Catheterization

Why catheterization?

Catheterization may be necessary for the following reasons:

• Emptying the bladder in case of urinary retention
• Irrigation of the bladder
• Introduction of medication (e.g. local chemotherapy)
• Bladder function test (urodynamics)
• Urine drainage after operations
• Urine drainage for pronounced inflammation of the urinary organs

What types of catheters are there?

There are different types of catheters: Disposable catheters, indwelling catheters and measuring catheters.

• Disposable catheters are thin plastic tubes that are inserted into the bladder and removed immediately after the required procedure.
• Indwelling catheters have an inflatable balloon at their tip that prevents the catheter from falling out. Indwelling catheters remain in the bladder for a longer period of time to drain urine, e.g. after surgery or in the event of urinary retention.
• Measuring catheters have several fine channels inside them to measure bladder and urethral pressure. This can provide important diagnostic information in the case of a bladder disorder. After the examination, the measuring catheter is removed again.

How is catheterization performed in women?

During catheterization, the patient is in gynecological position. After spreading the labia, the outer urethral orifice is cleaned with a disinfectant that does not cause a burning sensation on the mucous membranes. The instillation is then prepared with a local anesthetic, sterile and disinfectant lubricating gel, such as Instillagel®.

First, a drop of Instillagel® is applied to the urethral orifice so that the blunt and completely rounded cone of the syringe can be inserted easily. Instillagel® is then slowly injected into the urethra. Injecting Instillagel® unfolds and widens the urethra, making the catheter much easier to insert than simply coating the catheter with lubricant. It is important to wait 5 – 10 minutes after instillation of Instillagel® to allow the anesthetic effect to take full effect. Once this has happened, the doctor uses sterile gloves and forceps to insert the catheter into the bladder. When urine flows out, this indicates that the catheter tip is in the bladder. The patient can assist the catheterization by lying still and relaxed (pelvic floor relaxation). This can provide important diagnostic information in the case of a bladder disorder. After the examination, the measuring catheter is removed again.

How is catheterization performed in men?

During catheterization, the patient is in the supine position. After retracting the foreskin, the external urethral orifice is cleaned with a disinfectant that does not cause a burning sensation on mucous membranes. The instillation is then prepared with a local anesthetic, sterile and disinfectant lubricant, such as Instillagel®.

First, a drop of Instillagel® is applied to the urethral orifice so that the blunt and completely rounded cone of the syringe can be inserted easily. Instillagel® is then slowly injected into the urethra. Some patients experience a brief stinging or burning sensation, which disappears immediately.

Injecting Instillagel® unfolds and widens the urethra, making the catheter much easier to insert than simply coating the catheter with lubricant. It is important to wait 5 - 10 minutes after instillation of Instillagel® to allow the anesthetic effect to take full effect. During this time, the Instillagel® can be prevented from leaking by attaching a FARCO penile clamp. Once the anesthetic has taken effect, the doctor uses sterile gloves and forceps to insert the catheter into the bladder. When urine flows out, this indicates that the catheter tip is in the bladder. The patient can assist the catheterization by lying still and relaxed and breathing deeply as the catheter is advanced.

Is catheterization painful?

Catheterization is not usually painful. When the catheter is advanced carefully, a brief and somewhat uncomfortable sensation is felt at most, such as a short stinging or burning sensation in the urethra. If this feeling persists after some time, please consult your doctor.

Are complications possible?

Catheterization is sterile (= germ-free), so infections are very rare. A slight burning sensation and initially more frequent urination are possible after catheterization and disappear on their own in a short time. There may also be small traces of blood in the urine or underwear after catheterization, which is not a cause for concern. The risk of injury to the urethra during catheterization is extremely low and can be reduced by proceeding carefully and using a suitable lubricant such as Instillagel®.