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Last updated: 02/17/2009
Complications that may occur include:
- Trauma or introduction of bacteria into the urinary system, leading to infection and, rarely, septicemia.
- Trauma to the urethra or bladder from incorrect insertion or attempting to remove the...
catheter with the balloon inflated. Repeated trauma may cause scarring or stricture (narrowing) of the urethra. - Passage of urine around the catheter. Inserting a different catheter size can minimize this problem.
Sexual activity and menopause can also compromise the sterility of the urinary tract. Irritation of the urethra during intercourse promotes the migration of perineal bacteria into the urethra and bladder, causing UTIs. Postmenopausal women may experience more UTIs than younger women. The presence of residual urine in the bladder due to incomplete voiding provides an ideal environment for bacterial growth.
Urinary catheterization should be avoided whenever possible. Clean intermittent catheterization, when practical, is preferable to long-term catheterization.
Catheters should not be routinely changed. Each woman should be monitored for indication of obstruction, infection, or complications before the catheter is changed. Some women require weekly catheter changes, while others may need one change in several weeks. Fewer catheter changes will reduce trauma to the urethra and reduce the incidence of UTI.
Because the urinary tract is normally a sterile system, catheterization presents the risk of causing a UTI. The catheterization procedure must be sterile, and the catheter must be free from bacteria.
Frequent intermittent catheterization and long-term use of indwelling catheterization predisposes a woman to UTI. Care should be taken to avoid trauma to the urinary meatus or urothelium (urinary lining) with catheters that are too large or inserted with insufficient use of lubricant. Women with an indwelling catheter must be reassessed periodically to determine if alternative treatment will be more effective in treating the problem.
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Other Information
The female urethral orifice is a vertical, slit-like, or irregularly ovoid (egg-shaped) opening, 0.16–0.2 in (4–5 mm) in diameter, located between the clitoris and the vagina. The urinary meatus (opening) is concealed between the labia minora, which are the small folds of tissue that need to be separated to view the opening and insert a catheter. With proper positioning, good lighting, and gloved hands, these anatomical landmarks can be identified. Perineal care or cleansing may be required to ensure a clean procedural environment.
Catheterization of the female patient is traditionally performed without the use of local anesthetic gel to facilitate catheter insertion. But since there are no lubricating glands in the female urethra (as are found in the male urethra), the risk of trauma from a simple catheter insertion is increased. Therefore, an ample supply of an anesthetic or antibacterial lubricant should be used.
Once the catheter is inserted, it is secured as appropriate for the catheter type. A straight catheter is typically secured with adhesive tape. An indwelling catheter is secured by inflating a bulb-like device inside of the bladder.
Other Information
In 2000, the estimated number of doctor visits and outpatient hospital visits by adults aged 20 or older with “calculus of kidney and ureters” as a listed diagnosis was of 2 million visits with urolithiasis as the primary diagnosis.
From: NKUDIC
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