picture 2.

Figure 2 Single-lumen elbow catheter

2. Double-lumen urethral catheter: There are two lumens, one is a water injection hole and the other is a liquid outlet. Can be fixed, mainly used for indwelling urethral catheterization. As shown in Figure 3.

1) Dual-cavity single-capsule children-type urinary catheter: commonly used models F6 to F10, the volume of the balloon is usually 5ml, mainly used for indwelling catheterization in children.

2) Double-cavity single-capsule standard urinary catheter: commonly used models F12-F28, the airbag capacity is usually two kinds of 10ml and 30ml, mainly used for normal indwelling catheter without other restrictions.

3) Double-cavity single-capsule women-type urinary catheter: commonly used models F12-F24, the airbag capacity is usually 30ml, used for female indwelling catheterization.

4) Double-cavity single-capsule elbow-type urethral catheter: commonly used models F12-F20, the airbag capacity is usually 30ml, used for female indwelling catheterization.

Figure 3 Double-lumen urethral catheter

3. Three-cavity urethral catheter: There are three chambers-water injection chamber, medicine injection chamber, and drainage chamber. As shown in Figure 4. It is mainly used for short-term indwelling catheterization, drip infusion of bladder medicine, irrigation, drainage, etc. The clinical specifications are divided into six specifications: F14, F16, F18, F20, F22, F24.

Figure 4 Three-lumen catheter

Urethral Catheter Care Steps

1. Wash and remove germs from your hands to prevent infection.

2. Prepare the following utensils: a pack of cotton swabs, a roll of breathable paper tape, a plastic bag, a bedpan, physiological saline or boiled water, and an excellent iodine disinfection solution (if necessary).

3. Place the potty on the patient's hip.

4. Separate the labia or retract the foreskin by hand.

5. Wet a saline solution or boiled water with a cotton swab and clean the catheter about one inch (2.5 cm) near the end of the catheter. Use a cotton swab at a time and throw the dirty cotton swab into the prepared plastic bag .

6. Check for any scabs or abnormal drainage or secretions. If so, please inform the medical staff.

7. Fix the urinary catheter with breathable adhesive tape on the inside of the thigh (female patient) or lower abdomen (male patient) with a chevron patch method. The adhesive site must be changed every day to prevent long-term adhesion or catheter compression and skin damage.

Catheter Cautions

1. Strictly perform aseptic operation: insert the vagina by mistake or replace it immediately.

2. Control the rate and volume of urination in patients with urinary retention: Do not fast, put 600-800ml pinch tube.

3. Observe and record urine color, quantity and properties

1) Normal: 1500-2000ml / 24h; polyuria:> 2500ml / 24h; oliguria: <400ml / 24h; none: <50ml / 24h.

2) Color: normal: colorless and transparent or light yellow; abnormal: hematuria, hemoglobinuria, bilirubinuria, chyluria.

3) Properly fix the urinary tube to keep it open. When it is blocked, check and adjust the position of the urinary tube in time. Rinse it again and again if necessary.

4) It is not necessary to wash the bladder every day to prevent urinary system infection. It is necessary to scrub the urethral orifice twice. After the condition is stable, the tube is removed as soon as possible and strict aseptic operation is performed. The urine bag is replaced daily. Encourage patients to drink more water during the stay.

5) Prevent urethral bleeding and urination: insert the upper urinary tube to see the urine and then inflate or infuse the water with 4-5cm, then gently pull the urinary catheter outwards, it can effectively prevent urethral bleeding or exudate.

Catheterization Extended Reading

[1] Ding Yaying. Advances in prevention and nursing of urinary tract infection associated with urinary catheters [J]. Integrated Traditional Chinese and Western Medicine Nursing (Chinese and English), 2018, 4 (02): 182-184.

[2] Tang Wenxi, Huang Jiapeng, Li Jianjun. Systematic measures to reduce catheter-related infections [J]. Anesthesia Safety and Quality Control, 2018, 2 (01): 41-44.

[3] Cheng Yaqin, Long Haimei. Clinical Nursing Intervention for Complications of Patients with Indwelling Catheter [J]. Electronic Journal of Practical Clinical Nursing, 2018, 3 (19): 69-70.