In urinary catheterization, a plastic tube known as a urinary catheter (such as a Foley catheter) is inserted into a patient's bladder via their urethra. A balloon located at the end of the catheter is usually inflated with sterile water to prevent the catheter from slipping out once it has reached the bladder. In this manner, the patient's urine is collected and contained for various medical purposes. It can also be used to inject liquid. The procedure of catheterization will usually be done by a clinician, often a nurse, although self-catheterization is possible as well.
Catheters come in a large variety of sizes; materials (latex, silicone, PVC, or Teflon); and types (Foley catheter, straight catheter, or coude tip catheter). In the case of internal catheters, those inserted into the urethra, the smallest size is usually recommended, although a larger size is sometimes needed to control leakage of urine around the catheter. A large size can also become necessary when the urine is thick, bloody or contains large amounts of sediment. Larger internal catheters, however, are more likely to cause damage to the urethra. Some people have developed allergies or sensitivities to latex after long-term latex catheter use. In such cases, silicone or Teflon types should be used. Silver alloy coated urinary catheters may reduce infections.
Proper catheter use can also often be determined by the length of time for which the process is necessary: long-term (often called indwelling) or short-term use:
During long-term use, the catheter may be left in place during the entire time, or a patient may be instructed on a procedure for placing a catheter just long enough to empty the bladder and then removing it (known as intermittent self-catheterization). Patients undergoing major surgery are often catheterized and may remain so for some time.
Long-term catheterization can expose patients to an increased risk of infection. Long-term catheterization as a remedy for incontinence is not appropriate, as the risks outweigh the benefits.
For many patients the insertion and removal of a catheter can cause excruciating pain, so a topical anesthetic should be used for patients of both sexes. Catheterization should be performed as a sterile medical procedure and should only be done by trained, qualified personnel, using equipment designed for this purpose. If correct technique is not used then trauma may be caused to the urethra or prostate (male), urinary tract infection may be caused or a paraphimosis may occur (male uncircumcised patient). Because of this it is important that any practitioner undertaking this procedure first is both trained and adequately supervised until they are able to demonstrate an approved level of competence.
Complications of catheter use may include: urinary tract or kidney infections, blood infections (sepsis), urethral injury, skin breakdown, bladder stones, and blood in the urine (hematuria). After many years of catheter use, bladder cancer may also develop.
Recent developments in the field of the temporary prostatic stent have been viewed as a possible alternative to indwelling catheterization and the infections associated with their use.
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