Urinating around catheter

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Specializes in tele, stepdown/PCU, med/surg.

After a long night feeling useless, I then had to insert a foley and that didn't even go well. I had this ETOH withdrawal guy with MS and he was retaining. I inserted the catheter and eventually started getting urine....I inserted it further and didn't really see any further urine coming out. Then all of the sudden, above the catheter, urine began to shoot out of his meatus and wouldn't stop. So here he was with a catheter in, but he was urinating around it. It was not a leak, it was a stream.

I've never had that happen before, why does that happen? My charge said that it because I hadn't inflated the baloon yet, urine could still ocme out the sides. I've never heard of that explanation, but personally I've never had that happen before. It made a real mess, and what assurance do I have that it doesn't happen again? I tell you...until I get some answers, I'm gonna be scared to insert foleys.

Thanks!

Zach

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Specializes in Ortho, Case Management, blabla.

time for a larger catheter I think

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Specializes in ER, ICU, Neuro, Ortho, Med/Surg, Travele.

There are a couple of different reasons that urine could be flowing around the catheter.

1. balloon had not been fully inflated.

2. need larger catheter.

3 bladder spasms. (pt's with neurological issues, enlarged prostate, etc)

4. Catheter clogged with sediment or pus from infection.

Don't beat yourself up, it happens from time to time.

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Specializes in Med-Surg, Wound Care.
There are a couple of different reasons that urine could be flowing around the catheter.

1. balloon had not been fully inflated.

2. need larger catheter.

3 bladder spasms. (pt's with neurological issues, enlarged prostate, etc)

4. Catheter clogged with sediment or pus from infection.

Don't beat yourself up, it happens from time to time.

And catheter curled in the prostatic fossa...not in the bladder.

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Specializes in Physical Rehabilitation, med-surg.

It was either clogged with sediment or blood (not likely since it was new) or he was having bladder spasms. I guess it's also possible that the catheter wasn't all the way in the bladder.

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Specializes in Peds, PICU, Home health, Dialysis.

While in nursing school, there was an elderly cirrhotic and ETOH withdrawal patient who was admitted and the physician ordered a foley and a rectal tube (Flexiseal). As we inserted the foley, urine started flowing heavily around the catheter and it eventually stopped as the balloon was inflated. We then inserted the rectal tube and as that was inserted the patient had this burst of diarrhea and it went everywhere.

When we were done, we were soaked in urine and feces -- it was not a pleasant sight. :barf01:

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Specializes in med/surg, telemetry, IV therapy, mgmt.

the patient was distended with urine and had a urethral obstruction, probably has some bph. the catheter you inserted never made it into the bladder. the patient was so distended and needed to empty so badly that he just pushed the urine out around the catheter. usually a coudé tip catheter has to be inserted or a doc can insert a catheter using a rigid stylet to get the catheter through the obstruction.

there is a video on male catheter insertions that you can watch (video: male foley insertion and removal http://currency.medicine.dal.ca/videos/video10.htm). our urologist taught us to inject 10cc of sterile lubricant directly into the male meatus before inserting the catheter and to really hold the member straight up at a 90 degree angle in order to pass that catheter.

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People used to laugh when I said I'd rather put a cath in an old lady than an old man. At least with a woman, you know once you find the spot, that it will go in. Sure it's easy to find the spot with men, but never know if it will actually go all the way!:)

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