5. Purpose: Intermittent
Catheterization
To obtain a sterile urine specimen for diagnostic
evaluation;
to empty bladder content when the patient is unable to
void due to urinary retention, bladder distention, and
obstruction, or to measure residual urine after urination.
To instill medication for a localized therapeutic effect
and to instill contrast material (dye) into the bladder
through the urethral catheter for cystourethralgraphy (x-
ray of the bladder and urethra).
To empty the bladder for increased space in the pelvic
cavity to protect the bladder during labor and delivery
and pelvic and abdominal surgery.
monitor the urinary output and fluid balances of
critically ill patients.
6. Indwelling Catheterization
Indicated as palliative care for terminally ill or
severely impaired incontinent patients, for whom
bed and clothing changes are uncomfortable, and
as a way to manage skin ulceration caused or
exacerbated by incontinence.
Used to maintain a continuous out flow of urine for
patients undergoing surgical procedures that cause
a delay in bladder sensation, and for persons with
chronic neurological disorders that cause
paralysis or loss of sensation in the perineal area.
Bladder outlet obstruction, and for patients with
an initial episode of acute urinary retention to allow
the bladder to regain its tone.
7. cysto- Cytoscopy
Visual examination of the urinary
bladder using an instrument called a
cystoscope.
QuickTimeª and a
decompressor
are needed to see this picture.
8. Procedure
During a cystoscopy procedure, the
doctor uses a hollow scope
(cystoscope) equipped with a lens to
carefully examine the lining of your
bladder and your urethra. The
cystoscope is inserted into your
urethra and slowly advanced into
your bladder.
9. Procedure
Asked to empty bladder
Receive sedative or anesthtic
Numbing jelly applied to urethra
Small scope used for investigating signs
and symptoms
Large scope to take tissue samples or
pass tools into bladder
Sterile solution used to inflate bladder to
get a better view
10. Why it’s done?
Investigate causes of bladder signs
and symptoms
Diagnosing bladder and urinary
tract diseases and conditions
Treating bladder diseases and
conditions
Diagnosing an enlarged prostate
11. UTI - Urinary Tract
Infection
Infection, usually from bacteria, of
any organ of the urinary system.
Most oftern begins with cystitis and
may ascend into the ureters and
kidneys. Most common in women
because of their shorter urethra.
12. Symptoms
Strong, persistent urge to urinate
Burning sensation when urinating
Passing frequent, small amounts of urine
Cloudy urine
Strong smelling urine
In women- Pelvic pain
In men- Rectal pain
13. Types of Infections and
symptoms
Kidneys (acute pyelonephritis)
upper back and side pain
high fever
shaking and chills
nausea
vomiting
16. Tests and Diagnosis
Urine Culture and Sensitivity
Retrograde pyelogram
Cytoscopy
KUB (Kidneys, ureters, bladder)
17. uc- Urine Culture
A diagnostic laboratory test
performed to determine the
presence of bacteria in the urine.
18. Methods
The most common is the midstream clean-
catch technique. Hands should be washed
before beginning. For females, the external
genitalia are washed two or three times with a
cleansing agent and rinsed with water. In
males, the external head of the penis is
similarly cleansed and rinsed. The patient is
then instructed to begin to urinate, and the
urine is collected midstream into a sterile
container. In infants, a urinary collection bag
is attached over the labia in girls or a boy's
penis to collect the specimen.
19. Methods
Another method is the catheterized urine specimen in
which a lubricated catheter is inserted through the
urethra into the bladder. This avoids contamination
from the urethra or external genitalia. If the patient
already has a urinary catheter in place, a urine
specimen may be collected by clamping the tubing
below the collection port and using a sterile needle
and syringe to obtain the urine sample; urine cannot
be taken from the drainage bag, as it is not fresh and
has had an opportunity to grow bacteria at room
temperature. On rare occasions, the health care
provider may collect a urine sample by inserting a
needle directly into the bladder (suprapubic tap) and
draining the urine; this method is used only when a
sample is needed quickly.
20. Test Results
Negative culture results showing no
bacterial growth are available after 24
hours. Positive results require 24-72
hours to complete identification of
the number and type of bacteria
found.
21. RP - Retrograde
Pyelogram
Diagnostic X-ray in which dye is
inserted through the urethra to
outline the bladder, ureters, and
renal pelvis.
22. Reason for procedure
retrograde pyelogram may be used
in people suspected to have an
obstruction, such as a tumor, stone, blood
clot, or stricture in the kidneys or ureters.
It evaluates the lower portion of the ureter
to which urine flow is obstructed.
also used to evaluate placement of a
catheter or a ureteral stent.
The procedure may also be performed on
people with impaired kidney function.
23. Advantage
An advantage of the retrograde pyelogram
is that it can be performed even if the
patient is allergic to contrast dye because a
minimal amount of the contrast dye is
absorbed by the body (unlike another
more common test called an intravenous
pyelogram).
24. Procedure
outpatient basis or as part of your stay in a
hospital.
An intravenous (IV) line may be inserted in your
arm or hand.
You'll be asked to lie face up on the X-ray table
and place your legs in stirrups.
You may receive a sedative or general anesthesia
in the IV prior to the insertion of the endoscope.
An endoscope will be inserted through the
urethral opening and advanced into the bladder.
Once the endoscope is in place, the bladder can
be examined and a catheter may be inserted into
one or both ureters.
25. Procedure
The contrast dye will be injected through
the catheters.A series of X-rays will be
taken at timed intervals.
The catheter will be removed.
The physician will check for retention of
the contrast dye.
26. Retrograde Pyelogram X-
Ray
Upper and lower half
of right retrograde
pyelogram shows
hydronephrosis
(yellow arrow), filling QuickTimeª and a
defect at head of
decompressor
are needed to see this picture.
contrast column in
ureter (red arrow)
and "goblet" shaped
dilatation distal to
filling defect
27. After Procedure
After the procedure, you'll be taken to the recovery
room for observation. Once your blood pressure,
pulse, and breathing are stable and you're alert,
you'll be taken to your hospital room or discharged
to your home.Your urine output will be monitored
closely for volume and signs of blood. It may be red
from even a small amount of blood. This is
considered normal and doesn't necessarily indicate
a problem. You may be instructed to continue
monitoring your urine output for a day or so once
you're at home.You may experience pain when you
urinate. Take a pain reliever for soreness as
recommended by your physician. Aspirin or certain
other pain medications may increase the chance of
bleeding.
28. Sources
Fremgen, Bonnie F., & Suzanne S. Frucht. (2009). Medical
Terminology a living language (4th ed.). New Jersey: Pearson
Education
www.myoclinic.org/urology
www.yalemedicalgroup.org
