A urinary catheter is a flexible tube designed to drain urine from the bladder. This medical device helps manage conditions where a person cannot empty their bladder naturally. The procedure is generally safe and routine. Catheters serve as a temporary or long-term solution.
Understanding Female Anatomy for Catheter Placement
A catheter is inserted into the urethra to reach the bladder in a woman. The urethra is a narrow tube, approximately 4 cm long in adult females, that extends from the bladder to the outside of the body, allowing urine to pass.
The urethral opening, also known as the meatus, is located within the vulva, the external female genitalia. This opening is situated between the clitoris and the vaginal opening. The labia minora, which are two inner folds of skin, surround and protect these openings.
The urethra is a separate structure from the vagina. While close in proximity, the catheter is placed into the urethral opening, not the vaginal opening, to ensure proper urine drainage. Identifying the correct opening can sometimes be challenging.
The Catheter Insertion Process
Catheter insertion begins with careful preparation and maintaining a sterile environment. Healthcare professionals gather all necessary equipment, including the catheter and sterile water for balloon inflation. The patient is positioned comfortably on their back with knees bent and hips flexed to allow for clear visualization of the anatomy.
The area around the urethra is thoroughly cleansed using an antiseptic solution to minimize the risk of infection. This involves cleaning the labia and the area surrounding the urethral opening. Sterile gloves are donned to maintain aseptic technique.
The catheter tip is lubricated with a sterile gel to ensure smooth and comfortable insertion into the urethra. The catheter is then gently advanced into the urethral opening until urine begins to flow, indicating it has reached the bladder. Once urine flow is observed, the catheter is typically advanced a further 2-4 centimeters to ensure the balloon, if present, is fully inside the bladder.
For indwelling catheters, a small balloon at the end of the catheter is inflated with sterile water to keep it securely in place within the bladder. The catheter is then connected to a drainage bag, which collects the urine. The catheter tubing is secured to the patient’s leg or thigh with tape or a catheter strap, ensuring enough slack to prevent tension or injury.
Common Reasons for Catheterization
Urinary catheterization is performed for various medical reasons, often when a woman is unable to empty her bladder naturally or when precise monitoring of urine output is required. One common indication is acute urinary retention, where the bladder cannot empty due to obstructions or nerve issues. Catheters help relieve this discomfort and prevent bladder damage.
Catheterization is also performed during or after surgical procedures, especially pelvic surgeries, to ensure the bladder remains empty and to monitor fluid balance. In critically ill patients, a catheter allows for accurate measurement of urine output. For diagnostic purposes, catheters can be used to collect sterile urine samples or to introduce contrast for imaging studies of the urinary tract.
Catheters may be used for managing urinary incontinence when other methods are ineffective, or for intermittent bladder decompression in patients with neurogenic bladder dysfunction. They can also deliver medications directly into the bladder for certain treatments.