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Diagnostic:Diagnostic:
1.1. CystourethrographyCystourethrography
2.2. Urodynamic studyUrodynamic study
3.3. Measure Residual urineMeasure Residual urine Therapeutics:Therapeutics:
1.1. Relief of urine retention (BPH,…)Relief of urine retention (BPH,…)
2.2. Clot retentionClot retention
3.3. Postoperative Postoperative
Indications of catheterizations
Catheter sizes refer to the outside Catheter sizes refer to the outside circumferencecircumference
French (Fr) scale (circumference is in mm)French (Fr) scale (circumference is in mm)
1 Fr=0.33 mm in diameter. 1 Fr=0.33 mm in diameter.
French scale
Strait Strait cathetercatheter
Fixations of strait catheter by Fixations of strait catheter by plaster stripsplaster strips
Foley’s cathetersFoley’s catheters
Self retaining catheterSelf retaining catheter
Catheter (18-16F) is usually Catheter (18-16F) is usually satisfactory for adults. satisfactory for adults.
Inflating the balloon prematurely may Inflating the balloon prematurely may result in urethral ruptureresult in urethral rupture
Large-caliber catheters are used to Large-caliber catheters are used to evacuate blood clotsevacuate blood clots
Why Large balloons (30 mL)??Why Large balloons (30 mL)??
To decrease the balloon migrating into To decrease the balloon migrating into the prostatic fossa after TUR_P.the prostatic fossa after TUR_P.
Can be used as traction to control Can be used as traction to control hemorrhage from the prostatic fossahemorrhage from the prostatic fossa
The standard latex catheter can result in The standard latex catheter can result in severe reactions in patients with latex severe reactions in patients with latex allergiesallergies
Silicone varieties are good alternatives Silicone varieties are good alternatives even if it is to remain only for few days even if it is to remain only for few days
CatheterizationsCatheterizations
Catheter associated UTICatheter associated UTI
Incidence: Incidence: short term catheterization 10-20%short term catheterization 10-20% Long term catheterizations 100%Long term catheterizations 100%
Guideline to prevent catheter associated UTIGuideline to prevent catheter associated UTI Only when necessaryOnly when necessary Condom catheterCondom catheter Aseptic catheterization techniqueAseptic catheterization technique Using sterile lubricantUsing sterile lubricant
Condom catheterCondom catheter
Elastic adhesive band
The bag below the bladder levelThe bag below the bladder level
Should not touch the floorShould not touch the floor
In males, the catheter should be secured In males, the catheter should be secured above the thighabove the thigh
Guideline to prevent catheter associated UTI
The balloon may not deflateThe balloon may not deflate !!!!!!!!!!!!!!
1.1. Deflating by using Deflating by using torsiontorsion
2.2. Shortening the defective Shortening the defective lengthlength
3.3. Transluminal probing and Transluminal probing and perforationperforation
Probe
4.4. Percutaneous Percutaneous puncturepuncture
U/S guided puncture
5.5. Transrectal or transvaginal Transrectal or transvaginal puncturepuncture
Transvaginal Transrectal
6.6. Harpoon techniqueHarpoon technique
7.7. Rupture by Rupture by overdistentionoverdistention
8.8. Chemically induced ruptureChemically induced rupture
Obsolete !!!
Ureteric Ureteric stentsstents
Bilateral JJ stents, Stienstrass
Ureteric stentsUreteric stents
Facilitate internal drainage due to Facilitate internal drainage due to obstruction from internal or external ureteral obstruction from internal or external ureteral compressioncompression
To decrease sepsis or obstruction in the To decrease sepsis or obstruction in the presence of steinstrasse after ESWLpresence of steinstrasse after ESWL
Double-J catheters
1.1. performing retrograde pyelographyperforming retrograde pyelography
2.2. collecting urine for cytology or collecting urine for cytology or cultures cultures
3.3. performing brush biopsiesperforming brush biopsies
4.4. Draining an obstructed kidneyDraining an obstructed kidney
Ureteral catheterization
Suprapubic Suprapubic cathetercatheter
Suprapubic Catheter Suprapubic Catheter insertioninsertion
CystoscopeCystoscope
Flexible ureteroscopeFlexible ureteroscope
NephroscopeNephroscope
