Foley catheters and erections | allnurses

Foley catheters and erections

  1. 0 On occassion in the OR, when catheterizing a male patient, the pt becomes erect. My nurse manager says we cannot put a foley into an erect penis. All the surgeons and other nurses I work with say to continue with the catheterization and that the erection facilitates the process.

    I am trying to find evidence supporting either one of these statements or both.

    Any ideas?
  2. Visit  inspir8tion profile page

    About inspir8tion

    48 Years Old; Joined Apr '05; Posts: 159; Likes: 13.

    14 Comments so far...

  3. Visit  kathgail profile page
    0
    as what ive known in our lecture,since im still a junior nursing student, it is better to insert the catheter to an unerected.if ever the penis erects,we place cold packs on the base of the penis..
  4. Visit  mvanz9999 profile page
    0
    Question from peanut gallery: Is insertion painful for the patient?

    Sorry for the O/T post.
  5. Visit  inspir8tion profile page
    0
    The patient is under anesthesia, so don't know if it is painful.

    Can anyone point me to some literature on the subject (for or against)?
  6. Visit  brewerpaul profile page
    2
    Geez-- just the thought of a Foley would make me lose mine ;-)
    scoacrafter and Spikey9001 like this.
  7. Visit  heather2084 profile page
    0
    we dont put foleys in until the pt is out....saves work on us and a LOT on the pt
  8. Visit  inspir8tion profile page
    0
    In the operating room, we do not put foleys in patients until they are under anesthesia.
  9. Visit  brewerpaul profile page
    0
    Quote from inspir8tion
    In the operating room, we do not put foleys in patients until they are under anesthesia.
    At 56 y/o, with a touch of BPH, I find that comforting...
  10. Visit  juan de la cruz profile page
    1
    From a clinical medicine video (available only to on-line members) and an article in the New England Journal of Medicine, "Male Urethral Catheterization", Volume 354:e22, Number 21, May 25, 2006:

    Absolute contraindications for male urethral catheterization:
    Confirmed or suspected urethral injury such as a patient with pelvic injury or fracture. Physical findings include blood at the meatus, gross hematuria, perineal hematoma, and a "high-riding" prostate gland.

    Relative contraindications for male urethral catheterization:
    urethral stricture, recent urethral or bladder surgery, and a combative or uncooperative patient.

    None of the above states that penile tumescence is a contraindication. This physiologic response does not cause narrowing of the urethral passage. Remember how we have to hold the penis straight and perpendicular to body's plane to straighten the natural S-shaped curvature of the urethra as it begins from the meatus to the bladder sphincter and ease the catheter's insertion.
    The same concept applies with penile tumescence, this physiologic response straightens the urethral passage and can actually help in facilitating insertion of the catheter. Since the patient is already anesthetized, that is even better as the patient feels no discomfort.
    GadgetRN71 likes this.
  11. Visit  Spidey's mom profile page
    0
    Quote from mvanz9999
    Question from peanut gallery: Is insertion painful for the patient?

    Sorry for the O/T post.
    In the ER, I use lidocaine jelly for insertion.

    In the OR, they wait until the patient is under anesthesia.

    I've never had to insert a foley into an erect penis - and I've inserted alot. My dh says just the idea would keep him from having any reaction except maybe shrinking testicles.

    steph
  12. Visit  inspir8tion profile page
    0
    Thank you for the great response! I really appreciate it.

    Quote from pinoyNP
    From a clinical medicine video (available only to on-line members) and an article in the New England Journal of Medicine, "Male Urethral Catheterization", Volume 354:e22, Number 21, May 25, 2006:

    Absolute contraindications for male urethral catheterization:
    Confirmed or suspected urethral injury such as a patient with pelvic injury or fracture. Physical findings include blood at the meatus, gross hematuria, perineal hematoma, and a "high-riding" prostate gland.

    Relative contraindications for male urethral catheterization:
    urethral stricture, recent urethral or bladder surgery, and a combative or uncooperative patient.

    None of the above states that penile tumescence is a contraindication. This physiologic response does not cause narrowing of the urethral passage. Remember how we have to hold the penis straight and perpendicular to body's plane to straighten the natural S-shaped curvature of the urethra as it begins from the meatus to the bladder sphincter and ease the catheter's insertion.
    The same concept applies with penile tumescence, this physiologic response straightens the urethral passage and can actually help in facilitating insertion of the catheter. Since the patient is already anesthetized, that is even better as the patient feels no discomfort.
  13. Visit  fuzzball7 profile page
    0
    I would get an erection
  14. Visit  GadgetRN71 profile page
    0
    Believe it or not, I've never had this problem arise(wink) when it came time to put the foley in. I've had a few male patients get erections before they are put under, but we just deal with it professionally and try not to cause undue embarrassment for the patient.


    No, my problem seems to be either males with strictures, males with unruly and wily foreskin and once in a while, the penis that plays hide and seek. This is usually in a very obese male patient.

    All I know is, I'm grateful that we don't put foleys in under pts are asleep. Both for their sake and mine!


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