What different types of urinary catheters do you know?

• Latex catheters

• Silicone catheters (more suitable for long-term use)

• Three-way catheters used for irrigation of the bladder

• In/out catheters (single lumen) used for intermittent self-catheterisation (ISC)

• Beaked Coude catheter

How would you insert a male urethral catheter?

Position After explaining the procedure and obtaining consent the patient is placed supine and the genitals are cleaned using antiseptic solution. The foreskin must be retracted to clean the glans. Sterile drapes are used to cover the groin.

Procedure Local anaesthetic gel is inserted into the urethra through its meatal opening. The urethra should be held closed with firm pressure to allow the anaesthetic to take effect. The catheter is then inserted into the urethra and through the prostate and advanced as far as possible to ensure the bladder is reached. Once in the bladder urine will start to drain. A suitable catheter bag is connected to the catheter. The balloon is then inflated using an appropriate volume (10 ml if using an ordinary Foley catheter) of water.

Closure The patient is cleaned and the bag secured. A urinary sample is sent for microscopy and the residual volume of urine is noted and documented. Remember to pull back the foreskin to avoid the development of a paraphimosis.

How do you insert a suprapubic catheter?

Position After explaining the procedure and obtaining consent the patient is placed supine. It is important to examine the abdomen to ensure distension of the bladder. The lower abdomen is cleaned with an antiseptic solution and the area draped.