Urinary catheter insertion

The insertion of a urinary catheter is a common procedure and expertise comes with experience. As a rule, insertion in the female usually goes without problems or complications but where there are anatomical differences, such as post previous surgery, there may be difficulties. These issues can only be dealt with on a case by case basis and you may need gynaecological assistance in extreme cases.

Male insertion is not only more commonly required but can be a more difficult and higher risk procedure due, most commonly, to the large prostate.

The link available here provides information on male and female insertion and the following movie details insertion in the male.

Please, at all times, consider the dignity of the patient as this is an invasive and, for some, a very embarassing procedure. In our multicultural society please consider your approach and when you do not know what is acceptable, then ask professionally.

Tips when difficult:

Male

  • Use 2-3 tubes of lignocaine gel and close meatus for 5 minutes.

  • The second one you need to put in slowly to ensure it gets through to bladder.

  • Bigger is usually easier than smaller. Go up a size if difficulties encountered.

  • Pull penis down towards knees if encountering resistance, not upwards.

  • Often spasm stops insertion so get patient to wiggle toes and take big breaths in and out to distract them and enable relaxation.

  • Twist the IDC just when you encounter resistance and it may then go in.

  • Remember to replace the foreskin.

Female

  • Insert gloved index of non-dominant hand into vagina and push up. Straighten the urethra to assist view or use a speculum if meatus located on ant vaginal wall.

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