straight cathe

xoemmylouox, ASN, RN · Sep 25, 2009

Are you sure that you went far enough? With males you can hit their prostate and you may think that you made it to his bladder, but in fact it was just his prostate. If this happens have him take a deep breath and when he exhales slowly try to get past that darn prostate.

lwd338 · Sep 25, 2009

Do you feel the cath turning back on itself right about the prostate area?? sometimes there is a narrowing and the cath cant pass so it doubles back on itseld, use a smaller cath if you have one. when you hold the member hold it straight up and keep trying to pass it past the prostate. is he incontinent ?? place a texas cath on him and collect a spec that way so as not to induce trauma and then he CANT pee at all) good luck ;-)

BluegrassRN · Sep 25, 2009

I would rather cath a woman than a man any day. If they are having problems voiding, it's often a prostate problem, and then it is difficult to get the cath past it.

Also, you really have to bury that catheter. I've inserted caths where I had it buried all the way to the 'hub" before I got return.

Do you have lidocaine jelly that you can use to ease the insertion? We have Urojet, which is a lidocaine jelly that we use in cath insertions on pts not sensitive to lidocaine. I don't know if the lidocaine actually helps much, or if it's the pt just knowing that a topical numbing agent was used, but it seems to relax the patient and little and help ease insertion.

Unless that patient was BONE DRY or in total renal failure, I think you probably just weren't in. Do you have access to a bladder scanner?

husker_rn, RN · Sep 25, 2009

I agree that maybe you had trouble because of prostate narrowing. Had an ICU nurse teach me a neat trick; put the catheter in a freezer for a short while. The catheter will be slightly firm { no pun intended } and may allow you to get past the prostate easier.

jnrsmommy · Sep 25, 2009

I had a similar experience the first 2 male caths I had to do. Turned out, both of these guys had fistulas that were not known about, and I was just "lucky" enough to get the caths in there.

RNKPCE · Sep 25, 2009

I have had to go all the way to the hub before especially on men.

ChristyRN2009 · Sep 25, 2009

I agree, try to advance it as far as the hub. The second trick I know of that most of the time works with prostate issue caths is to (while the cath is inserted until resistance but no urine return) lift the scrotum and apply massaging pressure behind the testes. Sometimes you can even feel where the cath is, and I'm not sure if it actually manipulates the cath externally or relaxes the muscles around the urethra but it seems to work. Obviously if this doesn't work after 30 seconds you might just have an impossible cath.

dishes, BSN, RN · Sep 26, 2009

If you did not get any urine back, you were not in the bladder, a catheter can meet resistance for a number of different reasons such as urethral stricture, enlarged prostate, tight sphincter, these can best be diagnosed with a cystoscope by a urologist.

It could also be, that the angle you are holding the member when you insert the catheter is the problem. Some people try to insert the catheter with the member pointed down towards the catheter tray, but since the member has curves the catheter will meet resistance from this position. The member needs to be held at an upward angle to insert the catheter and lowered to drain the urine.

There are lots of instructions with images of the upward angle recommended for inserting a catheter in a male. Here is one link that shows it.

http://www.cnca.ca/PD%201488%20Intermittent%20Cath%20book.pdf

dishes

summerrose_10 · Sep 26, 2009

what a great link from dishes. thankyou for that.:redbeathe

yahaira2121 · Sep 26, 2009

Thank you to all of you who replied....i got really good suggestions and advice.

HM2VikingRN, RN · Sep 26, 2009

That angle of the dangle....