Catheterisation

Catheterisation is the insertion of a catheter into the urinary bladder to drain urine or to deliver medications or other therapies. It can be performed via the urethra or, less commonly, directly into the bladder through the lower abdomen (suprapubic catheter). Catheters are used for short-term drainage during and after surgery, to manage urinary retention, to measure urine output in acutely ill patients, and for certain neurogenic or bladder conditions.

Indications include acute or chronic urinary retention, urinary incontinence with overflow or retention, bladder outlet obstruction, during surgical procedures, and in patients unable to void adequately. Common types of catheters are indwelling urethral catheters (such as Foley catheters) retained by an inflated balloon, intermittent self-catheterization, suprapubic catheters, and external condom catheters for some cases of male incontinence.

The procedure is performed under aseptic technique with sterile equipment. A lubricated catheter is gently inserted into the bladder through the urethra; for some patients the catheter is connected to a closed drainage system and urine is collected in a bag kept below the level of the bladder. For intermittent catheterization, the catheter is inserted as needed and removed after drainage.

Care involves maintaining a closed drainage system, keeping the collection bag below the bladder, preventing kinks in the tubing, and providing daily perineal hygiene. Catheters require periodic changes and assessment by healthcare professionals, with duration and frequency depending on catheter type and patient factors.

Risks include catheter-associated urinary tract infection, urethral trauma, obstruction, encrustation, bladder spasms, and, in long-term use, urethral strictures or fistula formation. Prophylactic antibiotics are not routinely recommended. Alternatives include external catheters or non-catheter bladder management when appropriate.