How far to insert a catheter??

RN403, BSN, RN · Nov 29, 2014

For a male I usually lubricate almost the entire length of the catheter itself. For a female I usually lubricate the first 2 or 3 inches of te catheter.

for both male and female you should insert the catheter until you see urine flowing out. Then advance 1-2 inches further and inflate the balloon.

So when asked how far to insert the catheter it seems that the answer your instructor was looking for is that you advance until you see urine flowing about an then continue another one to two inches before inflating the balloon.

Class09 · Nov 29, 2014

maybe I'm just thinking to hard about it.. thanks for replying !

akulahawkRN, ADN, RN, EMT-P · Nov 29, 2014

If you look at a urinary catheter, you may find that there are eyelets on the side of the catheter and the balloon is just below that. Urethra lengths can vary, so if you think about this logically, you advance the catheter until you see urine flowing pretty well. That means that the eyelets are past the urethral opening in the urinary bladder. The balloon is still in the urethra. So you advance another couple of inches to ensure that the balloon has cleared that same opening before you inflate the balloon.

Inflating the balloon while it's still in the urethra will generally be quite painful and the patient probably won't have very fond feelings for you...

cayenne06, MSN, CNM · Nov 29, 2014

Huh. I only ever lubricate the tip. Generally I squeeze a big gob into the sterile bucket, and kind of dip the catheter in. But then again I only have female patients; I bet it makes a big difference when you are catherizing a male.

General rule of thumb is you advance till you see urine, but it is still important to know the average length of a female/male urethra, so you know something's up if you've advanced 8 inches in a female and aren't getting urine.

Female: 2 inches

Male: 8 inches

rob4546, ADN, BSN, MSN · Nov 29, 2014

Yeah, you are over thinking this. You lubricate the catheter for safety, ease of insertion, or prevent pain, not due to urethra length. I generously glob lube a couple inches and it usually lubes the rest as it is inserted.

Don't force it, for men you might have to twist it a bit and straighten the member... (can I say member on allnurses?). Once you get urine advance until the balloon is in the bladder and then inflate. The length is just a approximation so that you can visualize the amount to insert. Everyone is different.

anh06005, MSN, APRN, NP · Nov 29, 2014

With some men I've even had to insert almost the entire dang thing before I saw urine. I might stop and try the balloon to see if I have resistance or if the pt hurts because, honestly, it's not a 12 inches to the bladder. But I just insert however much until I see urine, inflate balloon, then tug a little to get excess out/get balloon in the right spot.

And I've never had good experiences with women and inserting catheters. I have only ever actually seen the urethra once (something to get excited about!). Otherwise it's a shot in the dark on a hope and a prayer. And many of these old ladies having hip/back/knee issues doesn't help.

Did I mention I don't often cath women anyway? Lol

anh06005, MSN, APRN, NP · Nov 29, 2014

Oh and keep in mind there is "information to pass the test" and "real life nursing" are sometimes quite different.

And if what you think isn't what your instructor thinks is correct ask for clarification. "Well you say this but I think the book says this. Can you clarify?" Whip your book out if you need to. You need to know which is correct for the exam.

Here.I.Stand, BSN, RN · Nov 29, 2014

I'm very liberal w/ the lube myself; I figure too much will only have to be wiped away once the catheter is in, but too little and I risk pain and urethral irritation for the pt. I have no idea why your book says specifically 1-2 inches of lube.

I was taught to advance it 1-2 inches after seeing urine. I honestly don't pay too close attention to how many inches of the catheter is in...unless it's a female with difficult anatomy and I'm thinking it might be in the lady parts (once it's in a few inches and I'm still not seeing urine, that's a clue that it might in fact be in the lady parts.) I just go until I see urine, then another 1-2 inches. People have varying lengths of urethrae, just like we have different sizes of feet; that's why the length to insert isn't an exact science.

NurseGirl525, ASN, RN · Nov 30, 2014

I was taught to lube the first 1-2 inches, insert until you see urine, then advance another 1-2 to ensure the catheter is in to inflate the balloon. Everyone's urethra is a different size, especially men. I think you are over thinking it.

ktwlpn, LPN · Nov 30, 2014

And I've never had good experiences with women and inserting catheters. I have only ever actually seen the urethra once (something to get excited about!). Otherwise it's a shot in the dark on a hope and a prayer. And many of these old ladies having hip/back/knee issues doesn't help.
Did I mention I don't often cath women anyway? Lol

Try turning them on their side and going in from the back (atrophy has made everything droop, it's often really easy to visualize in that position) or place them on their back on top of a fracture pan turned upside down (juts the pelvis up).Also ask them to cough as you wipe with the betadine-the urethra will "wink" at you. Have plenty of catheters available-if you miss just leave that one in place,it will block something (an instructor gave me that tip ) Now back to topic....

RN403, BSN, RN · Nov 30, 2014

Excellent tips, ktwlpn!