A straight catheter, also known as an intermittent catheter, is a thin, flexible tube used to empty the bladder. This procedure is performed when an individual is temporarily or permanently unable to void naturally or completely. The catheter is inserted through the urethra into the bladder to allow urine to drain out, and it is removed immediately afterward. Unlike an indwelling or Foley catheter, which remains in place for an extended period, the straight catheter is designed for single use. A trained technique is required to ensure safety and minimize the risk of infection.
Understanding the Purpose and Necessary Supplies
Straight catheterization is necessary for various conditions that cause urinary retention, the inability to fully empty the bladder. This can be a symptom of a neurogenic bladder, where nerve damage—often from conditions like spinal cord injury or multiple sclerosis—interferes with bladder function. It is also used to manage overflow incontinence or after certain surgical procedures that temporarily impair voiding. Regularly emptying the bladder is important because retained urine can lead to painful distention and serious urinary tract infections (UTIs).
Preparation requires a specific set of supplies to maintain a sterile and gentle procedure. You will need a prescribed straight catheter, which may be uncoated or pre-lubricated (hydrophilic) and sized appropriately. A sterile, water-soluble lubricating jelly is needed if the catheter is not pre-lubricated, along with antiseptic wipes or solution for cleaning the insertion site. A container or toilet is required to collect the draining urine, and thorough hand washing should be performed before gathering all items.
Detailed Guide to Straight Catheter Insertion (Male and Female)
The technique for straight catheter insertion begins with meticulous hand hygiene and positioning to maximize comfort and visibility. After washing hands with soap and water, the user should be positioned either lying down on their back or sitting upright, ensuring the collection container is placed conveniently. The sterile catheter kit should be opened carefully, maintaining the sterility of the catheter, and any necessary lubricant should be applied.
Male Procedure
For a male, the penis should be held perpendicular to the body with the non-dominant hand, which remains non-sterile. The glans, or head of the penis, must be cleaned thoroughly using an antiseptic wipe, wiping in a circular motion from the urinary opening outward. If the person is uncircumcised, the foreskin must be retracted before cleaning and held in that position during the procedure.
The first seven to ten inches of the catheter should be coated with sterile, water-soluble lubricant. Holding the lubricated catheter with the dominant, sterile hand, gently insert the tip into the urethral opening, applying light, steady pressure. A slight resistance may be felt as the catheter passes through the sphincter, but force should never be used. The catheter is slowly advanced until urine begins to flow into the collection container.
Once urine flow is established, the catheter is inserted an additional one to two inches to ensure the eyelets are fully within the bladder. The catheter is held in place while the bladder completely drains. When the flow stops, the catheter should be slowly and gently withdrawn, and the foreskin, if retracted, should be returned to its normal position.
Female Procedure
For a female, positioning typically involves lying on the back with knees bent and hips rotated outward, sometimes referred to as the “frog” position, or sitting on the toilet with one leg slightly elevated. A small mirror can be useful to help visualize the urethral meatus, which is located just above the vaginal opening. The labia are separated with the non-dominant hand to expose the urethral opening.
The area around the meatus must be cleaned using an antiseptic wipe. Separate the labia minora and wipe from front to back, using a fresh wipe for each pass to prevent contamination. Lubricant is applied to the first two or three inches of the catheter tip.
The catheter is gently inserted into the meatus, aiming slightly upward, until urine begins to flow, which typically occurs when the catheter has been inserted about three inches. Once urine flows, the catheter should be advanced an additional one inch to confirm proper placement. The catheter is held steady until the bladder is fully empty, and then it is slowly and smoothly removed.
Recognizing and Addressing Potential Issues
Following the procedure, the used supplies must be handled correctly to prevent the spread of bacteria. Single-use catheters and their packaging should be discarded immediately in a waste receptacle, while any collection container should be emptied and cleaned. The hands should be washed thoroughly again after the disposal of all materials.
It is important to monitor for signs of complications. If there is persistent or severe pain during insertion, or if the catheter cannot be advanced after two or three gentle attempts, the procedure should be stopped, and medical advice sought. The appearance of blood in the urine, especially if it is more than just a slight pink tinge, warrants immediate attention.
Signs of a possible urinary tract infection should be addressed promptly by a healthcare professional. These symptoms can include cloudy or foul-smelling urine, a burning sensation when attempting to void, fever, chills, or new lower abdominal pain. Inability to drain the bladder, despite successful insertion, or leakage around the catheter may indicate a blockage or a need for a different catheter size, and should also be reported to a doctor.