Catheterization may be defined as the introduction of a catheter through the urethra to the bladder. A catheter may be placed for purposes such as (1) to prevent or relieve bladder distention due to the patient’s inability to urinate, (2) to empty the bladder prior to installation or irrigation, (3) used postoperatively because the bladder cannot function on its own due to anesthesia, (4) to obtain a sterile urine sample free from any genital secretions, (5) to remove urine residue, and (6) to prevent bed-wetting among incontinent patients.

Materials Needed:

  1. Catheter (Fr. 16 and Fr. 14 are the most commonly used, the higher the number, the larger the size)
  2. Urine bag
  3. Sterile gloves
  4. Lubricant
  5. Kidney basin
  6. 10 cc syringe
  7. 10 cc Sterile water
  8. Specimen bottle (if for analysis or culture)
  9. Flushing tray
  10. Bed pan

Anatomy

The urethral orifice is the part where the urine exits among females. Among males, it is the passage of semen and urine.

Female catheterization may be more difficult than male catheterization because you may get confused between the vaginal orifice and the urethral orifice. But always keep in mind that the urethral orifice is at least 1 inch below the clitoris.

Step by Step Guide to Female Catheterization

  1. Prepare all the necessary equipment at the bedside.
  2. Explain the procedure to the patient. Ask the patient if she has fully understood the method. Note: Female catheterization is an invasive procedure; therefore, consent must be properly signed.
  3. Place the patient in dorsal recumbent position (knees flexed and feet apart). Maintain patient’s privacy by exposing only the body parts involved.
  4. Render perineal care if necessary.
  5. Open the sterile catheter and the sterile urine bag. If you are alone, put a small amount of lubricant in sterile gauze. If you have an assistant, ask her to apply lubricant aseptically.
  6. Don your gloves, then pick up the catheter and attach it to the urine bag. Lubricate the catheter.
  7. With one hand, hold the catheter. Use the other side to open the labia minora utilizing your thumb and index finger.
  8. Keep the labia apart; examine the proper parts. Ask the patient to take a deep breath and to bear down slightly. Insert the catheter gently in the urethral orifice; wait until urine backflow is observed.
  9. Inflate the balloon by injecting 10 cc of sterile water in the Y-port to anchor the catheter in place.
  10. Attach the catheter to the patient’s thigh using adhesive tapes.
  11. Document the date and time of the procedure, the patient’s urine output, and the patient’s reaction.

Precautions

  1. Avoid membrane lining breakage by properly locating the meatus. Do not use force upon insertion.
  2. Never catheterize a patient unless ordered by the physician.
  3. Patients with indwelling catheters are at a higher risk of acquiring urinary tract infection. As nurses, it is our role to provide proper hygiene care.

Before practicing female catheterization, make sure that you are knowledgeable enough in the anatomy and physiology of the urinary system as well as aseptic technique.

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