Inserting Foley Cath into Male patient

[cn2007rn]

I have a question about inserting a foley into a male patient:

I am a currently a nursing extern and have inserted a foley into 2 males patients, both patients I hit the prostate and could go no further (hit resistance). I pulled back a little but when advancing the cath I hit resistance again. I was told there is one spot where the cath can go into the prostate area and will not be advanced into the bladder.

I am wondering how to avoid this, in school they tell you it's easy, it's one hole, but in real life I haven't had urine come into the tubing yet!!

Thanks! :)

[leslie :-D]

i still hesitate when having to cath a man over 50, knowing his prostate will likely be enlarged.

if you have access to a coude catheter, use it. it has a rounded tip which enables probable access to the bladder outlet.

also if the pt has a uti, make sure he has been taking abx for a couple of days, to ensure decreased inflammation/swelling of adjacent structures.

if you still have problems, please, get urology involved.

i've had doctors who have traumatized a males' urethra from literally ramming a catheter through.

the urology dept will have assistive devices to enable catheterization.

much luck, to you and your male pts! :)

leslie

[TazziRN, RN]

Try using a sterile tube of lido jelly and the insertion tip, squeeze some into the urethra directly. Then, when you reach the point of resistance, tell the pt to take a deep breath and bear down slightly like he's trying to go. If that doesn't work, try the same thing with a coude.

[Crocuta, RN]

In addition to the other suggestions, a couple things have helped me - grab the member and pull it tight toward the toes and then down toward the sheets. I've found that this position gets things nice and straight. When you hit the resistance, use your insertion hand to start twisting the catheter as you apply slight insertion pressure. Within 1/4 to 1/2 of a rotation, the cath tip finds the right spot to slip through.

Don't be afraid to stop advancing and let the patient take a few breaths and relax. It's amazing how much us dudes can clamp down when you come at us with a torture device.

[banditrn]

In addition to the other suggestions, a couple things have helped me - grab the member and pull it tight toward the toes and then down toward the sheets. I've found that this position gets things nice and straight. When you hit the resistance, use your insertion hand to start twisting the catheter as you apply slight insertion pressure. Within 1/4 to 1/2 of a rotation, the cath tip finds the right spot to slip through.

Don't be afraid to stop advancing and let the patient take a few breaths and relax. It's amazing how much us dudes can clamp down when you come at us with a torture device.

Crocuta - I know exactly what you're saying, but the way you described it, it sounds brutal.:roll

Tazzy, I was taught to do the same thing, but with KY.

[TazziRN, RN]

Tazzy, I was taught to do the same thing, but with KY.

KY doesn't do anything to numb the tract.

[TazziRN, RN]

It's amazing how much us dudes can clamp down when you come at us with a torture device.

*snort*

:rotfl: :rotfl: :rotfl:

[annmariern]

I found the opposite, pulling the member toward the body to help.

[MereSanity]

We were always taught when that happens to "shift down"...lower the member to a more horizontal position.

[cn2007rn]

Thanks for all of the replies!!

Straightening the member does make a lot of sense, I will be sure to try this techique next time. Poor guy! haha!

[SteveNNP, MSN, NP]

gaaaaah.... all this talk of pulling it this way and pushing it that way is giving me the willies!

BTW, The catheter is restricted by the enlarged prostate pressing on the urethra. There's no way you could push the catheter into the prostate. There's only a small duct, not really a passageway.

Good Luck!

[Lisa CCU RN, RN]

Bump.