foley catheter

Sounds like it wasn't positioned properly. Did the person who inserted it have a return?

I would have drained the balloon and repositioned the foley, then reinflated. Currently we don't irrigate a catheter but remove and put a new one in. Theory is irrigation results in extra bladder infections.

I would think the best person to explain to you what happened here is the RN you were with at the time.

This is just my thought from what you have described - perhaps the balloon wasn't fully inflated and the catheter slipped out from the bladder and was part way in the urethra? This would explain the pt's feeling of urgency. Then maybe when the RN repositioned it, she relocated it back into the pt's bladder, thus restoring the flow?

As I say, just my thoughts from how you describe the event.

(Not something I would advocate, by the way)

If I had 800 cc's of urine in my bladder, I'd feel urgency too!

No, wait. Make that "desperation." (Where's the sweating smiley?)

Occasionally the rubber of the foley inside the bladder softens a bit with constant contact with urine. Sometimes with repositioning the patient and the patient moving around the tubing can get kinked or twisted within the urethra causing the blockage and catheter not to drain. Gentle manipulation and a change of position may be just enough to get the catheter to twist back into proper position to drain. Think of a rubber band being twisted,, it wants to bounce back into a more natural position when you let go of it correct? The same process is done when you let the water out of the balloon,, you release the tension and it springs back into position,, then you reinflate the balloon with the water. Either process gets the same result

As a forinstance.. I had a patient TVH/anterior repair who had an order to remove foley this am. Patient had complained all night of pain, given nubain IV, foley appeared to be draining fine.

When i took it out this morning, the bulb was obviously bloody,, and patient got up and immediately urinated 600ml. Poor girl was so uncomfortable all night,, if someone would have just taken the water out of the balloon,, tried to reposition foley in the bladder,, she might have had a better night.

Since foleys work by gravity, they will not drain properly if the tube is compressed/kinked, if the pt is lying on part of the tube, or if the pt is in a position that does not easily facilitate drainage. And if it cannot drain, the pt will definitely have that sense of urgency.

Also consider that foley insertion accounts for a lot of nosocomial infections, so that urgency (even with a properly draining foley) can be s/s of a brewing UTI.

I've seen that happen all the time. The tubing isn't kinked and the patient isn't lying on it. Sometimes a just picking up the tubing and moving it a few inches seems to be all it needs to get the urine flowing. I wonder if it just gets adhered to the bladder wall and then just moving the tubing moves it enough so the bladder drains.