Should urine catheterization hurt?

[swellnurse]

Do you do a lot of catheterizations? Especially in-and-out for urine culture?

When catheterizing for a urine culture, should the patient feel pain?

What is your real-world experience?

Do some patients simply experience pain for no explained reason or is there always a reason/cause? (ie, technique, underlying problem)

Is it different based on age or male/female?

[brownbook]

I used to insert foley's prior to C-sections (we have since changed that policy, it is done in OR after spinal), the women hated it. Even with lubricated lidocaine.

Do your "kits" include lidocaine? Are these the small little catheter kits just for cultures or "regular size" foleys?

I don't think technique makes a big difference. Everybody is different. And certainly it can hurt. Some people are just big babies...(joking...it really can hurt!)

[swellnurse]

I'm mainly asking about the small/little ones for cultures. Is that the main difference for pain? French/size?

[classicdame, MSN, EdD]

I think it depends on reasn. If the pateint has irritated tissue in the ureter's from infection or surgery then, yes, it will hurt some.Some people dread it so much that they imagine more pain.

[Esme12, ASN, BSN, RN]

I'm mainly asking about the small/little ones for cultures. Is that the main difference for pain? French/size?

DO you mean small little ones as in patients? Like a pedi population?

It is uncomfortable.....I wouldn't say painful. In my experience men object much more than females and an enlarged prostate will cause discomfort when inserting. In the pedi population they will scream from beginning to end just because they have to be help immobile and not necessarily because it hurts.

[swellnurse]

Thanks, Esme12

That is what I've heard from other nurses who do a lot of caths...particularly peds.

But in literature (up-to-date) and in lay press articles from time-to-time there is a suggestion or down-right statement that catheterization in young kids is painful. Some parents of kids worry when they hear this and when asked say that they had catheterizations that were excruciatingly painful...so they emphatically disagreed that catheterization of their children would not be painful. I don't doubt their experience but want to have/give/share accurate information. Knowing what to say to discern how their experience may have been different (eg, cathing to empty the bladder) would be important.

BTW, I totally agree that there are kids that are more stressed by fearing what might be done to them and just react strongly with the environment (no real pain). One adult woman explained the "discomfort" as being a new sensation with anxiety that it might start hurting.

Thanks!

[ICURN3020]

I dreaded catheterization more than anything when I went into labor. I knew that I would have to have that procedure done as my baby was breech and I was having a c-section.

Personally, I find it to be one of the most uncomfortable procedures ever. I've had a few surgeries and generally have a very high pain threshold but I absolutely hate catheterizations.

[amoLucia]

I don't know if it's the catheter going in that's the issue, or perhaps it might be all the others - particularly positioning. Positioning 'tight' legs and that labial 'spread' has seemed to be more uncomfortable.

[VANurse2010]

I've had one. I'd call it uncomfortable, but not painful. You know what's more uncomfortable? Having 800cc of urine in your bladder!

[MunoRN, RN]

I've had a broken femur reduced and a foley placed one right after another, it was the catheter that hurt the most. Keep in mind you're pushing a foreign object up a tract not made for it through valves meant to keep things from traveling in that direction. The anatomy is different, and shorter, for women, but for men it can be very painful particularly when nurses use only the amount of lubricant needed for a female. Use plenty of lubricant, preferably an entire lidocaine jelly tube and give it a little time to work.

[canoehead, BSN, RN]

I think for some people it's defintiely painful, but for most not. I usually describe it as not enjoyable at all, but not painful, more like getting something stuck up your nose. Then I lube the hell out of that catheter.

[Katie71275]

I've don't plenty of them and my experience has been it causes a little pinching pain and that should go away pretty quickly as you advance the catheter.