How to Insert a Catheter in a Female Patient

Catheterization is a medical procedure performed for various purposes, for instance, to drain the bladder of a patient who has urinary retention problems. For female patients or their families or people concerned for them, it is important to be informed about how to insert a catheter in a female patient.

Catheterization 

A catheter is a flexible, thin tube made of medical-grade materials such as silicone, latex, or polyurethane. The insertion of a catheter can be used on a female patient who needs to drain her bladder due to urinary retention. There are some other occasions when a catheter needs to be inserted into her bladder, for instance when she needs to undergo intravesical instillation of medications. Intravesical instillation refers to the direct administration of therapeutic agents into the bladder via a catheter. 

The following is a presentation of the indications for catheterization. Whatever the purpose of a catheter insertion is, apparently the insertion of a catheter must be done properly on the female patient.

Catheterization may be indicated in any of the situations below:

1) For a patient with urinary retention problems, a catheter is inserted into the bladder to help him/her relieve himself/herself;

2) In certain surgical procedures, there is a need to maintain an empty bladder during the surgery;

3) To obtain sterile urine samples for laboratory analysis. This means that the doctor needs to take urine samples from the bladder so that the sample is sterile; 

4) For bladder irrigation purposes. Bladder irrigation refers to clearing blood clots or other debris from the bladder.

Catheterization procedure

The following description of the catheterization procedure helps promote your understanding of how to insert a catheter in a female patient.

1 Preparatory steps

1) Required equipment: before the catheterization, make sure the following things and equipment for the procedure are available.

A. Sterile gloves

B. Sterile drape

C. Antiseptic solution (e.g., iodine or chlorhexidine)

D. Sterile lubricant

E. Sterile catheter (size appropriate for the patient)

F. Syringe with sterile water

G. Urine collection bag

H. Sterile gauze or cotton balls

2) Preliminaries

A. Clearly explain the procedure to the patient so that they understand the purpose and process. Obtain informed consent.

B. Thoroughly wash your hands and put on sterile gloves to maintain asepsis.

C. Position the patient on her back with knees bent and legs apart. This position provides access to the urethral opening.

2 Cleansing the area

Use sterile gauze or cotton balls soaked in antiseptic solution to clean the labia and urethral opening. Always wipe from front to back to prevent contamination from the anal region.

Place a disposable holed drape between the patient's legs to prevent contamination. (The opening of the holed drape is strategically placed to expose a specific area of the patient's body where a surgical procedure or medical intervention will be performed. The rest of the drape covers and protects the surrounding areas to maintain a sterile field and prevent contamination.)

3 Lubricate the catheter

1) Open the catheterization kit using an aseptic technique. Ensure all items remain sterile.

2) Apply a generous amount of sterile lubricant to the catheter tip. This reduces friction and eases the catheter's passage through the urethra.

4 Insert the catheter

1) For a second time, use sterile gauze or cotton balls soaked in antiseptic solution to clean the labia and urethral opening.

2) With one hand, gently separate the labia to expose the urethral opening. It is located just above the vaginal opening and below the clitoris.

3) Hold the catheter in your other hand and gently insert it into the urethra. Advance the catheter slowly and smoothly. If resistance is encountered, ask the patient to take deep breaths and relax. Must not force the catheter, as this may cause injury.

5 Ensuring that the catheter is properly placed within the bladder 

1) After inserting the catheter into the urethra in step 3, continue advancing the catheter until urine begins to flow; at this point, the catheter has reached the bladder. Once urine flow is observed, advance the catheter an additional 1-2 inches to ensure it is fully in the bladder.

2) The catheter has a balloon to keep it in place. Inflate the retention balloon with sterile water. The volume of water used should be as specified by the catheter manufacturer, usually between 5 to 10 milliliters.

6 Securing the catheter and connecting the collection bag

1) Secure the catheter to the patient's thigh using adhesive tape or a catheter securement device.

2) Connect the catheter to the urine collection bag. The bag should be positioned below the level of the bladder to promote gravity drainage and reduce the risk of backflow (Backflow can to infections).

7 Final steps

1) Dispose of all used materials such as gloves and other disposable items, according to relevant infection control protocols. Wash hands thoroughly after removing gloves.

2) Document the procedure in the patient's medical record, including the type and size of the catheter, the amount of water used to inflate the balloon, any patient reactions or complications, and the time of insertion.

Important considerations

1) Sterility is crucial to prevent infections, such as catheter-associated urinary tract infections (CAUTIs). Sterile equipment should not be touched by non-sterile surfaces.

2) Insert the catheter gently to avoid urethral trauma or discomfort. For this reason, the catheter must be adequately lubricated to minimize insertion discomfort. Some catheters (for example those manufactured by Hangzhou Bever Medical Devices Co., Ltd.) have tubes that are coated with hydrophilic materials that react with water to create highly lubricated surfaces, minimizing insertion discomfort. For more information about lubrication performances, you can refer to the manufacturer’s website at www.bevermedical.com

Hydrophilic catheters from Hangzhou Bever Medical Devices Co., Ltd. with lubrication performances

3) Check for signs of patient discomfort, bleeding, or infection. If fever, pain, or cloudy urine is observed, prompt actions are to be taken. 

Benefits of understanding

Understanding how to insert a catheter in a female patient is one of the skills of a competent medical professional, and is also informative for the patient and her concerned family members and friends. This knowledge may allay the anxieties the patient has about catheterization.