How to Put in a Catheter

This content is from
pages 206 to 208 of Disabled Village Children

Health workers and parents can easily be taught to put in a catheter. With a little practice, children with paraplegia and some children with quadriplegia 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.
middle	side view
		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.

More methods for an automatic bladder

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.

In many areas this is the easiest method because other supplies are difficult to get. However, a Foley can cause many problems, including:

Bacteria can get into the bladder, causing a high risk of infection.
Continuous bladder irritation can cause bladder stones to form.
The catheter may cause a sore on the underside of the penis through which urine leaks. This may need surgery to correct.

If you have tried other methods unsuccessfully or no other equipment is available, a Foley catheter may be the only choice. To prevent complications it is very important that it be used carefully:

Always wash your hands well before touching the catheter.
Clean the skin around the catheter with soap and water at least twice a day and after each bowel movement.
Do not disconnect the collection bag except to empty and wash it.
Wash it out with soap or bleach (Clorox) and water once a day.
If the catheter must be clamped, use a sterile plug, never a glass ampule (small bottle). It may break and cause injury.
Keep the collection bag below the level of the bladder to keep the urine from flowing back.
Tape the catheter to the leg when in a wheelchair. Boys should tape the catheter on belly when lying down.
Check regularly to make sure the urine is emptying and that the catheter is not plugged up. Avoid sharp bends or folds in the tubing.
When turning, lifting, or moving the person, remember to move the bag too. Do not let it pull at the catheter or stay under the person.
If the catheter gets plugged up, take it out, squirt boiled water through it, and put it back. Or use a new one. In emergencies, you can squirt a little (cool) boiled water back through the catheter while it is in place. Use a sterile or very clean syringe.

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.

condom catheter

regular condom

polyethylene bag

A condom catheter is a thin rubber bag that fits over the penis. It has a tube that connects to a collection bag. They come in different sizes.

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 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.)

1.	2.	3.

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.	6.
	tape
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.
7.	8.	9.

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.

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This page was updated:04 Apr 2024

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