Steps in female catheterization

  • Place the patient in the supine position with the knees flexed and separated and feet flat on the bed, about 60 cm apart. If this position is uncomfortable, instruct the patient either to flex only one knee and keep the other leg flat on the bed, or to spread her legs as far apart as possible. A lateral position may also be used for elderly or disabled patients.
  • With the thumb, middle and index fingers of the non-dominant hand, separate the labia majora and labia minora. Pull slightly upward to locate the urinary meatus. Maintain this position to avoid contamination during the procedure.
  • With your dominant hand, cleanse the urinary meatus, using forceps and chlorhexidine soaked cotton balls. Use each cotton ball for a single downward stroke only.
  • Place the drainage basin containing the catheter between the patient’s thighs.
  • Pick up the catheter with your dominant hand.
  • Insert the lubricated tip of the catheter into the urinary meatus.
  • Advance the catheter about 5-5.75 cm, until urine begins to flow then advance the catheter a further 1-2 cm.
  • Note:  If the catheter slips into the vagina, leave it there to assist as a landmark. With another lubricated sterile catheter, insert into the urinary meatus until you get urine back. Remove the catheter left in the vagina at this time.
  • Attach the syringe with the sterile water and inflate the balloon. It is recommended to inflate the 5cc balloon with 7-10cc of sterile water, and to inflate the 30cc balloon with 30-35cc of sterile water.
  • Improperly inflated balloons can cause drainage and leakage difficulties.
  • Gently pull back on the catheter until the balloon engages the bladder neck.