Tips and Tricks for Difficult Urethral Catheterization

Abstract

Male urethral catheterization may be difficult in patients with enlarged prostate glands or other potentially obstructive conditions as urethral stenosis, after prostatic TUR undermining bladder neck, old and recent false passages, sphincteric spasm among others. Alternative techniques or tricks to surpass problematic urinary catheterization are usually known by experienced nurses and physicians. If repeated catheterization attempts are done, the risk of failing and complications appearing increase significantly. Improper insertion of catheters also may increase healthcare costs due to prolonged hospitalization, immediate and/or delayed surgical interventions transforming a minor technique into a huge problem for the patient, doctors, and healthcare system. Improved techniques for catheter placement are essential for all healthcare personnel involved in the management of the patient needing a urethral catheterization, including nurses and doctors from both primary and hospital medicine. The aim of this article is to show some tips and tricks that may be helpful for the blind placement of urethral catheters. The phrase "primum non nocere" acquires its maximum meaning in this context. Sanitary personal must be prudent in the number of attempts, have a clear strategy of what can be done in each moment and know how to stop or seek help in case of not being able to probe the patient in 2 or 3 attempts. If all these recommendations fail a urologist have to be required to place a catheter in a safe way including the use of endoscopic optic devices.