Nurses General Nursing
Published Mar 24, 2015
dudette10, MSN, RN
3,530 Posts
I don't mean to make it sound funny, but there is just no other way to describe it. The men are usually obese with dependent edema, the scrotum is very large, but the member is nowhere to be found, although the urethral opening is evident. There seems to be no structure to the urethra, so it's difficult to advance more than an inch, and you're not sure which direction to apply force on the catheter.
i tried making a circle with my "dirty" thumb and forefinger, then press down around the urethra, but that still didn't help. Any tricks to this?
EmergencyRN22
113 Posts
I just grab it the best I can and go for it. Usually use lido jelly in those types to ease their pain. I've seen men have to be sedated for foley placement. Maybe use a coude catheter?
perhaps urology consult?
ChellyFutureNP
75 Posts
I would suggest a urology consult.
Caffeine_IV
1,198 Posts
I try to have an extra person that can really grab and tug whatever is there as straight as possible and go for it.
calivianya, BSN, RN
2,418 Posts
Having an extra set of hands to mash down around the opening to see if you can get the member to pop out is always helpful. If that doesn't work, I agree with getting a urology consult. If you can't get a hold of the member itself, all you're probably going to be able to do is fish around aimlessly and make the patient uncomfortable for no reason.
jadelpn, LPN, EMT-B
9 Articles; 4,800 Posts
Urology consult--
Extra set of hands.
Sometimes placing a urinal under the opening to the member will encourage just enough for you to be able to advance a cath. I wouldn't use a coude cath, as the risk for trauma is too great with an inverted or semi-inverted member, so if the urologist wants to have a go, by all means, have at it then.
If you can use your resources, and urology is not available, those nurses in the OR are the foley queens!! Swear they can get a foley in anyone pretty effortlessly. See if one of them will come to you.....
Nurse SMS, MSN, RN
6,843 Posts
You can put the patient in Trendelenburg, if they don't have a health condition that makes it unsafe, combined with an extra set of hands or three.
RNsRWe, ASN, RN
3 Articles; 10,428 Posts
Just an aside, but I both grimaced and laughed at this description, and thought "wonder how many fellas reading this are groaning and reaching to protectively cover their pants about now?
Farawyn
12,646 Posts
How can you NOT click on this?
We call this phenomenon "turtle-ing".
I agree with all the above posters. Coax a bit and if no go, call uro.
I hate cathing males. I always feel so bad.
Once had a fella describe it to me as "a broomstick coated in shards of glass shoved up..."
Glad it wasn't me who had done it.....but he said it was like that every time, no matter who did it.
Just OUCH.
Thanks for the responses!