Foley insertion on a male patient

[divaRN*]

Now I know the general technique to place a foley and have done this many times. Where i run into a problem is with BPH or strictures. What are some tips on how to advance the catheter into the bladder. Any specific position? Movement of the catheter? And has anyone heard of a foley becoming coiled in the testicles? I have never heard of it until recently when another RN was describing a difficult cath. Any advice on how to deal with the difficulties that arise with male catheterization would be greatly appreciated!

[lovescoffee]

RH-CC2011, I know it sounds funny, but after working ER & ICU, the "reach for the sky" method (shall we call it) really does help! I'm in CRNA school now and we've learn all about aligning axis, so if you think about it, it aligns and allows gravity to be your friend! lol Also, the deep breath, lube, and lidojet/urojet are helpful! And you definitely CAN feel it coil in the testicles. As awkward as it may be (esp. at first) go ahead and feel for it. Learn what it "should" feel like/the norm, and then always check there with a difficult cath! Practice is the key!

GOOD LUCK!!!

[cherrybreeze, ADN, RN]

Have never felt a cath coil in the testicles. Bunch up in the urethra, yes.

[MrWarmHearted]

agreed with the above on coude and lido if possible. Also if you have an extra set of hands, try having the other person hold the member and the testicles up as you insert

[P_RN, ADN, RN]

I always put the curve point down. When meeting resistance, slowly rotate it. while asking him to cough forcefully. You can ask the doc if you can insert some lidocaine gel with a slip tip syringe (not a luer lock) that will lubricate and give some topical anesthesia to the meatus and urethra.

[canesdukegirl, BSN, RN]

Have never felt a cath coil in the testicles. Bunch up in the urethra, yes.

Agreed, cherry. It is impossible to coil a catheter in the testicles.

[lovescoffee]

I'm sorry, I guess my terminology was incorrect.... What I should have said was that the cath coils in the urethra and can be felt in the scrotum upon palpation. This is due to the cath not being able to pass the enlarged prostate. Personally, if I have inserted a foley (without resistance, never force it) and am not getting urine output, I will feel there first. This lets me know if I've coiled.

Also, once inserted but not getting output, pressing downward on their stomach a little sometimes helps. In ICU we had a lot of incontinent/oliguric pts so getting an instant nice yellow flow to confirm placement was out of the question.

Hope this sounds more correct....

[diabo, RN]

So glad I don't need one......................yet:crying2:

[divaRN*]

haha this is why i did not understand what she was talking about! just wanted to make sure i wasnt missing something....

[divaRN*]

Coiled in the testicles??? Check your anatomy book, please!!!!

Also, I have gotten orders for lidocaine gel, and used plenty of it, when there was a difficult placement.

haha this is why i did not understand what she was talking about! just wanted to make sure i didnt miss anything in anatomy class...

[4_Sq]

When catheterizing any patient, one of the best suggestions is to use lots of lubricant, (try not to block the catheter lumen however)

Never inflate a catheter balloon unless you get urine back.

If you feel resistance, do not increase pressure, you do not want to create a false passage

In BPH, you may want to choose a slightly larger catheter (for the stiffness) but call a urologist rather than creating a life long problem for the patient.. remember, despite what you may have been told, catheterization is a sterile procedure, and sterile technique must be followed..

A coude catheter may negotiate the curves better in a male patient, but make sure (as mentioned previously, some facilities require a Dr. order for it.

NEVER BE AFRAID TO CALL A UROLOGIST!!!:igtsyt: