April 23, 2024

Urinary Catheters

A urinary catheter is a hollow flexible tube placed through the urethra into the bladder to drain or collect urine. Catheters allow urine to exit the body when a person cannot urinate on their own or to more accurately measure urine output in a clinical setting. Catheters come in different types to suit different needs. They are widely used in hospitals and nursing homes to manage urinary conditions.

Types of Urinary Catheters
There are different types of urinary catheters depending on intended use and duration. Some common types include:

Indwelling or Foley Catheter
An indwelling catheter is also known as a Foley catheter. It has a balloon at the tip that is inflated with sterile water once inserted into the bladder to keep it from falling out. These catheters remain in place for longer durations ranging from a few days to months. They are commonly used after urologic surgeries or for patients with urinary retention.

Intermittent Catheters
Intermittent catheters are also called straight catheters. They do not have a balloon tip and need to be inserted and removed for each drainage of urine. They are commonly used by patients with spinal cord injuries to empty their bladder several times a day.

External Catheters
External catheters, also called condom catheters, fit over the penis like condoms. They collect urine in an attached bag without entering the body through the urethra. They are less invasive and preferred by male patients for short term use.

Pediatric Catheters
Pediatric catheters are smaller in size and designed for use in babies and young children. They come in various diameters to suit different age groups.

Materials Used for Catheters
Modern catheters are made of different materials which affect biocompatibility and risk for infection:

Latex Catheters
Traditional urinary catheters were made of latex which is a form of natural rubber highly prone to encrustations and biofilm formation leading to greater infection risk. Latex can also cause allergic reactions in some people.

Silicone Catheters
Silicone catheters are more biocompatible than latex with lower friction and encrustation formation. However, they are also more expensive.

Hydrogel-coated Catheters
Some catheters have additional layers of hydrogel polymers which reduce urethral irritation and encrustations. They have lower infection rates than non-coated catheters.

Foley Catheter Procedure
A Foley catheter insertion is usually a quick bedside procedure done by doctors or nurses. The main steps involved are:

1. Prepare the insertion area by cleaning the urethral opening with an antiseptic solution.

2. Lubricate the tip of the catheter for ease of insertion.

3. Gently insert the catheter into the urethra while holding the penis or labia apart.

4. Inflate the balloon with sterile water once inside the bladder to hold it in place.

5. Connect the catheter to a drainage bag below the level of the bladder.

6. Secure the catheter to the patient’s thigh to prevent movement.

Potential Complications of Catheters
While catheters provide an essential clinical service, they also increase risk for certain complications if left in for prolonged periods:

Urinary Tract Infections (UTI)
Biofilm formation inside catheters predisposes to bacterial colonization leading to UTIs. This is the most common catheter associated complication.

Blockages and Encrustations
Mineral buildup called encrustations can block catheters over time inhibiting proper drainage. This often requires catheter replacement.

Urethral Trauma
Friction from catheters irritates the urethra causing lesions, urethritis or strictures especially with longer indwelling catheters.

Risk for Bacteremia
Bacteria from catheter-associated UTIs can sometimes escape into the bloodstream causing severe infections like sepsis.

Catheter Care and Management
Following appropriate protocols for catheter insertion, maintenance and prompt removal reduces associated risks:

– Sterile closed drainage systems limit external bacterial contamination.

– Regular hand hygiene and disinfection of connection ports prevents infection transmission.

– Keeping the catheter and bag below the bladder gravitational flow prevents reflux and blockages.

– Checking for balloons leaks, kinks and draining problems ensure proper functioning.

– Removing catheters as soon as they are no longer clinically essential reduces overuse risks.

Urinary catheters provide essential clinical benefits but also increase infection and tissue damage risks, especially when left in place for extended periods. Strict adherence to aseptic protocols during insertion, maintenance and prompt catheter removal help minimize associated adverse effects. Following guidelines-based practices ensure safe and appropriate usage.

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it