Foley Catheter Issue?

Updated:   Published

So, the other day, with the help of a coworker, I successfully placed a Foley catheter into a male for the first time...or, did I?

My coworker had me keep inserting the catheter into his member until we got urine return. When we saw urine output, we inserted the syringe to inflate the balloon. What I noticed was that, although we were able to insert about 10cc into the catheter, it was a little difficult to do so. I'm not sure if it is because I wasn't used to the amount of pressure needed to insert fluid, or if there was something else going on.

Anyway, we get the catheter inserted, and urine is draining. Urine is yellow and clear with no order. In a couple of hours, his entire leg bag is more than half full.

However, the patient also complained that the new catheter felt like it was "burning." I consulted with a couple of other nurses, as to what may be going on, and they didn't have much of a comment. They said the discomfort was likely due to having the catheter being changed, and that the previous one hadn't bothered him because he'd gotten used to it. They also did not have any good suggestions as to what may help relieve the patient's discomfort. However, one of the nurses thought it possibly could be the material on the catheter causing the discomfort. I don't remember if the catheter had latex in it, as my coworker selected the catheter for me to use. At the same time, I did look at the patient's chart and he wasn't known to have any allergies.

Anyway, there were no supervisors around, so, because it was draining well, I left the catheter in for the oncoming nurse to take a look at. Initially the oncoming nurse didn't seem too concerned about it either. Also, I did see the patient get up and start ambulating, so I'm wondering if he was actually in that much pain.

Needless to say, without any good answers, it's been bothering me a bit. Any ideas of what may be causing the problem?

1
Up Vote Up Vote ×
Specializes in Nurse Leader specializing in Labor & Delivery.

Irritation, allergic reaction, beginnings of a CAUTI?

1
Up Vote Up Vote ×

Seems like it would be irritating all on its own. It's not meant to go there, after all. Most of the individuals I've put catheters in were too "out of it" to complain, but many/most post op patients complain of some burning after catheter removal.

Up Vote Up Vote ×
Specializes in Emergency, Telemetry, Transplant.

Does your facility use betadine to cleanse prior to insertion? The first time I inserted a Foley, the pt experienced a lot of burning because I did not allow the betadine to fully dry--lesson learned on that one.

1
Up Vote Up Vote ×
psu_213 said:
Does your facility use betadine to cleanse prior to insertion? The first time I inserted a Foley, the pt experienced a lot of burning because I did not allow the betadine to fully dry--lesson learned on that one.

Yes, we do and this could be a possibility. I'm not sure I remember how long I waited before cleansing with betadine before inserting the catheter. How long does it typically take to dry/would you recommend waiting?

1
Up Vote Up Vote ×
klone said:
Irritation, allergic reaction, beginnings of a CAUTI?

All possibilities, but am unsure because I didn't see any redness in the site area and the urine was clear, yellow with no odor.

1
Up Vote Up Vote ×
Sour Lemon said:
Seems like it would be irritating all on its own. It's not meant to go there, after all. Most of the individuals I've put catheters in were too "out of it" to complain, but many/most post op patients complain of some burning after catheter removal.

Hmm, okay, good to know.

1
Up Vote Up Vote ×
Specializes in LTC, assisted living, med-surg, psych.

I get nasty bladder spasms when I have a Foley in. The only thing that helps me is Pyridium.

1
Up Vote Up Vote ×
Specializes in Nurse Leader specializing in Labor & Delivery.
JustANurse2018 said:
All possibilities, but am unsure because I didn't see any redness in the site area and the urine was clear, yellow with no odor.

That doesn't mean that that's not it. The irritation and allergic reaction would be inside, not visible externally. And not all UTIs cause an odor or cloudy urine.

1
Up Vote Up Vote ×
Specializes in Emergency Department.

Just a couple of observations. One is that when inserting a catheter into a male, even if you get good urine return, keep going just a bit. The male urethra is very long compared to the female urethra so you want to nearly bury the entire length of the catheter. This is because the islets for drainage are before the balloon. The islets will be well into the urinary bladder and draining before the balloon has completely entered the urinary bladder. So, when you start getting urine return you want to advance the catheter about another 5-7 cm... just like you would in a female. The resistance you felt when inflating the balloon could have been part of the balloon basically wedging itself out of the urethra into the urinary bladder. That would lead to a little stretching of the urethra, possibly without tearing it, and this could very easily cause the discomfort you describe as part of the balloon could be either wedged into the urethra or it could be actually free from it but gave a little stretch in the process.

Also, I've noticed that sometimes people do complain about some discomfort from the catheter being present in the urethra. This discomfort can be the patient feeling like they have to pee or it can be a bit of a mild irritation simply because the catheter is there. The urethra is flexible and the diameter likely varies a bit so if the urethra doesn't want to be a 16F size but perhaps is most comfy at a 14F or a 12F even thought it will accommodate a 16F, that is also a potential source of irritation.

It is good to know that pyridium does help with foley catheter discomfort. I'm going to keep that in mind for the future... and suggest that to the providers if/when my patients experience some significant catheter discomfort. I knew there was a reason I opened this thread... ;)

1
Up Vote Up Vote ×

My biggest concern is that you state that you inserted the foley until urine return and then inflated the balloon. I was always taught that you insert the foley until the "Y", inflate the balloon and then allow the foley to drop until resistance. If the balloon is inflated in the urethra it can cause discomfort and ultimately ischemia of the tissues. Sometimes men do have bladder spasms, but they are not that common. I once inserted a foley and it actually looped around in the urethra. The urologist said it was not a common occurrence, but it does happen. Prior to that I always thought that foleys in men were the easiest because you can see the urethra, and there is only one hole. Now I take my time to make sure it is inserted properly every time..

Best of luck!!!

1
Up Vote Up Vote ×
Specializes in Critical care.
VivaLasViejas said:
I get nasty bladder spasms when I have a Foley in. The only thing that helps me is Pyridium.

Ditropan can be used for bladder spasms too. Also, if they are really bad a B&O suppository.

1
Up Vote Up Vote ×
+ Add a Comment