Foley catheters are medical devices used to drain urine from the bladder. They serve various purposes when individuals cannot urinate independently or require precise monitoring of urine output. This article provides an overview of Foley catheters, their application, and why professional handling is paramount.
What is a Foley Catheter?
A Foley catheter is a thin, flexible tube designed to drain urine from the bladder into a collection bag. It is an indwelling catheter, remaining in place for an extended period, unlike intermittent catheters removed after each use. The device consists of two channels, or lumens. One allows urine to drain into the collection bag, while the other connects to a small balloon at the catheter’s tip. This balloon is inflated with sterile water once inside the bladder, securing the catheter and preventing it from slipping out.
Foley catheters are used for medical reasons such as urinary retention, where a person cannot empty their bladder due to conditions like an enlarged prostate, bladder weakness, or nerve damage. They are also employed during and after surgeries, especially those involving the abdomen, pelvis, or urogenital system, to keep the bladder empty and allow for healing. These catheters also monitor urine output in critically ill patients, assessing kidney function and fluid balance. They can also manage severe urinary incontinence or deliver medication directly to the bladder.
The Catheter Insertion Process
Inserting a Foley catheter involves a careful procedure performed by healthcare professionals. Preparation includes gathering sterile equipment like the catheter, sterile gloves, antiseptic solution, and lubricating gel. The patient is positioned to allow access to the urethra.
Healthcare providers maintain a sterile environment throughout insertion to minimize infection risk. The urethral opening is cleaned with antiseptic, and sterile lubricating gel is applied to the catheter to reduce discomfort and trauma. The catheter is then gently advanced through the urethra until its tip reaches the bladder, indicated by urine in the drainage tube.
Once the catheter is correctly positioned within the bladder, the small balloon at its tip is inflated with sterile water using a syringe. This anchors the catheter inside the bladder, preventing dislodgement. The catheter is connected to a drainage bag, and the tubing is secured to the patient’s leg to prevent pulling or kinking.
Why Professional Expertise is Essential
Foley catheter insertion is a medical procedure requiring trained healthcare professionals due to risks associated with improper technique. A significant concern is the risk of infection, particularly catheter-associated urinary tract infections (CAUTIs), which can lead to severe conditions like sepsis. Non-sterile technique can introduce bacteria into the urinary tract, increasing this risk.
Incorrect insertion can also cause urethral trauma or injury, such as tears, false passages, or strictures. Using excessive force or inflating the balloon within the urethra can damage the delicate urethral lining. Such injuries can result in pain, bleeding, and long-term complications like urethral narrowing.
Selecting the appropriate catheter size requires professional judgment. Catheters are sized using the French (Fr) gauge, where each unit corresponds to 0.33 millimeters in diameter. An incorrectly sized catheter can cause discomfort, leakage, or trauma to the urinary tract. Healthcare providers are trained to choose the smallest effective size to ensure patient comfort and prevent complications. They also recognize and manage potential complications during insertion and understand contraindications for catheter use.
Caring for a Foley Catheter
Proper care for a Foley catheter is important for comfort and to prevent complications. Daily hygiene practices include washing hands before and after handling the catheter. The insertion site should be gently cleaned with soap and water at least twice a day.
Maintaining the drainage system correctly is also important. The collection bag must always be kept below the level of the bladder to prevent urine from flowing back into the bladder, which can cause infection. Drainage bags should be emptied regularly, typically when they are about half to two-thirds full, or every 4-6 hours. The tubing connecting the catheter to the bag should be free of kinks or loops to ensure continuous urine flow.
Patients and caregivers should be aware of signs that might indicate a complication. These can include fever, chills, pain in the lower abdomen or around the groin, cloudy or foul-smelling urine, or leakage around the catheter. Increased bladder spasms or blood in the urine also warrant attention. Drinking plenty of fluids, if advised by a healthcare provider, can help maintain good urine flow and reduce the risk of infection. Catheters are removed by a healthcare professional when no longer needed, by deflating the balloon with a syringe before gently withdrawing the tube.