How to decrease pain during foley cath or straight cath procedure

@Love_2_Learn: Excellent advice! The breathing technique you mention works brilliantly, not only for cath removal but for cath insertions and any procedure where there will be a few seconds of pain/discomfort like injections, starting IVs, etc.

I was taught to (and do) always use lidocaine gel. One syringe for females and two for men (anatomical reasons). Always give it a couple of minutes to take effect before inserting catheter. Some times we have to cause our patients pain in order to help them but if at all possible (like in this case) I believe that it should be avoided.

While this procedure might not be very painful or uncomfortable for some people, others find that it is. With an easy remedy available, I see no reason not to use it.

I had a catheter when I had surgery and it didn't hurt at all when the nurse removed it the next day. I also had one inserted while I was awake for a urine sample and they didn't hurt.

I think breathing techniques work exceptionally well. They are atleast better than just doing it. I also think it's helpful to explain that it will be uncomfortable. I have used the urojet gel before and it does seem to work well if you give it time. I wish we did have a standing order for it. And on a side note, I was taught to always always always insert the Foley all the way to the hub to be sure you don't inflate the balloon while it's in the urethra. The tubing curling in the bladder isn't harmful. Always clean the patient afterwards as well. We miss that step sometimes but the lube staying there is uncomfortable too.

Well, it's probably best to look at research first. A very well done study on lidocaine and catheters published in 2005 found that a wait time of 15 minutes was required for success. More recent studies have looked at lidocaine and shorter wait times and found no reduction in pain. So, use lidocaine and leave it in the urethra for at least 15 minutes. The problem is keeping it in--there are clamps that can be used that are not painful, but you can use a sterile gloved finger over the meatus--make sure you have a chair handy. Or have the patient cover the meatus with a sterile gloved finger. Also, do the procedure slowly and remove the catheter slowly. And stop when the patient tells you to or shows signs of pain. Some patients (also verified by research) find the procedure almost unbearably painful.

"Attention to his privates?" "Prolonging the procedure?" Wow!! This is basic lack of empathy.

"Attention to his privates?" "Prolonging the procedure?" Wow!! This is basic lack of empathy.

To what are you referring?

Even without lido the key to a comfortable insertion on men is lubrication. After you have adequate lube to fully coat the catheter, inject(slowly) 1-2cc directly into the meatus. Make sure the member is held straight and at a 90deg relation to the body. If you hit resistance as you pass through the prostate, pull up GENTLY on the member- directly away from the body- this will provide better alignment of the urethra to the bladder through the prostate. Slow steady pressure is most effective to pass a tight insertion.

Well, it's probably best to look at research first. A very well done study on lidocaine and catheters published in 2005 found that a wait time of 15 minutes was required for success. More recent studies have looked at lidocaine and shorter wait times and found no reduction in pain. So, use lidocaine and leave it in the urethra for at least 15 minutes. The problem is keeping it in--there are clamps that can be used that are not painful, but you can use a sterile gloved finger over the meatus--make sure you have a chair handy. Or have the patient cover the meatus with a sterile gloved finger. Also, do the procedure slowly and remove the catheter slowly. And stop when the patient tells you to or shows signs of pain. Some patients (also verified by research) find the procedure almost unbearably painful.

15 minutes of standing at the bedside...when I could use that time to pee myself? Nope. Compassion is one thing, but I have needs too.

Here is what a urologist taught me:

Lots of lube or lido gel.. I was taught to inject the lido gel into the meatus and wait a few minutes. Never never check the balloon. That is an old practice from when foleys were made of rubber. The new ones are made of some kind of plastic. When have you ever seen the balloon break anyway. It is not going to cause harm even if it is defective.

When you check the balloon with air and deflate it that leaves sharp ridges on the foley. That is the source of the discomfort.

Some men have a very narrow urethra and the 16 Fr catheter causes very real irritation and pain. Change it to a 12 Fr foley and that fixes that.

Great advice ladies. I graduated about 1 year ago and I am still learning so much everyday!!!

also tell the pt to breathe and don't bear down.