Inserting an Indwelling Urinary Catheter – Female
An indwelling catheter is a thin, flexible tube with internal lumen(s), which is inserted into the bladder to allow drainage of urine into an attached bag. Urethral catheterisation is the insertion of a catheter into the urinary bladder via the urethra. Suprapubic catheterisation is the insertion of a catheter into the bladder via the anterior abdominal wall.
Urinary catheters can be made of latex, polyvinylchloride (PVC) or silicone. They are classified as external (condom catheter), intermittent, long- or short-term catheters.
The main reasons for the insertion of a catheter are to:
- relieve urinary retention
- accurately monitor urinary output
- instil medications
- manage and maintain urinary system during and/or post a surgical procedure
- facilitate bladder irrigation for management of haematuria
- manage fistula and promote healing
- conduct investigative procedures
- measure residual urine after voiding
- preserve skin integrity
- provide comfort measures in end-of-life care.
Catheters are measured in Charriere (Ch) or French gauge (Fg or Fr). Catheter sizes range from
5–24 Fr; the higher the number the greater the diameter of the catheter. It is important that a suitable size be selected to avoid leakage of urine around the catheter or trauma to the urethra or bladder. Depending on the indication, size 12–14 Fr is generally used for female urethral catheterisation (ANZUNS 2013).
Complications of urinary catheterisation include catheter-associated urinary tract infection (CAUTI), haematuria, fistula formation, calcium formation, bladder stones, squamous cell carcinoma (SCC) of the bladder and trauma to bladder neck, urethra and/or meatus.
As this is an aseptic procedure, ANTT principles should be strictly adhered to. Before performing this procedure, it is imperative that the nurse has a sound knowledge of the pathophysiology related to the female urinary tract and any contraindications regarding female catheterisation. Nurses will need to comply with industry requirements, National Safety and Quality Health Service Standards (second edition), organisational guidelines and procedural direction to safely perform this procedure.