A Foley catheter is a thin tube inserted into the bladder to drain urine from the body. The tube allows urine to drain from the bladder into a collecting bag. It is inserted through the urethra in the penis or the urethra opening in the vagina. They are commonly used after prostate, bladder and certain gynecological surgeries to allow urine drainage. They are also used for patients with difficulty urinating or retaining urine.
Types
There are different types based on material, design and intended use:
- Intermittent Catheters: For short term use - These are inserted when needed and then removed. They help empty the bladder fully without staying in place.
- Indwelling Catheters: For long term use - These remain in place for longer periods, often permanently for some patients. They have a balloon at the tip that is inflated with sterile water once inserted to keep it in place.
- Coated Catheters: The inner surface is coated with antibiotics or hydrogel layers to reduce risk of infections.
- Pediatric Catheters: Specifically designed for infant, child and teenage patients. Foley Catheters come in narrow bore sizes.
- Straight Tip Catheters: For male patients - The tip is straight for easier insertion through penis.
- Coude Tip Catheters: For female patients - The tip has a gentle curve for easier insertion through urethra.
Foley Catheter Insertion Procedure
Here are the basic steps for catheter insertion:
- Ensure patients privacy and explain procedure to them clearly before starting.
- Wash hands thoroughly and put on sterile gloves.
- Clean genital area and inner thighs of patient with antiseptic solution.
- For males, retract foreskin if present and clean glans penis. For females, spread labia gently to locate urethra opening.
- Lubricate tip of catheter tapered end with water soluble gel.
- Insert tip gently inside urethra while holding penis or Labia gently. Advance at an angle parallel to body midline.
- Once in bladder, inflate balloon as per instructions with sterile water using syringe provided.
- Gently withdraw catheter until slight resistance felt from inflated balloon and secure to leg properly using straps.
- Connect catheter to drainage bag and observe for any difficulty, bleeding or pain. Document procedure and time of insertion.
Post Insertion Care of Foley Catheter
Foley Catheters are some important tips for post insertion care:
- Keep collecting bag below bladder level to ensure proper drainage.
- Apply mild antiseptic solution daily around urethral opening and peri-genital skin.
- Drink adequate fluids to keep urine dilute unless restricted.
- Observe catheter balloon integrity, do not over inflate.
- Report any leakage, discomfort, blockage or hematuria (blood in urine) immediately.
- Replace every 2-4 weeks or earlier if signs of infection or blockage occur to prevent long term complications.
- Clean collection bag tubing connections regularly with antimicrobial solution.
- Keep bag off floor and empty bag completely when full to avoid back pressure on bladder.
Potential Complications of Indwelling Catheters
Long term indwelling catheters can potentially lead to certain risks if proper insertion techniques and care is not followed. Some common complications include:
Urinary Tract Infections (UTI): Developing biofilms on catheter surface increases risk of UTI significantly that can spread to kidneys. Stringent aseptic techniques and periodic replacement is key to prevention.
Bladder Spasms: Irritation from catheter can cause painful bladder muscle spasms requiring medication management.
Blockages: Debris, crystal formation or blood clots may obstruct catheter lumen below balloon. Regular flushing helps dissolve clots.
Urethral Trauma: Friction within urethra can damage tissue leading to pain, bleeding or false passages on long term use. Softer, lubricated catheters reduces this risk.
Catheter Tip Malposition: Rarely tip gets placed wrongly into bladder neck instead of bladder requiring correction to drain urine effectively.
Alternatives to Indwelling Catheters
For long term needs, intermittent catheterization every 4-6 hours provides an alternative to reduce infection risk compared to indwelling catheterization. Suprapubic catheters directly into lower abdomen also gets bypass urethra trauma risks but insertion is more invasive. Condom catheters for males helps drain urine from penis without inserting tube inside. Newer advanced catheters with antibiotic or hydrogel coatings or modified surfaces also help reduce risks with indwelling use.
Foley catheters provide effective temporary drainage of urine from bladder for surgical patients or those with voiding difficulties. Proper techniques, care and timely replacement as per clinical needs minimize potential complications with their use. Alternatives help those requiring longer term non-invasive solutions.
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