Foley’s catheterization is a medical procedure done in cases of Urinary Retention, usually in Acute cases. Foley catheter is inserted to drain and empty the bladder of urine. In this article, we will discuss about Foleys catheter- Definition, Indications, Equipment, Procedure and Complications.
Foley Catheter is a type of Indwelling catheter. The types of Urinary Catheters are:
Temporarily inserted into the bladder and removed once the bladder is empty.
Remain for longer duration, i.e, many days or weeks, and are held in position by an inflated balloon in the bladder. These are preferred because they are more convenient and prevent recurrent insertion of catheter done in cases of Intermittent Catheters. However, Indwelling catheterization is more prone to infections, such as Urinary Tract Infections (UTI).
Rather than insertion through Urethra, these are inserted via suprapubic incision and accessing bladder directly. It is used when other methods are contraindicated or are not possible.
Foleys Catheter Insertion is indicated in the following conditions:
- Acute Urinary Retention
- Continuous bladder irrigation
- Chronic obstruction causing hydronephrosis
- Decompression of neurogenic bladder
- Post-op care for patients
- During childbirth when mother has epidural anesthesia
Following are equipment tools you should get before reaching the patient for Foleys catheterization:
- Foleys Catheter of appropriate size (sizes vary from #10 to #22, average adult size is #14 to #16)
- Urine bag
- Sterile gloves
- Syringe filled with 10ml of NS (Normal Saline)
- Cotton swabs and betadine for cleaning the area
- Lubricant (for smooth insertion)
Before initiation of Foleys catheterization, take the consent of patient and explain the medical procedure. Cover the area with curtains or try for possible methods of safeguarding the privacy of patient.
Following is step-by-step procedure of performing a Urinary catheter (Foleys) insertion:
- Put on sterile gloves since urethral cavity is a sterile area and can be infected easily with bacteria and other pathogens
- Clean the genital area with betadine and cotton swabs
- Put the lubricant jelly inside the urethra and also on your hand
- Take the Foleys catheter and dip it in lubricant jelly
- Gently insert the foleys catether in the urethral meatus
- Once reached, attach the Urine bag and secure it
- Inflate the balloon with using the 10ml NS syringe
- Secure the catheter and urine bag at a lower level and attach it. This ensure gravitational flow preventing from ascending tract infections
- If there is no urine coming, the catheter tube may be pressed and twisted to create a negative pressure and allow flow of urine from bladder to urine bag
- Note down the color, amount and consistency of urine in the Urine bag
The most common complication of Foleys catheter insertion is Urinary Tract Infection (UTI). Following are complications that can occur after catheterization:
- Allergic reaction
- Hematuria (blood in urine)
- Bladder stones
- Urethral injury
- Septicemia in long standing infections
The symptoms of Urinary Tract Infections are:
- Cloudy urine (due to pus)
- Blood in the urine
- Foul-smelling urine