: Aslam N, Moran PA. Catheter use in gynaecological practice. The Obstetrician & Gynaecologist 2014;16:161–8.

1. CATHETER USE IN
GYNAECOLOGICAL PRACTICE
Dr. Hashem Yaseen
Supervision by : Dr. Rawan Obaidat
Review

2. Key Contents
 Indications for catheter use in
gynaecological practice.
 Types of catheters and catheterisation.
 Evidence for early versus delayed removal
of catheters postoperatively.
 Complications.

3. Introduction
 Three main groups:
1. Indwelling urethral catheterisation
2. suprapubic
3. clean intermittent self-catheterisation
(CISC).
 The indications for catheter
use in gynaecological practice.

6. Indwelling urethral catheterisation

7. Indwelling urethral catheterisation
 The first indwelling urethral catheter (IUC) was described in
1973 by Foley.
 The two most common types:
1. Polytetrafluoroethylene,(PTFE) latex
2. 100% silicone (non-latex)
•PTFE or Teflon which makes the latex more inert and gives it a smooth surface. This reduces the incidence of urethritis
and encrustation.
•The coating used for long-term latex and 100% silicone catheters is a hydrophilic polymer. The catheter surface absorbs a
small amount of bodily fluid which lubricates its surface and reduces the friction between the catheter and urethral wall.
This helps to reduce the risk of bacterial colonisation and encrustation.

8. Indwelling urethral catheterisation
 Factors that influence indwelling urethral catheter (IUC)
selection:
1. Length:
Female catheters are typically 26 cm in length
and male 42 cm. The latter may occasionally
be preferable for obese female patients

9. Indwelling urethral catheterisation
 Factors that influence indwelling urethral catheter (IUC) selection:
2. External diameter:
Catheter size is identified by Charriere (Ch) or French gauge (Fg) or
French (F). These represent the external diameter of any
catheter. It is recommended to use the smallest size; for women
(for example 12–14 Ch). However a bigger size is to be used to
drain and clear the urinary bladder when urine contains heavy
grit (encrustation) or debri

10. Indwelling urethral catheterisation
 Factors that influence indwelling urethral catheter (IUC)
selection:
3. Catheter balloon infill volume
The manufacture of each catheter recommends how to inflate
the catheter balloon. The usual practice is to use 10 ml of
sterile water for both latex and 100% silicone catheters in
adults, and 3–5 ml in children. An alternative solution used
to inflate a 100% silicone catheter is 5% aqueous glycerine
in 10 ml sterile water. This helps to reduce catheter balloon
diffusion. Sodium chloride 0.9% should not be used as this
crystallises in the inflation channel and may result in
deflation failure. Similarly, air should not be used as it
causes the balloon to float on the surface of urine.

11. Indwelling urethral catheterisation
 Factors that influence indwelling urethral catheter (IUC)
selection:
4. Lubrication
An appropriate lubricant from a single-use container
should be used to minimise urethral trauma and
infection.

12. Steps in female
catheterization

13. Steps in female
catheterization
 Place the patient in the supine position with the knees flexed and separated and
feet flat on the bed, about 60 cm apart. If this position is uncomfortable, instruct
the patient either to flex only one knee and keep the other leg flat on the bed, or
to spread her legs as far apart as possible. A lateral position may also be used for
elderly or disabled patients.
 With the thumb, middle and index fingers of the non-dominant hand, separate
the labia majora and labia minora. Pull slightly upward to locate the urinary
meatus. Maintain this position to avoid contamination during the procedure.
 With your dominant hand, cleanse the urinary meatus, using forceps and
chlorhexidine soaked cotton balls. Use each cotton ball for a single downward
stroke only.
 Place the drainage basin containing the catheter between the patient’s thighs.
 Pick up the catheter with your dominant hand.
 Insert the lubricated tip of the catheter into the urinary meatus.
 Advance the catheter about 5-5.75 cm, until urine begins to flow then advance
the catheter a further 1-2 cm.

14. Steps in female catheterization~ cont
 Note: If the catheter slips into the vagina, leave it there to assist as a landmark.
With another lubricated sterile catheter, insert into the urinary meatus until you
get urine back. Remove the catheter left in the vagina at this time.
 Attach the syringe with the sterile water and inflate the balloon. It is
recommended to inflate the 5cc balloon with 7-10cc of sterile water, and to
inflate the 30cc balloon with 30-35cc of sterile water.
 Improperly inflated balloons can cause drainage and leakage difficulties.
 Gently pull back on the catheter until the balloon engages the bladder neck.

16. Complications

17. Complications 1

18. Complications 2