Traction Foley s/p cystoscopy? Ouch?

[stellina615]

Hi all,

Still studying for the NCLEX and have again encountered something in my study materials that I haven't encountered with a pt yet. This question is asking about a cystoscopy in which the pt is experiencing bleeding afterwards, and then mentions something about applying traction to a Foley. There is no further explanation about how this is done, and the only thing I can imagine in my mind is inflating the balloon and then the nurse just standing at the foot of the pt's bed tugging on it for awhile, or the doc adjusting some kind of horrible bladder traction weight. This also sounds like it would hurt a lot...maybe not relative to a stone, but still! Can someone help me understand what is meant by Foley traction and how it's done? Thank you!

-Erin

[cherrybreeze, ADN, RN]

Traction is done with tape...the foley is "pulled" (not CRANKED on, but enough to let the balloon apply some pressure to the base of the bladder) and then taped to the leg (often with a LOT of tape ). It's most often done following prostatectomies, and left in place for a day or so. From my experience, it doesn't tend to bother patients much more than the catheter itself would. Also, it is usually only done with a foley that has a large capacity (30cc balloon), a small one wouldn't make much difference.

[stellina615]

Thank you Cherry! That makes a lot more sense to me than the weird Buck's bladder traction setup I had devised in my mind :)

[cherrybreeze, ADN, RN]

Glad that helps...just picture the foley tubing taped like crazy to the patient's leg, without much slack on the cath, and that's what you've got (I tried to find a pic, but I couldn't). We use it much less than we used to, with the advancement of robotic procedures, etc, patients tend to have less bleeding post op. We also now RARELY see a CBI, whereas we used to have them all the time (NOT upset to see them go, haha!).

[roser13, ASN, RN]

"We also now RARELY see a CBI"

Uh oh

Still seeing lots of CBI's where I work. Maybe 50% of TUR P's and BT's. Wonder if our surgeons are behind the times?!

[cherrybreeze, ADN, RN]

"We also now RARELY see a CBI"

Uh oh

Still seeing lots of CBI's where I work. Maybe 50% of TUR P's and BT's. Wonder if our surgeons are behind the times?!

Hm, I'm not sure....all I can say is that where I am, they're a rarity (when I started 8 years ago, EVERY prostatectomy had one!). They only use them now if someone really has some serious bleeding issues post op, or gross hematuria that is undiagnosed, etc.

They were on their way out well before our facility started doing robotic prostatectomies, but since then they've gone down even further. They are doing more with holmium laser, I know that, and that seems to have made a difference as well...