Healthcare and Medicine Reference
In-Depth Information
CHAPTER 18
Monitoring: Urinary Catheterisation
Adam Low 1 and Michael Foster 2
1 University Hospital Birmingham, Birmingham, UK
2 Heart of England NHS Foundation Trust, Good Hope Hospital, Birmingham, UK
Contraindications
Pelvic trauma - check for blood at the urethral meatus and
OVERVIEW
By the end of this chapter you should be able to:
understand the indications and contraindications for insertion of
perform a digital rectal examination for a high riding prostate.
This would suggest a urethral tear and catheterisation may cause
additional trauma.
A relative contraindication is a known urethral stricture which
a urinary catheter
identify and understand the relevant anatomy
be aware of different types of urinary catheter
would make urethral catheterisation diffi cult. A specialist urology
opinion should be sought.
describe the procedure of performing a urethral and suprapubic
catheterisation
understand the complications of urethral and suprapubic
Urogenital anatomy
The differences in male and female urogentital anatomy are illus-
trated in Figures 18.1 and 18.2. The main difference is in urethral
length; the male urethra is 18-20 cm long and the female is just
catheterisation.
Introduction
Urinary catheterisation is a relatively simple practical procedure
to master and gets easier with practice. It is important to familiar-
ise yourself with the catheter packs used in your hospital and the
catheter types available in your clinical area. Remember to take a
chaperone with you and always document this in the notes. Follow
your hospital's infection control procedures.
Rectovesical
pouch
Bladder
Suspensory
ligament
Prostatic
urethra
Prostate
Membranous
urethra
Anal canal
Perineal
body
Urethral catheterisation
Spongiose
urethra
Indications
Acute urinary retention.
Figure 18.1 A sagittal section through the male pelvis. (From Faiz O,
Moffat D. (2006) Anatomy at a Glance , 2nd edn. Blackwell Publishing,
Oxford, with permission.)
To monitor fl uid balance, for example in septic and shocked
patients.
Epidural/spinal anaesthesia or in sedated patients.
Intraoperatively.
Deeply unconscious patient - for example tricyclic antidepres-
Rectum
sant overdose.
To manage urinary incontinence, for example in elderly patients
Uterovesical
pouch
Recto-uterine pouch
Posterior fornix
of vagina
Cervix of uterus
Sphincter aniexternus
Bladder
Urethra
Vagina
Vestibule
Perineal body
who are immobile and incontinent.
To irrigate the bladder in cases of profuse haematuria.
Intravesical drug therapy, for example to administer chemother-
apy in bladder carcinoma.
Anal canal
Figure 18.2 A sagittal section through the female pelvis. (From Faiz O,
Moffat D. (2006) Anatomy at a Glance , 2nd edn. Blackwell Publishing,
Oxford, with permission.)
 
Search Pocayo ::




Custom Search