Genitourinary: Removing indwelling catheters

An indwelling urinary catheter is also called the Foley catheter or retention catheter. It is a tube that goes through the urethra into the bladder where it remains, allowing urine to drain continuously into a drainage bag.

It consists of a balloon that can be inflated inside the bladder to keep the catheter from slipping out, a long tubing, and the drainage bag that collects urine.

Before we talk about how to remove an indwelling catheter, here are some general considerations. Before beginning the procedure, ask the nurse to tell you the exact amount of water that had been used to inflate the balloon and check the port on the balloon catheter, which will tell you the recommended volume used to inflate the balloon.

It’s important to remove all the water; otherwise, a partially inflated balloon could cause trauma to the urethral wall during the removal.

Close the room’s door and bedside curtain and respect the client’s privacy. Keep in mind that using an indwelling catheter can lead to decreased muscle tone and temporary urinary incontinence after the catheter is removed.

Finally, inform the client that it’s normal to experience some burning sensation and decreased urine volume the next time they void.

All right, so first, gather the supplies you’ll need including gloves, a bath blanket, a disposable bag, and the correct sized syringe as directed by the nurse.

Confirm this size is correct by double-checking the number stated on the balloon port of the catheter. Start by making sure that the wheels on the bed are locked and the side railings on the working side are down.

Lower the head of the bed so that the bed is flat and at a comfortable working height. Next, put your gloves on and cover the client with a bath blanket, exposing only the genital area.

Ask them to open their legs and bend their knees, if they can. If not, help them to do so.

Unclip the catheter tubing from the bedsheet. Next, slide the syringe plunger up and down several times to loosen the plunger and then pull the plunger back to the 0.5 milliliter mark.

Then, insert the hub of the syringe to the catheter's balloon port and allow the fluid to fully drain into the syringe. Let gravity pull the fluid down naturally and do not pull back on the syringe because this can cause ridges to form on the balloon, leading to discomfort or trauma.

Make sure that the entire amount of fluid that had been originally inserted has been removed, and then pull the catheter out gently in one slow, smooth action without using any force.

Inspect the catheter once it’s fully out to make sure no part is left in the client. Finally, provide perineal care, making sure the client is dry and comfortable before discarding the used catheter into the appropriate container.After the procedure, you should notify a nurse immediately if you notice changes in the color, clarity, or odor of the urine; the presence of blood or particles in the urine; complaints of pain; burning or irritation that persists; discharge from the catheter insertion site; or urine leaks.

Make sure to document these alongside the date and time and the amount of urine present in the drainage bag. If the catheter can’t be removed smoothly with minimal force, try deflating the balloon and retrying the process.

In biological males, gently applying a small amount of traction on the penis can help straighten the urethra. If water in the balloon does not drain into the syringe, repositioning the client can help straighten kinks in the catheter.

If that fails, detach and replace the syringe with a new one. Alright, as a quick recap… Before removing an indwelling catheter, ask the nurse to tell you the amount of fluid that had been used to inflate the balloon and double-check with the number on the balloon port.

Make sure to remove the entire amount of fluid, and then slowly and smoothly, pull the catheter out. After the procedure, remember to document the details and report any unusual signs or symptoms to the