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Tricks for putting in Foleys in males whose penises have disappeared.

Has 9 years experience. Specializes in Med/Surg, Academics.

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 penis 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

Specializes in Emergency Room.

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?

Edited by EmergencyRN22
Spelling, grammar

ChellyFutureNP

Has 8 years experience. Specializes in Primary Care, Progressive Care.

I would suggest a urology consult.

Caffeine_IV

Has 7 years experience. Specializes in LTC, med/surg, hospice.

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

Specializes in ICU.

Having an extra set of hands to mash down around the opening to see if you can get the penis 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 penis itself, all you're probably going to be able to do is fish around aimlessly and make the patient uncomfortable for no reason.

Urology consult--

Extra set of hands.

Sometimes placing a urinal under the opening to the penis 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 penis, 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

Has 9 years experience. Specializes in Critical Care; Cardiac; Professional Development.

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.

I try to have an extra person that can really grab and tug whatever is there as straight as possible and go for it.

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

Has 25 years experience.

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.

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.

dudette10, MSN, RN

Has 9 years experience. Specializes in Med/Surg, Academics.

Thanks for the responses!

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