Inserting IDC

Foley catheters, as we call them stateside, are usually placed by the nurse caring for the patient, unless there are specific issues with a particular patient, such as age, etc. Some units will have the female nurses do the caths on the female patients and the make nurses do the males.........

If you have never inserted one before, then it would be best for you to watch someone do the procedure first..............you will feel more confident, or just have a more seasoned nurse go with you. Depends on your comfort level as well.

It's up to you whether you want to watch first and then do, or just go right ahead and do. I started out doing female foleys, and when the time came to do a male foley, I just went ahead and did it. The only thing that can be different than a female foley insertion (other than the fact that there's only one hole you can put it in) is if they're uncircumcised (this guy was, and I had never seen an uncircumcised member before, but I just used the procedure as it was explained to me in training) or if they have an enlarged prostate, it might be difficult to get all the way in. Also, the older they get, the smaller the member tends to be, and it is very hard to really find the urinary meatus amongst all that floppy skin. But it's all about your comfort level. If you feel more comfortable watching first, that shouldn't be any problem.

Years ago I worked on a surgical floor where we had lots of post-op TURPs and we occassionally had to change their foleys (IDCs) because they got clogged up with blood clots which we couldn't flush out. I learned how to do male caths from the surgeon. Here is what I was taught and it works quite well. First, let me say that I prefer insertion kits that include a 10cc syringe that is filled with a water-based lubricant rather than the ones with the small foil package of lubricant.

After cleansing with Betadine you hold the member in your non-sterile hand and pull straight up. You have to straighten that bend in the urethra as much as you can, but don't pull too hard and hurt the guy. The syringe-full of sterile lubricant is injected into the meatus, all 10cc. The catheter then slides in quite nicely, even around the one curve as the urethra is pretty well lubricated. I usually insert all the way to the Y, inflate the balloon with the whole 10cc of sterile water if I've seen urine in the drainage tube and then gently pull the catheter back until I feel the resistance of the balloon against the internal opening of the urethra. I've very seldom had many men complain about a lot of pain when I've cathed them this way, although it is still uncomfortable for them to some extent. The alternative to the lubrication process is to make sure the foley is well lubricated along it's entire length. It does become rather slippery itself as you try to insert it and maintain a hold on it. That is why I like the technique of injecting the sterile lubricant directly into the urethra--you have more control and better hold on the catheter.

I had never thought of this as a way to do a male cath... it makes sense though! Thanks for the tip!