Hesperian Health Guides
How to Put in a Catheter
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Health workers and parents can easily be taught to put in a catheter. With a little practice, paraplegic and some quadriplegic children can also learn.
Note: The best catheter size is usually from #8 or #10 for a small child to #14 or #16 for a large child.
|Children as young as age 5 can learn to catheterize themselves.|
|A mirror can help girls to find the urine hole.|
Note: The great care with cleanliness shown here (boiling the catheter, wearing gloves) is important when using a fixed (Foley) catheter. However, for periodic use of a regular catheter, a clean rather than sterile technique is more practical (and therefore may be safer). Wash the catheter well with clean water after each use and keep it in a clean container. Wash your hands well before using it. See note on "Methods for Automatic Bladder".
|1. If possible boil the catheter (and any syringe or instrument you may be using) for 15 minutes, or at least wash them well and keep them clean.||2. Bathe well (at least daily). Wash well under foreskin or between vaginal lips and surrounding areas.|
|3. Wash hands with soap. After washing touch only things that are sterile or very clean.||4. Put very clean cloths under and around the area.|
|5. Put on sterile gloves— or rub hands well with alcohol or surgical soap.||6. Cover the catheter with a lubricant (slippery cream) like K-Y Jelly that dissolves in water (not oil or Vaseline).|
|7. Pull back foreskin or open the vaginal lips,|
|and wipe the urine opening with a sterile cotton soaked with surgical soap.|
|8. Holding the lips open or the foreskin back, gently put the catheter into the urine hole. Twist it as necessary but DO NOT FORCE IT.|
|Hold the penis straight at this angle.|
|9. Push the catheter in until urine starts coming out—then 3 cm more.
||10A. If using a regular catheter, each time you pee tighten your stomach muscles or gently massage the lower belly to empty all urine. Then take out the catheter, wash it well, boil it, and store it in a clean jar or towel.||10B. If using a Foley (permanent) catheter, inject 5 cc. of sterile water into the little tube, to fill the balloon (or up to 10 cc. if it is a 30 cc. Foley), and connect the bigger tube to the collection tube or leg bag.|
|Change the catheter every 2 weeks (or more often if there is an infection).|
To avoid infections when using a catheter, it is important to be very clean and to use only a catheter that is sterile, boiled, or very clean.
3. FOLEY CATHETER (fixed catheter): With this method, the catheter is left in all the time to drain the urine from the bladder continuously. A Foley is often used immediately after injury, and in some cases, for many months or years. The catheter connects to a collection bag that can be attached to the leg and worn under the clothes.
4. CONDOM CATHETER: This is a practical method for men and boys who cannot control their urine. It can be used in combination with triggering, to avoid accidental wetting.
If condom catheters are too costly or not available, a regular condom (‘rubber’, ‘sheath’, or ‘prophylactic’ for family planning) can be attached to the collection tube with a rubber band or tape.
Or a thin, very clean plastic bag can be used. Or, on a child, use the finger of a rubber glove (or a ‘fingercot’).
To hold the condom on the penis, a special very stretchy adhesive tape can be used as shown in this series of drawings.
How to put on a condom using tape
WARNING! Use only Con-stay or another easily stretchable adhesive tape. (Ordinary adhesive tape can stop blood flow when the penis swells.)
|Cut off hair.||Pull back skin. Wash with soap and water and dry well.||Apply ‘skin prep’ (tincture of benzoin) to help condom stick to skin.|
|4. Pull foreskin forward over head of penis.||5. tape||6.|
|Roll on condom leaving some space here.||Loosely wrap Constay tape around condom so it sticks to itself.||Roll the condom back over the tape.|
|Add a second strip of tape, ½ on the condom and ½ on the skin.||Cut off the rubber rim.||Connect condom to leg bag.|
|One of the safest and cheapest ways to hold a condom on the penis is to cut a ring out of soft foam rubber. Pass the condom under the ring and turn it back over it.||The ring can be used again and again. So can the condoms if they are carefully washed.|
IMPORTANT PRECAUTIONS FOR CONDOM USE:
- Be sure it is not too tight—it could stop blood flow and severely harm the penis. Avoid non-stretch tape.
- If the penis has erections (gets hard and bigger), try to put on the condom when it is big.
- Remove the condom once a day and wash the penis well.
- If possible, remove it at night. Use a bottle or urinal to catch the urine.
- Check the condom and penis often to be sure everything is all right.
- If the penis becomes injured, swollen, or looks sore, remove the condom until the penis is healthy.