Foley Catheterization In Lucknow

Required Contents –

  1. Sterile appropriate sized gloves
  2. Povidone iodine
  3. Sterile Sponge holding forceps
  4. Sterile gauze pieces
  5. Sterile drape
  6. Sterile syringe 10 or 20ml without luer-lock
  7. Sterile water or normal saline for instillation
  8. Sterile foley catheter of suitable size with protective covering
  9. Sterile urobag / leg-bag (whichever appropriate)
  10. Sterile xylocaine jelly 2% suitable for instillation with a nozzle

Procedure (male) -

  1. Obtain consent and have everything ready. One trained assistant is preferably required for the procedure.
  2. Lay the patient supine
  3. Clean any smegma from the glans and prepuce
  4. Check with the patient for any known sensitivity to povidone iodine
  5. Paint penile shaft, glans, prepuce, scrotum, adjacent thigh and pubic region with povidone iodine
  6. Drape the region with only penis exposed
  7. Attach the nozzle in xylocaine jelly tube
  8. Encircle the corona glandis with dry gauze piece to hold the penis with non-dominant hand
  9. Gently instill the jelly into urethra while asking the patient to relax the sphincter (as if passing urine). Penile clamp may be used for holding the jelly in urethra (not essential)
  10. WAIT for at least 2-3 min for the xylocaine to anesthetize the urethra
  11. Ask the assistant to handover the foley and urobag WITHOUT BREACHING the sterility
  12. DO NOT remove foley from inner plastic covering. Remove the plastic cover from tip of catheter taking care of not touching the foley per se. apply some jelly on the tip of the catheter
  13. Hold the penis with non-dominant hand with the help of the gauze piece and hold the foley through the cover.
  14. Gently start inserting the foley. Make sure to complete insert the catheter till its Y junction and efflux of urine before inflating the retention balloon.
  15. Once the catheter is placed into bladder, connect the foley with urobag to prevent spillage of urine.
  16. Inflate the balloon with ~10ml of sterile water or NS (0.9%)
  17. Split-open the plastic cover on the foley and fix the catheter / urobag appropriately to avoid any pull / stretch on the catheter

Procedure (female) –

  1. Obtain consent and have everything ready. One trained assistant is preferably required for the procedure.
  2. Lay the patient supine with legs folded and spread-out
  3. Clean any discharge or inspissated secretions from introitus / clitoris
  4. Check with the patient for any known sensitivity to povidone iodine
  5. Paint introitus (with front-backward swiping movements), adjacent thigh and pubic region with povidone iodine
  6. Drape the region with only introitus exposed
  7. Attach the nozzle in xylocaine jelly tube
  8. Spread the labia with non-dominant hand
  9. Gently instill the jelly into urethra while asking the patient to relax the sphincter (as if passing urine).
  10. WAIT for at least 2-3 min for the xylocaine to anesthetize the urethra
  11. Ask the assistant to handover the foley and urobag WITHOUT BREACHING the sterility
  12. DO NOT remove foley from inner plastic covering. Remove the plastic cover from tip of catheter taking care of not touching the foley per se. apply some jelly on the tip of the catheter
  13. Spread the labia with non-dominant hand with the help of the gauze piece and hold the foley through the cover.
  14. Gently start inserting the foley. Make sure to insert the catheter approximately half way to its Y junction (12 - 15 cm) and efflux of urine before inflating the retention balloon.
  15. Once the catheter is placed into bladder, connect the foley with urobag to prevent spillage of urine
  16. Inflate the balloon with ~10ml of sterile water or NS (0.9%)
  17. Split-open the plastic cover on the foley and fix the catheter / urobag appropriately to avoid any pull / stretch on the catheter