Catheterisation (Guidelines)

• Acute urinary retention (AUR)
• Chronic urinary retention, only if symptomatic and/or with renal compromise
• Monitoring renal function hourly during critical illness.
• Monitoring /recording/draining residual urine volumes (wherever possible, a bladder scanner is the preferred option to measure residual urine volumes).
• During and post-surgery, for a variety of reasons.
• Allowing bladder irrigation / lavage.
• Allowing instillation of medications, for example, chemotherapy.
• Bypassing an obstruction / voiding difficulties.
• Enabling bladder function tests, for example, urodynamic assessment.
• Facilitating continence and maintain skin integrity (when all conservative treatment methods have failed).
• Obtaining a sterile urine specimen.

Process

• See: Commencing bladder irrigation - Royal Marsden Manual (rmmonline.co.uk)

Catheter Selection and equipment

• See: Community catheter formulary (Formularies) | Right Decisions (scot.nhs.uk)
• Catheter size
• PPE
• Sterile catheter pack
• Sterile gloves
• Type: indwelling, suprapubic, intermittent, long-term, short-term
• Leg bags, belly bags, night bags
• Stands, link systems, catheter valves, fixation devices, support garments

Escalation

Number of attempts: 

• There should be a maximum of 3 attempts to catheterise by 3 different people.
• If these are unsuccessful then a dose of gentamicin should be given (unless other sensitivities available) and either the urologist on-call or surgical registrar should be contacted to consider suprapubic catheterisation.

Visible haematuria: 

• Consider inserting a 3-way catheter and performing a bladder lavage and commencing irrigation.