2026-02-14
During the intermittent catheterization process, the amount of urine collected by different operators on the same patient within the same period may vary by 50 to 100 ml. This difference is caused by the different operation methods and skills of the operators. Improper operation can result in incomplete drainage of the patient's urine volume, leading to an increase in residual urine volume and an increased risk of infection! The judgment of residual urine volume may also be inaccurate. The following are the precautions:
1：The depth of the urinary catheter insertion should be such that urine is visible before inserting a little more (1 to 3 cm). The appropriate depth is when the urine flow is relatively thick and rapid, rather than stopping after inserting to a certain depth (for example, 4 to 6 cm for women).
2：During the initial stage after the urinary catheter is inserted, abdominal compression should not be performed. At this time, due to the full bladder, applying pressure will cause a sharp increase in the internal pressure of the bladder, leading to the risk of urine reflux. Moreover, patients who can feel pressure on their abdomen at this time will experience extreme pain and discomfort. Once the bladder becomes looser, start applying slight pressure. Then, as the internal pressure in the bladder gradually decreases (the urine flow becomes slower and the urine stream becomes thinner), the pressure should be gradually increased, but the pressure should be within the range that the patient can tolerate without causing damage to the abdomen. The pressure applied makes the urine flow become rapid and thick, indicating that the pressure application is effective. At the end stage of catheterization, some patients may have residue in the catheter. At this time, the pressure application hand should not be released. Wait until the residue in the catheter no longer flows out, then release the pressure application hand. Otherwise, due to the removal of pressure, the negative pressure in the bladder will increase, causing the residue and urine to flow back into the bladder.
3：When during the catheterization process the urine flow slows down and becomes thinner, and abdominal pressure does not make the urine flow faster and thicker, you can rotate the catheter to change the angle of the side hole at the head of the catheter within the bladder, and also change the depth of the catheter insertion into the bladder (insert or withdraw slightly), so that the head of the catheter can again be submerged in the urine surface. When the above measures are taken until the urine flow resumes or becomes faster and thicker, the catheter should be retained at this position (the insertion length and angle), and urine can continue to be drained. If the urine flow slows down and becomes thinner again, the above measures should be taken again. Repeat this several times, and if no urine flows out, it indicates that the urine in the bladder has been basically drained. If the patient can change their position, they can change their position appropriately before the catheter is removed at the end of the catheterization to raise the head of the bed.
4：When removing the urinary catheter, the entire level of the catheter should be lower than the level of the urethral opening. At this point, the hand applying pressure should maintain the original pressure position.
5：The position for catheterization of the patient is usually the supine position. If the patient can sit up, a semi-recumbent position or a sitting position can be adopted. For male patients who can stand, a standing position for catheterization (self-catheterization) can be used. Because the amount of urine drained in the supine position is 50 to 150 ml less than that in the sitting or standing positions.
6：During the process of catheterization, if the patient experiences spasm, do not apply pressure to the abdomen to prevent the spasm from worsening. If a male patient has difficulty inserting the urinary catheter due to spasm, one can wait until the spasm subsides and then choose a slightly thinner urinary catheter with more lubricant and insert it quickly. When it reaches the prostate part of the urethra and feels some resistance, slightly lift the penis towards the abdominal wall in the direction opposite to the urethra. At this point, the resistance will decrease, making it easier to insert the catheter. If the resistance is too high and it is difficult to insert, do not repeatedly forcefully insert it, as this may cause urethral bleeding and aggravate the spasm. At this time, manual inhibition of the spasm can be adopted, or drugs can be used to control the spasm.
7：The choice of the urinary catheter should be based on the diameter of the patient's urethra, and a slightly thicker catheter should be selected to facilitate the discharge of residual urine. The urine flow that is discharged will be thicker, and the catheterization time can be shortened.
8：During a woman's menstrual period, using a urinary catheter or allowing some of the urine to be discharged partially can help reduce the frequency of catheterization.
The above content, some of the techniques still need to be further improved, innovated and perfected. This is merely for readers' reference and learning.
The content of this article is sourced from the internet. The author assumes no responsibility for it. Without permission, copying is strictly prohibited.
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