Other than UTI, any other reasons foley leaks?

systoly · Oct 18, 2011

kinked or occluded tubing

allnurses Guide · Oct 19, 2011

Gotta be useful somehow :)
(and humor helps )

You are! :):):)

Humor is essential!

dishes, BSN, RN · Oct 19, 2011

dishes, the only problem is, in our hospital, we have 1 -- count'm, ONE -- urologist. And he's supposed to be retired ( he's about 105, we joke, "gee, were there kidneys when you went to medical school?"). You call him about a leaky foley, OMG, it doesn't bear thinking about.
What I'd do: First, first, first is the catheter actually in the urethra? Yes, I've had a prior shift try to drain a uterus. Not pretty.
1) check the balloon. How much water's in there, deflate, advance, reinflate to proper size. Look it over from one end to the other. Is it kinking? Are the person's thighs so big they are occluding the catheter? Try to flush it and see if you get back what you put in, or if it shoots out -- if it does, the catheter may be "U" shaped, holding the urethra open enough to leak, enough to catch a little urine, but not doing the job.
2) What's the size? Is this a woman who's had 10 kids, a guy with a long standing catheter? Go up a size if it seems appropriate.
3) Get a bladder scan. We actually had a shipment of bad catheters, and they just weren't draining because the holes were too small. If the person's got 800 in their bladder, that's a good reason for it to leak.
4) Is it really urine? Where's it coming from? I had a patient who actually was "double barrelled" -- she had an opening in the lady parts, and one in the bladder. Somehow, thru the gift of some seriously weird anatomy, she could "pee" out of her lady parts, despite the presence of the catheter.
5) tell the person to relax their bottom like they were going to urinate. I've had folks who must have been doing the "sphincters of steel" videos, because they could clamp down and completely occlude the catheter. When I got them to relax, the urine flowed like a river.

Re point #4, it may not have bern weird anatomy but an unfortunate result from a hysterectomy, as this type of leaking can happen when a woman has a fistula.