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Articles, Publications &  Research Urethra Gauge™ Images Urinary Catheterization
Catheter Associated Urinary Tract Infections (C.A.U.T.I.) Urethra Gauge™ Instructions Urinary Catheters & WOCN Supplies
Catheter Sizes Urethra Gauge™ News Urinary Strictures
Foley Catheters Urethra Gauge™ Patent Documents (.pdf) Urinary System and How it Works
French Catheter Scale Urethra Gauge™ Patent Documents (.html) Urinary Tract Infections (U.T.I.)
Urethra Gauge™ FAQ's Urethra Sizes Wound, Ostomy, and Continence Nurse Resources

Urinary Catheterization

Urinary catheterization

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In urinary catheterization, or "cathing" for short, a plastic tube known as a urinary catheter that is gently slid into a patient's bladder via their urethra. Catheterization allows the patient's urine to drain freely from the bladder for collection, or to inject liquids used for treatment or diagnosis of bladder conditions. The procedure of catheterization will usually be done by a clinician, often a nurse, although self-catheterization is possible as well.

Contents

[hide]

[edit] Catheter types

A Tiemann -type catheter installed for a male doll in an exercise.

Catheters come in several basic designs:[1]

Catheter diameters are sized by the French catheter scale (F). The most common sizes are 10 F (3.3mm) to 28 F (9.3mm). The clinician selects a size large enough to allow free flow of urine, and large enough to control leakage of urine around the catheter. A larger size can become necessary when the urine is thick, bloody or contains large amounts of sediment. Larger catheters, however, are more likely to cause damage to the urethra. Some people develop allergies or sensitivities to latex after long-term latex catheter use making it necessary to use silicone or Teflon types. Silver alloy coated urinary catheters may reduce infections.[3]

[edit] Sex differences

In males, the catheter tube is inserted into the urinary tract through the penis. A condom or Texas catheter can also be used. In females, the catheter is inserted into the urethral meatus, after a cleansing using povidone-iodine. The procedure can be complicated in females due to varying layouts of the genitalia (due to age, obesity, Female genital cutting, childbirth, or other factors), but a good clinician should rely on anatomical landmarks and patience when dealing with such a patient. In the UK it is generally accepted that cleaning the area surrounding the urethral meatus with 0.9% sodium chloride solution is sufficient for both male and female patients as there is no reliable evidence to suggest that the use of antiseptic agents reduces the risk of urinary tract infection.[4]

Common indications to catheterize a patient include acute or chronic urinary retention - (which can damage the kidneys), orthopedic procedures that may limit a patient's movement, the need for accurate monitoring of input and output (such as in an ICU), benign prostatic hyperplasia, incontinence, and the effects of various surgical interventions involving the bladder and prostate.

For some patients the insertion and removal of a catheter causes excruciating pain, so a topical anesthetic is used. Catheterization should be performed as a sterile medical procedure and should only be done by trained, qualified personnel, using equipment designed for this purpose, except in the case of intermittent self catheterization where the patient has been trained to perform the procedure himself or herself. If correct technique is not used there may be trauma to the urethra or prostate (male), urinary tract infection, or a paraphimosis in the uncircumcised male.

[edit] Catheter maintenance

A catheter that is left in place for more than a short period of time is generally attached to a drainage bag to collect the urine. This also allows for measurement of urine volume. There are two types of drainage bags: The first is a leg bag, a smaller drainage device that attaches by elastic bands to the leg. A leg bag is usually worn during the day, as it fits discreetly under pants or skirts, and is easily emptied into a toilet. The second type of drainage bag is a larger device called a down drain that may be used overnight. This device is hung on a hook under the patient's bed - they are never to be placed on the floor due to the risk of bacterial infection.

During long-term use, the catheter may be left in place during the entire time, or a patient may be instructed on a procedure for placing a catheter just long enough to empty the bladder and then removing it (known as intermittent self-catheterization). Patients undergoing major surgery are often catheterized and may remain so for some time. The patient may require irrigation of the bladder with sterile saline injected through the catheter to flush out clots or other matter that does not drain.[5]

[edit] Effects of long term use

The duration of cathetarization can have significance for the patient. Incontinent patients commonly are catheterized to reduce their cost of care. However, long-term catheterization carries a significant risk of urinary tract infection. Because of this risk catheterization is a last resort for the management of incontinence where other measures have proved unsuccessful. Other long term complications may include blood infections (sepsis), urethral injury, skin breakdown, bladder stones, and blood in the urine (hematuria). After many years of catheter use, bladder cancer may also develop.

[edit] Combating infection

Everyday care of catheter and drainage bag is important to reduce the risk of infection.[6] Such precautions include:

Recent developments in the field of the temporary prostatic stent have been viewed as a possible alternative to indwelling catheterization and the infections associated with their use. [7]

[edit] See also

[edit] References

  1. ^ a b Hanno, Philip M., Wein, Alan J., Malkowicz, S. Bruce. Clinical manual of urology. McGraw-Hill Professional, 2001. p. 78.
  2. ^ Black, Mary Ann. Medical nursing.Springhouse Corp., 2nd ed., 1994. p. 97.
  3. ^ Jeffrey A. Norton, Philip S. Barie, R. Randal Bollinger, Alfred E. Chang, Stephen F. Lowry, Sean J Mulvihill, M.D., Harvey I Pass, M.D., Robert W Thompson, M.D. Surgery: Basic Science and Clinical Evidence.Springer, 2nd ed., 2008. p. 281.
  4. ^ Royal Marsden Handbook of Clinical Nursing Procedure 6th ed., London.
  5. ^ Lippincott Williams & Wilkins. Best practices: evidence-based nursing procedures.Lippincott Williams & Wilkins, 2nd ed. 2006 p. 454-555.
  6. ^ "Care for your catheter". http://www.healthline.com/adamcontent/urinary-catheters. Retrieved 2008-09-12.
  7. ^ Neal D. Shorea, Martin K. Dineenb, ‡, Mark J. Saslawskyc, §, Jeffrey H. Lumermand and Alberto P. Corica (March 2007). "A Temporary Intraurethral Prostatic Stent Relieves Prostatic Obstruction Following Transurethral Microwave Thermotherapy". The Journal of Urology 177 (3): 1040–1046. doi:10.1016/j.juro.2006.10.059.

[edit] External links

 

Catheter Sizes

French

MM

Inches

12

4.00

.1572

french.gif (2806 bytes)
Relatives sizes are very approximate

14

4.67

.1834

16

5.33

.2096

18

6.00

.2358

20

6.67

.2620

22

7.33

.2882

24

8.00

.3144

26

8.67

.3406

28

9.33

.3568

30

10.00

.3930

32

10.67

.4192

34

11.33

.4454

36

12.00

.4716

38

12.67

.4978

40

13.33

.5240

French Catheter Scale

Urethra Gauge™

ABSTRACT

A urethra gauge™ for measuring an inner size of a urinary tract. The gauge permits a clinician to measure the size of the urethral lumen (proximal to an outer orifice of the urethra) before a catheterization is performed. Selecting a properly-sized catheter for insertion into a patient by measuring the size of the urethral lumen before performing a catheterization is believed to reduce: (1) catheter-associated-urinary-tract infections; (2) urethral injuries due to inserting a catheter that is too large for the urethra; and/or (3) leakage associated with catheters that are too small for a particular patient.

A gauge for determining an internal size of a urethra, comprising: a rod having a distal-end point and a proximal-end point, the rod having an outer-peripheral surface with at least a portion having progressively increasing cross-sectional areas extending from the distal-end point to the proximal-end point; wherein the cross-sectional area of the outer-surface of the rod at the distal-end point corresponds to a first-potential size for the internal size of a urethra; wherein the cross-sectional area of the outer-surface of the rod at a proximal-end point corresponds to a second-potential size for the internal size of a urethra larger than the first-potential size; and wherein between the distal-end point and the proximal-end point, are an array of points located on the outer-peripheral surface of the rod with indicia which correspond to a plurality of potential sizes for the internal circumference of a urethra larger than the first-potential size, but less than the second-potential size.

 

Urinary Tract Infection (U.T.I.)

Definition

A urinary tract infection is an infection that begins in your urinary system. Your urinary system is composed of the kidneys, ureters, bladder and urethra. Any part of your urinary system can become infected, but most infections involve the lower urinary tract — the urethra and the bladder.

Women are at greater risk of developing a urinary tract infection than are men. A urinary tract infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a urinary tract infection spreads to your kidneys.

Antibiotics are the typical treatment for a urinary tract infection. But you can take steps to reduce your chance of getting a urinary tract infection in the first place.

Symptoms

Not everyone with a urinary tract infection develops recognizable signs and symptoms, but most people have some.

In general, urinary tract infection signs and symptoms develop rapidly and can include:

Types of urinary tract infection
Each type of urinary tract infection may result in more-specific signs and symptoms, depending on which part of your urinary tract is infected.

Part of urinary tract affected Signs and symptoms
Kidneys (acute pyelonephritis)
  • Upper back and side (flank) pain
  • High fever
  • Shaking and chills
  • Nausea
  • Vomiting
Bladder (cystitis)
  • Pelvic pressure
  • Lower abdomen discomfort
  • Frequent, painful urination
  • Low-grade fever
Urethra (urethritis)
  • Burning with urination

Causes

CLICK TO ENLARGE

Illustration of the female urinary system 
Female urinary system
Illustration of the male urinary system 
Male urinary system

The urinary system is composed of the kidneys, ureters, bladder and urethra. All play a role in removing waste from your body. Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, the defenses sometimes fail. When that happens, bacteria may take hold and multiply into a full-blown infection in the urinary tract.

The most common urinary tract infections occur mainly in women and affect the bladder and urethra.

Risk factors

Some people appear to be more likely than are others to develop urinary tract infections. Risk factors include:

 

recurrent urinary tract infections
In women, the immune system may play a role in the risk of recurrent urinary tract infections. Bacteria can attach to cells in the urinary tract more easily in women lacking protective factors that normally allow the bladder to shed bacteria. More research is needed to determine the exact factors involved and how these factors can be manipulated to benefit women with frequent urinary tract infections.

PREVENTION 

First Step to Prevent: Urinary Tract Infection, Catheter Associated Urinary Tract Infection

  1. Use a Device called the Urethra Gauge™

    Urethra Gauge™

A urethra gauge™ for measuring an inner size of a urinary tract. The gauge permits a clinician to measure the size of the urethral lumen (proximal to an outer orifice of the urethra) before a catheterization is performed. Selecting a properly-sized catheter for insertion into a patient by measuring the size of the urethral lumen before performing a catheterization is believed to reduce: (1) catheter-associated-urinary-tract infections; (2) urethral injuries due to inserting a catheter that is too large for the urethra; and/or (3) leakage associated with catheters that are too small for a particular patient.

A gauge for determining an internal size of a urethra, comprising: a rod having a distal-end point and a proximal-end point, the rod having an outer-peripheral surface with at least a portion having progressively increasing cross-sectional areas extending from the distal-end point to the proximal-end point; wherein the cross-sectional area of the outer-surface of the rod at the distal-end point corresponds to a first-potential size for the internal size of a urethra; wherein the cross-sectional area of the outer-surface of the rod at a proximal-end point corresponds to a second-potential size for the internal size of a urethra larger than the first-potential size; and wherein between the distal-end point and the proximal-end point, are an array of points located on the outer-peripheral surface of the rod with indicia which correspond to a plurality of potential sizes for the internal circumference of a urethra larger than the first-potential size, but less than the second-potential size.

 

www.UrethraGauge.com

HOME ABOUT US CONTACT US ORDERING PRODUCTS SITEMAP

Articles, Publications &  Research Urethra Gauge™ Images Urinary Catheterization
Catheter Associated Urinary Tract Infections (C.A.U.T.I.) Urethra Gauge™ Instructions Urinary Catheters & WOCN Supplies
Catheter Sizes Urethra Gauge™ News Urinary Strictures
Foley Catheters Urethra Gauge™ Patent Documents (.pdf) Urinary System and How it Works
French Catheter Scale Urethra Gauge™ Patent Documents (.html) Urinary Tract Infections (U.T.I.)
Urethra Gauge™ FAQ's Urethra Sizes Wound, Ostomy, and Continence Nurse Resources

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