Steps in male catheterization

  • Place the patient in the supine position with legs extended and flat on the bed.
  • Prepare the catheterization tray and catheter and drape the patient appropriately using the sterile drapes provided. Place a sterile drape under the patient’s buttocks and the fenestrated (drape with hole) drape over the penis.
  • Apply water-soluble lubricant to the catheter tip.
  • With your non-dominant hand, grasp the penis just below the glans and hold upright.
  • If the patient is uncircumcised, retract the foreskin. Replace the foreskin at the end of the procedure.
  • With your dominant hand, cleanse the glans using chlorhexidine soaked cotton balls. Use each cotton ball for a single circular motion.
  • Place the drainage basin containing the catheter on or next to the thighs.
  • With you non-dominant hand, gently straighten and stretch the penis. Lift it to an angle of 60-90 degrees. At this time you may use the urojet to anesthetize the urinary canal, which will minimize the discomfort.
  • With your dominant hand, insert the lubricated tip of the catheter into the urinary meatus.
  • Continue to advance the catheter completely to the bifurcation i.e. until only the inflation and drainage ports are exposed and urine flows (this is to ensure proper placement of the catheter in the bladder and prevent urethral injuries and hematuria that result when the foley catheter balloon is inflated in the urethra).
  • Note: If resistance is met during advancement of the catheter: Pause for 10-20 seconds. Instruct the patient to breathe deeply and evenly. Apply gentle pressure as the patient exhales
  • If you still meet resistance, stop the procedure and repeat above steps.
  • 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 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.
  • Attach the urinary drainage bag and position it below the bladder level. Secure the catheter to the thigh. Avoid applying tension to the catheter.
  • Remove drapes and cover patient. Ensure drainage bag is attached to bed frame. Remove your gloves and wash hands.
  • Note: Never inflate a balloon before establishing that the catheter is in the bladder and not just in the urethra. If the patient reports discomfort, withdraw the fluid from the balloon and advance the catheter a little further, then re-inflate the balloon.