Catheterization

Catheterization is the introduction of the catheter into the natural channel or cavity of the human body.
Especially often catheterization is used in urological practice (catheterization of the bladder and upper urinary tract).
Indications: the excretion of urine in acute or chronic its delay, the introduction of drugs for therapeutic or diagnostic purposes.
Catheters - special pipes of different diameters, lengths and shapes.
Catheters are made of metal, of elastic plastic, silk, or other fabrics, impregnated, coated with lacquer, and soft rubber.
The thickness of catheters is determined by the scale of charger, which has 30 rooms, each room is different from the next 1/3 mm For catheterization bladder most common catheters no 16-20, for catheterization ureters- №№ 4-6.
Metal, rubber, elastic catheters (plastic) sterilized by boiling during 30 minutes Sterile catheters store during the day on the table under sterile sheets.
Elastic catheters are sterilized by immersing them in a solution of oxycyanide mercury (1 : 1000) for 30 minutes Elastic catheters from fabrics, impregnated, coated with varnish, sterilized in pairs formalin within 24 hours in a special cupboard sterilizer. On the bottom shelf put a few tablets of formalin, and on the top stack catheters. In the same locker store right stock catheters, always ready to use.


Fig. 1. Rubber catheter Nelaton.

Fig. 3. Fixation of a permanent urethral catheter.

In practice, more often applied rubber catheters Nelaton (Fig. 1) and Timana (Fig. 2, 2). Catheterization soft catheters can perform the nurses.
When catheterization strictly observe the rules of aseptics: 1) sterilization catheters; 2) treatment arms producing catheterization; 3) disinfection external opening of the urethra.
Hands before catheterization is washed with soap and treated with alcohol. The outer opening of the urethra is treated with a cotton ball soaked in the disinfectant solution (corrosive sublimate 1:1000, furatsilina 1:5000, oxycyanide mercury 1:1000).
Technique catheterization in men: the patient lies on his back with legs spread slightly. A catheter is put a few drops of lubricant (glycerin, liquid petroleum jelly or Vishnevsky ointment). Sex member seize the left hand near the head between the third and fourth fingers so that I and II fingers feel comfortable to disclose the outer opening of the urethra. The catheter give the right hand, which gallbladder end tweezers capture above the window on 4-5 cm, and the outer end is placed between the fourth and fifth fingers.
As the introduction of the catheter is carried out smoothly, the penis gently pull on a catheter. The most important step catheterization is the overcoming of the external sphincter located in the perineal part of the urethra. If you feel resistance is not necessary to apply force. Continuing to exert gentle pressure, it is only necessary to wait for the relaxation of the sphincter.
For carrying out of the catheter through the rear part of the urethra, modified adenoma of the prostate, apply elastic catheters with curved upwards beak - Mercier (Fig. 2, 1) or Timann. Control over the provision of the bill, which the promotion of the catheter through the urethra should be addressed strictly to the front, is scallops on the pavilion of the catheter. If catheterization soft and elastic catheters cannot apply metal (Fig. 2, 3-6), which introduces only an experienced doctor. When catheterization metal catheter use force is absolutely unacceptable, since it leads to damage to the urethra and the formation of a false move.
Catheterization women usually easy for any rubber or shorter metal female catheter (Fig. 2, 7).
For instillation, washings, stop bleeding, overcoming of stricture of the urethra, etc., offered a number of special catheters (Fig. 2, 8-15).
Put the catheter may be left on a long term (so-called permanent). Fixation produce gauze ribbons or thick silk threads, first tying them on the catheter, and then behind the glans penis, wrapped in gauze cloth (Fig. 3).
As permanent catheters, administered to women in the urethra, and men through suprapubic fistula, use catheters, Mezzera (Fig. 2, 16) or Maleko (Fig. 2, 17). The head of the catheter in the moment of introduction is extended to length of a special mandrel (Fig. 2, 18).
Frequent catheterization to prevent infection, and the so-called urethral fever (fever due to suction the infected content through pinholes of the mucous membrane of the urethra) before removing the catheter in the bladder impose 15-20 ml disinfectant (the furatsilina 1 : 5000, 2% colloid, nitrate of silver 1 : 3000 or 3-5% syntomycin emulsion). With the same purpose, appoint 5-10 ml of 40% solution of hexamethylenetetramine (urotropine) or intravenous antibiotics.catheters
Fig. 2. Catheters: 1 - elastic Mercier; 2 - rubber Timana; 3 - 6 - metal; 7 - female metal; 8 - elastic installer; 9 - catheter for continuous rinsing; 10 - 12 - for the installation and washing of the urethra; 13 and 14 to overcome strictures (Motetega, Bartini); 15 - Pomerantsev - Foley; 16 and 17 - capitate rubber (16 Pizzera, 17 Maleko); 18 - catheter, Pizzera on the mandrel.