Indications
- • Acute retention
- • Strict urine output monitoring
- • Bladder outflow obstruction
- • Perioperative
- • Sacral pressure ulcer protection
Contraindications
- ⚠ Suspected urethral injury (blood at meatus, high-riding prostate, perineal haematoma) — call urology
Equipment
- • Catheter pack (drape, swabs, gloves)
- • 12–16 Fr Foley (silicone if long-term)
- • Lidocaine gel 11 mL (men) / 6 mL (women)
- • 10 mL water for balloon
- • Drainage bag
Technique
- • Aseptic non-touch technique
- • Clean meatus, instil lidocaine gel, wait 3–5 min
- • Advance catheter to hilt (men) or until urine flows (women)
- • Inflate balloon with 10 mL sterile water only after urine flow
- • Connect to closed drainage system
- • Document residual volume, type/size, indication
Complications
- ⚠ Trauma / false passage
- ⚠ UTI
- ⚠ Bladder spasm
- ⚠ Paraphimosis (if foreskin not replaced)
- ⚠ Long-term: strictures, stones
Aftercare
- • Daily catheter review (HOUDINI criteria for removal)
- • Hourly urine output if critical
- • Catheter care bundle
Clinical pearls
- • Never force the catheter — call urology for blind suprapubic only if trained
- • Replace foreskin to prevent paraphimosis
- • TWOC after retention with α-blocker started 24 h prior
Perform under supervision until competent. Follow local SOPs and consent policy.
