Specific considerations

Pediatric catheterization:

  • Size- 5, 6, 8, 10Fr. or smaller depending on the size of the urethra and age of child.
  • Rarely are catheters left indwelling, typically they are intermittent and are used to obtain sterile urine sample to rule-out infection.
  • In children <2years of age, a 5Fr. feeding tube can be used if a small diameter catheter is not available.
  • Using feeding tubes can cause urethral trauma
  • A second pair of hands for assistance is recommended for very young children.
Male catheterization:
  • 16Fr. or 18Fr. catheter is typically used for most men, as they are more rigid and often easier to insert past the prostate.
  • In males it is helpful to use a Urojet (syringe with lidocaine jelly) to minimize the discomfort with the catheterizations.
  • Males who present with gross hematuria require 3-way Foley catheters with the largest diameter that can be safely inserted. (22Fr., 24Fr.,)
  • Catheters should be attached to the inner upper thigh with a CathSecure. This will minimize discomfort and prevent the catheter from being pulled on/out.
  • When the foreskin is retracted for the purpose of catheterization remember to return it back to its original place.
  • If resistance is met while inserting the catheter, due care is used not to damage the enlarged prostate. Never inflate the balloon until urine has been visualized and is draining.

Female Catheterization:

  • 12fr., 14Fr.or 16Fr. catheter is typically used.
  • Positioning is important to properly visualize the urethra in females.
  • If you are unable to visualize the urethra, raise pelvis with a pillow. blanket or inverted bedpan.
  • If you insert catheter into the vagina leave it in place as a landmark and start again with another sterile catheter.
  • Never inflated the balloon until you see urine.
  • If patient presents with gross hematuria a larger 3-way catheter needs to inserted.

Prior to starting, explain to the patient what is going to happen and why they need to be catheterized. Assess patient's understanding and answer any questions they may have. Collect supplies, it is helpful to bring a second catheter in case of contamination of the first catheter. Clear off work space/ bedside table and begin to position the patient. Raise the bed to an appropriate working height and position yourself on the opposite side of your dominant hand. Keep in mind that it may be necessary to obtain additional help with the catheterization.