Xylocaine for foley catheterization in males

[deannaZ]

I am working on a new policy for catheterization in my hospital. We are currently debating whether or not to ROUTINELY use Xylocaine for every catheterization on a male. I cannot find anything definitive in the literature. I know that Xylocaine is often used. I checked with the two tertiary urology wards where the nurses catheterize males quite frequently, including males with prostate disease, who tell me that Xylocaine is not routinely used due to the risk of urethral injury/creation of a false pasage/fistula etc. They tell me that 10 cc of muco in the catheter is as effective and decreases the risk of injury, due to the loss of sensation during catheterization.

Can people tell me what is routine practice and in the policies of your facilities?

Thanks!

[Sarah, RNBScN]

We use xylocaine 2% gel aka: UROJET. Our urologist recommends it.

[chartleypj]

We use urojets too.

Paula

[Dave ARNP]

Any male cath = Urojet.

You grab both when you go to do a cath.

And after my episode of retention that got me a cath... Urojet is a God send!

Dave

[VivaLasViejas, ASN, RN]

I wanna know how come we girls don't get the "numby stuff" for cath insertions? It doesn't exactly feel good to us, either......

BTW, I routinely use lidocaine jelly for cath insertions on males.

[FutureRN~Pookie]

Originally posted by mjlrn97

I wanna know how come we girls don't get the "numby stuff" for cath insertions? It doesn't exactly feel good to us, either......

I was wondering that also.

Kacy

[Mimi2RN, ASN, RN]

At our facility, ambulatory surgery patients had to urinate before they were allowed to go home. One man, post hernia repair, tried and tried but couldn't go.

I called the doc, and he ordered in-and-out cath. When I told the patient, he became very agitated. "What can I bite on?", he cried. I gave him a wash cloth, which he kept in his mouth until it was over. I drained several hundred cc's from his bladder, he felt much better, and was able to go home.

[Rae Mayer]

I am currently devising an order set/policy for the urojet in the hospital I work at. Do you have a policy and or order set for the urojet?

[caroladybelle, BSN, RN]

I wanna know how come we girls don't get the "numby stuff" for cath insertions? It doesn't exactly feel good to us, either......

And could we come up with a better way of doing mammograms, too.

[LeesieBug]

Hadn't you heard? Women don't feel pain.... its all in their heads!

Sorry.....I have just had too many experiences with bad doctors telling me or family members that we are just "stressed" or that we are "exaggerating " our pain.

[TonyaPacu]

:angryfire I think it sounds like a good idea to use the "numby stuff". At our facility we don't typically use any unless we can't get the catheter in and the urologist uses it himself.

[TMnurse]

It is a good idea. I have some thoughts. I cath patients all the time and also work with urologists who do the same. I would say that it the typical medical model mindframe they NEVER allow enough time to let the local do it's job. Pretty much shoot the jelly and bame! Cath right behind... how can that be effective? I would recommend contacting the sales rep to see if they have info on time/action. Also, I would do a small study of patients immediately post cath and rate thier pain. As a male who has never been cathed, I can't really say. However, I have found that many of our patients seem to tolerate caths really well. Finally, rather than blanket "all male patients get a local jelly" maybe it would be better to determine who typically benefits from local. I.E. patients with uretheral inflammation... or BPH... or UTI. This would likely include you female popluation. Good Luck with this. Perhaps, you could post here again and let us know how this goes.