Urethral catheterisation
Choose and insert a 2-way or 3-way catheter.
Before starting
- Only a trained and competent clinician should catheterise.
- Do not catheterise blindly if there is suspected urethral injury: pelvic/perineal trauma, blood at the meatus or recent urethral reconstruction. Call the Surgical SHO/Urology team.
- Explain, consent, preserve dignity, check allergies and use aseptic technique.
Choose the catheter
| Catheter | Use |
|---|---|
| 2-way catheter | Routine bladder drainage. One drainage lumen and one balloon lumen. Use the smallest suitable size under local policy. |
| 3-way catheter | Clot retention or bladder irrigation. For haematuria with clot retention use a 22–24 Fr three-way catheter under the local pathway. |
How to insert
- Position the patient; clean and drape using aseptic non-touch technique.
- Instil anaesthetic/lubricant gel according to local policy and allow it time to work.
- Advance gently. In a male patient, advance to the catheter bifurcation before balloon inflation.
- Confirm the catheter is in the bladder. Inflate the balloon with sterile water using the volume printed on the catheter.
- Connect the drainage bag, secure the catheter and record type, size, balloon volume, urine and residual volume.
- For a 3-way catheter, only start manual washout or irrigation after position is confirmed and according to the agreed haematuria pathway.
If it will not pass
Do not force the catheter and do not make repeated traumatic attempts. Stop, document what was tried and call the Surgical SHO/Urology team.