Urine leaks and IDC'c

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  1. If urine is bypassing an indwelling catheter I would opt to

    • 16
      replace the catheter with a smaller one
    • 18
      replace the catheter with a larger one
    • 0
      Leave the catheter in situ and clamp the catheter
    • 18
      Do something else

52 members have participated

Specializes in ICU.

Okay - this came up at work yesterday and interestingly 50% of the staff said put in a LARGER catheter and 50% said put in a SMALLER catheter.

:studyowl:So, now it is up to me:p I have to find some recent research on this, very possibly because I opened my mouth and said that the research was done back in the dark ages when I was training at my hospital.

I was one of the advocates for smaller catheter on the basis that urine bypassing the catheter is usually caused by bladder spasm from a too large catheter. There ensued some cognitive dissonance in relation to this;)

In the meantime, given the split in the beliefs held by the staff on duty I thought I would post a poll and see what other nurses out there thought.

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Specializes in MDS coordinator, hospice, ortho/ neuro.

I'd check to see if the catheter that was there was patent first. There are some folks out there that just put out lots of mucus , crystals, etc......do they have a UTI? esp. if that cath has been there a while.

Are they having bladder spasms because that cath is unsecured and getting tugged on?

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Specializes in Med/Surge, Psych, LTC, Home Health.

I personally would leave it alone for the time being until a decision can be made as to whether the patient can just have the catheter taken out alltogether. I wouldn't just automatically take that catheter out and put another one in.

OTOH, it depends on the situation. A small leak, the above would apply. A very large leak, I'd go ahead and call and see if the doc wants another one put in.

Also, there are patients that have permanent indwelling catheters. In that case, I would try putting in a larger one.

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Specializes in ICU.

Lots and lots of Googling later I found the answer.

http://www.o-wm.com/article/2272

This is an awesome article and supports what other articles say - you put in a smaller catheter not a larger one.

However you are right about checking for other causes - I did not know that constipation can cause bladder spasms.

As for removing the catheter - my poor patient was in ICU so that was NOT an option.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Advice seen in this thread: overinflate catheter balloon

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