Urethral Bladder Catherization for Men

Describes urethral bladder catherization for men with urinary retention. The goal of the urethral bladder catherization steps is to reduce risk of bacterial infection in the bladder while draining urine from the bladder. Incidentally, the urethral bladder catherization steps below are a work in progress subject to better ways to achieve goals.

Urethral Bladder Catherization at Home without Showering

Supplies

Coude catheter (Make sure you get the right size to make insertion smooth and painless. If you find it uncomfortable or hard to insert, ask for a catheter with a smaller diameter - a small FR rating.)
Lubricant
Regular liquid soap
Alcohol free 99.9% anti-bacterial liquid soap
99.99% anti-septic liquid soap (use until used up)
Hibiclens (chlorhexidine gluconate) (until used up)
Betadine (Povidone-Iodine) prep pads
Floor towel
Paper towels for drying hands
Tissue papers for staging area and drying penis
Cotton ball
Urine collector

Preparation

Lay out dry paper towels so that they are easily accessible
Put cotton ball near where you will wash your hands.
Place urine collector so that it is easy to collect urine
Place coude catheter so that it is easily accessible
Put lubricant near the urine collector
Place regular liquid soap, 99.9% anti-bacterial liquid soap, 99.99% anti-septic liquid soap or betadine, or Hibiclens near where you will wash your hands.

Urethral Bladder Catherization Steps

  1. 1
    Wash hands with regular liquid soap.
  2. 2
    Dry hands with regular or bath towel
  3. 3
    Lay out paper towels

a. Paper towel #1 for drying hands
b. Paper towel #2 for drying hands prior to inserting catheter
c. Tissue paper #1 for staging lubricant, antiseptic toilette, and cotton ball
d. Fold tissue paper #2 (for drying penis head) and place on top of paper towel #1

  1. 4
    Lay out and open catheter container.
  2. 5
    Lay out antiseptic toilette, lubricant, cotton ball on tissue paper #1.
  3. 6
    Wash hands with alcohol free 99.9% anti-bacterial liquid soap for 20 seconds.
  4. 7
    Use soapy hand to clean penis head for 15 seconds.
  5. 8
    Rinse hands to get rid of soapy water.
  6. 9
    Pick up cotton ball and soak in tap water.
  7. 10
    Use cotton ball to get rid of soapy water. Wipe from tip to the body.
  8. 11
    Discard cotton ball.
  9. 12
    With tissue paper #2 folded twice, dry penis using strokes instead of pressing paper against the penis. This will avoid tissue paper sticking to the penis.
  10. 13
    Shake hands towards floor to get rid of excess water. Then dry hands with paper towel #1. Roll towel #1 for supporting lubricant packet on tissue paper #1.
  11. 14
    Open antiseptic toilette and wipe lubricant packet.
  12. 15
    Open the lubricant packet – leaving an opening for inserting the catheter and mount it facing upwards on tissue paper #1 supported by rolled up used paper towel #1.
  13. 16
    Wash hands with Hibiclens or 99.9% anti-bacterial liquid soap for 20 seconds.
  14. 17
    Shake hands toward floor to get rid of excess water. Then dry hands with paper towel #2 and air dry if necessary.
  15. 18
    Grab the catheter’s rubber end with right hand and pull out catheter from container. Next, use the left hand to hold the catheter’s rubber end. Now, hold the middle of the catheter with the right hand.
  16. 19
    Use left hand to hold sterile lubricant packet and immerse head of catheter inside the lubricant packet with the right hand. 
  17. 20
    Spread lubricant along first few inches of the catheter and empty packet to leave large amount of lubricant near the catheter’s tip.
  18. 21
    Hold the catheter with the bent tip up or the blue line on top.
  19. 22
    Hold penis with left hand such that your sterile hand is near and a little further out from the opening. Also, hold the penis at 60 degrees angle with the body.
  20. 23
    Drop lubricant blob from near the tip of catheter to area of the penis opening and a little above it. Then, along with the barrier provided by the hand holding the penis, the lubrication covers the opening and helps lubricate the catheter as it is pushed into the penis. This step will help lubricate the catheter as it enters the penis and make for a very smooth and nearly painless insertion.
  21. 24
    Very slowly, insert catheter inside the penis. Try to sync insertion with breath inhalation or exhalation, whichever works best. Also, lift catheter slightly upwards as your insert, so tubing presses against the upper part of the urethral channel.
  22. 25
    Also, you can try stretching the penis to make it easier for the catheter to find its way through as it goes deeper.
  23. 26
    As the catheter goes in start increasing the penis angle with the body to 90 degrees and more so that the catheter can easily go around the curve and upwards towards the bladder.
  24. 27
    As you approach the half-way point on the catheter, point penis downwards a bit to make it easy for the catheter to reach bladder along a straighter path.
  25. 28
    If there is obstruction, just stop and insert catheter a mm at a time. Yes, it will take long but it protects the urinary tract and lowers chances of bleeding or injuring the urethral channel.
  26. 29
    After 60% of the catheter is inside, put the rubber end of catheter inside the urine collector. However, make sure the catheter tubing does not touch the collector. Its OK if some of the tubing near the outer end touches the collector.
  27. 30
    Keep pushing until urine starts to flow. After urine flow stops push it a few more mm until all residual urine is removed.
  28. 31
    When urine stops flowing, remove the catheter. First, hold the penis, about 90 degrees from the body, with one hand right up to the tip and almost touching the catheter. Next, gently pull it out, a little bit at a time, while slightly exerting an upward pressure.

Urethral Bladder Catherization at Home after Showering

Urethral Bladder Catherization Steps

  1. 1
    Place collector in position to collect urine.
  2. 2
    Take a shower.
  3. 3
    As you dry up, don’t let towel touch the upper half of the penis.
  4. 4
    Lay out and open catheter container.
  5. 5
    Lay out paper towels

a. Paper towel #1 for drying hands prior to inserting catheter
b. Tissue paper #1 for staging lubricant and antiseptic toilette

  1. 6
    With tissue paper #2 folded twice, dry penis using strokes instead of pressing tissue paper against the penis. This will avoid tissue paper sticking to the penis.
  2. 7
    Lay out antiseptic toilette, lubricant on tissue paper #1.
  3. 8
    Open antiseptic toilette and wipe lubricant packet.
  4. 9
    Open the lubricant packet – leaving an opening for inserting the catheter. To make it easy for grabbing the packet, mount it vertically on tissue paper #1 using the folded antiseptic toilette for support.
  5. 10
    Wash hands with Hibiclens or 99.9% anti-bacterial liquid soap for 20 seconds.
  6. 11
    Shake hands towards floor to get rid of excess water. Then, dry hands with paper towel #1 and air dry if necessary.
  7. 12
    Grab the catheter’s rubber end with right hand and pull out catheter from container. Next, use the left hand to hold the catheter’s rubber end. Now, hold the middle of the catheter with the right hand.
  8. 13
    Use left hand to hold sterile lubricant packet and immerse head of catheter inside the lubricant packet with the right hand. 
  9. 14
    Spread lubricant along first few inches of the catheter and empty packet to leave large amount of lubricant near the catheter’s tip.
  10. 15
    Hold the catheter with the bent tip up or the blue line on top
  11. 16
    Hold penis with left hand such that your sterile hand is near and a little further out from the opening. Also, hold the penis at 60 degrees angle with the body.
  12. 17
    Drop lubricant blob from near the tip of catheter to area of the penis opening and a little above it. Then, along with the barrier provided by the hand holding the penis, the lubrication covers the opening and helps lubricate the catheter as it is pushed into the penis. This step will help lubricate the catheter as it enters the penis and make for a very smooth and nearly painless insertion.
  13. 18
    Very slowly, insert catheter inside the penis. Try to sync insertion with breath inhalation or exhalation, whichever works best. Also, lift catheter slightly upwards as your insert, so tubing presses against the upper part of the urethral channel.
  14. 19
    In addition, you can try stretching the penis to make it easier for the catheter to find its way through as it goes deeper.
  15. 20
    As the catheter goes in start increasing the penis angle with the body to 90 degrees and more so that the catheter can easily go around the curve and upwards towards the bladder.
  16. 21
    As you approach the half-way point on the catheter, point penis downwards a bit to make it easy for the catheter to reach bladder along a straighter path.
  17. 22
    If there is obstruction, just stop and insert catheter a mm at a time. Yes, it will take long but it protects the urinary tract and lowers chances of bleeding or injuring the inside channel.
  18. 23
    After 60% of the catheter is inside, put the rubber end of catheter inside the urine collector. However, make sure the catheter tubing does not touch the collector. Its OK if some of the tubing near the outer end touches the collector.
  19. 24
    Keep pushing until urine starts to flow. After urine flow stops push it a few more mm until all residual urine is removed.
  20. 25
    When urine stops flowing, remove the catheter. First, hold the penis, about 90 degrees from the body, with one hand right up to the tip and almost touching the catheter. Next, gently pull it out, a little bit at a time, while slightly exerting an upward pressure.

Catherization Procedure while on Travel

Briefcase or Bag Organization for Urethral Bladder Catherization

Biggest Pocket

Catheters
Plastic bags

Middle Pocket

Liquid Soap
Hand wipes (Mediwips or Wet Ones)
Baby Wipes
Clips
Hangers
Lubricant
Antiseptic towelettes
Betadine (Povidone-Iodine} Prep Pads

Smallest Pocket

Paper towels
Plastic Bag

Public Toilets

Urethral Bladder Catherization Steps where Privacy is available, as in a car
  1. 1
    Use 1st hand wipe to clean hands. Discard wipe.
  2. 2
    Spread 2nd hand wipe on flat surface.
  3. 3
    Use antiseptic toilette to wipe Betadine pad and lubricant and place on 2nd hand wipe.
  4. 4
    If necessary, wrap up antiseptic towelette and hand wipes and store in plastic bag. Put plastic bag in middle pocket.
  5. 5
    REPEAT ABOVE TO HAVE 2x ready to go plastic bags (in case contents fall on the floor).
Urethral Bladder Catherization Steps in Men’s Toilet
  1. 1
    Use hand wipe to clean your hands. Discard hand wipe.
  2. 2
    Place two catheters in biggest pocket so they stick out from the pocket’s zipper. Open catheter wrapper on one and pull catheter out slightly to make sure it comes out easily without sticking to its container.
  3. 3
    Open ready to go plastic bag so you have easy access to Betadine pad and lubricant in the antiseptic towelette.
  4. 4
    Pull down pants, pull up shirt and use clips to keep shirt away from penis.
  5. 5
    Clean hands using 2nd hand wipe. Discard hand wipe and let hands dry.
  6. 6
    Clean penis head with baby wipe. Clean penis head with Betadine pad wrapped in antiseptic towelettes. Remember to wipe penis head downward once.
  7. 7
    Discard betadine pad and its container.
  8. 8
    Take out lubricant from antiseptic towelette and tear it open with your hands.
  9. 9
    Hold open lubricant with left hand.
  10. 10
    Pull out catheter with right hand and hold it with your mouth gripping the rubber end.
  11. 11
    Use left hand to hold sterile lubricant packet and immerse head of coude catheter inside the lubricant packet with the right hand. 
  12. 12
    Spread lubricant along first few inches of the catheter and empty packet to leave large amount of lubricant near the catheter’s tip.
  13. 13
    Hold the catheter with the bent tip up or the blue line on top
  14. 14
    Hold penis with left hand such that your sterile hand is near and a little further out from the opening. Also, hold the penis at 60 degrees angle with the body.
  15. 15
    Drop lubricant blob from near the tip of catheter to area of the penis opening and a little above it. Then, along with the barrier provided by the hand holding the penis, the lubrication covers the opening and helps lubricate the catheter as it is pushed into the penis. This step will help lubricate the catheter as it enters the penis and make for a very smooth and nearly painless insertion.
  16. 16
    Very slowly, insert cateter inside the penis. Try to sync insertion with breath inhalation or exhalation, whichever works best. Also, lift catheter slightly upwards as your insert, so tubing presses against the upper part of the urethral channel.
  17. 17
    In addition, you can try stretching the penis to make it easier for the catheter to find its way through as it goes deeper.
  18. 18
    As the catheter goes in start increasing the penis angle with the body to 90 degrees and more so that the catheter can easily go around the curve and upwards towards the bladder.
  19. 19
    As you approach the half-way point on the catheter, point penis downwards a bit to make it easy for the catheter to reach bladder along a straighter path.
  20. 20
    If there is obstruction, just stop and insert catheter a mm at a time. Yes, it will take long but it protects the urinary tract and lowers chances of bleeding or injuring the inside channel.
  21. 21
    .Keep pushing until urine starts to flow. After urine flow stops push it a few more mm until all residual urine is removed.
  22. 22
    When urine stops flowing, remove the catheter. First, hold the penis, about 90 degrees from the body, with one hand right up to the tip and almost touching the catheter. Next, gently pull it out, a little bit at a time, while slightly exerting an upward pressure.
  23. 23
    Insert catheter into original container.
  24. 24
    Wrap container with catheter in paper towel and put it in plastic garbage bag.
Urethral Bladder Catherization Steps in Clean Toilets
  1. 1
    Use 1st hand wipe to clean your hands. Discard wipe.
  2. 2
    Spread 2nd hand wipe on flat surface.
  3. 3
    Use 1st antiseptic towelette to wipe Betadine pad and place pad on 2nd antiseptic towelette.
  4. 4
    Use 3rd antiseptic towelette to wipe lubricant container and place container on 2nd antiseptic towelette.
  5. 5
    Place two catheters in biggest pocket so they stick out from the pocket’s zipper. Open catheter wrapper on one and pull catheter out slightly to make sure it comes out easily without sticking to container.
  6. 6
    Pull down pants, pull up shirt and use clips to ensure shirt stays above and away from penis.
  7. 7
    Clean hands using hand wipe. Discard and let hands dry.
  8. 8
    Clean penis head with baby wipe. Next, clean with Betadine pad. Remember to wipe penis head downward.
  9. 9
    Discard Betadine pad and its container.
  10. 10
    Take lubricant from antiseptic towelette and tear it open with your hands.
  11. 11
    Hold open lubricant with left hand. 
  12. 12
    Pull out catheter with right hand and hold it with your mouth gripping the rubber end.
  13. 13
    Use left hand to hold sterile lubricant packet and immerse head of coude catheter inside the lubricant packet with the right hand. 
  14. 14
    Spread lubricant along first few inches of the catheter and empty packet to leave large amount of lubricant near the catheter’s tip.
  15. 15
    Hold the catheter with the bent tip up or the blue line on top
  16. 16
    Hold penis with left hand such that your sterile hand is near and a little further out from the opening. Also, hold the penis at 60 degrees angle with the body.
  17. 17
    Drop lubricant blob from near the tip of catheter to area of the penis opening and a little above it. Then, along with the barrier provided by the hand holding the penis, the lubrication covers the opening and helps lubricate the catheter as it is pushed into the penis. This step will help lubricate the catheter as it enters the penis and make for a very smooth and nearly painless insertion.
  18. 18
    Very slowly, insert catheter inside the penis. Try to sync insertion with breath inhalation or exhalation, whichever works best. Also, lift catheter slightly upwards as your insert, so tubing presses against the upper part of the urethral channel.
  19. 19
    In addition, you can try stretching the penis to make it easier for the catheter to find its way through as it goes deeper.
  20. 20
    As the catheter goes in start increasing the penis angle with the body to 90 degrees and more so that the catheter can easily go around the curve and upwards towards the bladder.
  21. 21
    As you approach the half-way point on the catheter, point penis downwards a bit to make it easy for the catheter to reach bladder along a straighter path.
  22. 22
    If there is obstruction, just stop and insert catheter a mm at a time. Yes, it will take long but it protects the urinary tract and lowers chances of bleeding or injuring the inside channel.
  23. 23
    Keep pushing until urine starts to flow. After urine flow stops push it a few more mm until all residual urine is removed.
  24. 24
    When urine stops flowing, remove the catheter. First, hold the penis, about 90 degrees from the body, with one hand right up to the tip and almost touching the catheter. Next, gently pull it out, a little bit at a time, while slightly exerting an upward pressure.
  25. 25
    Insert catheter into original container.
  26. 26
    Wrap container with catheter in paper towel and put it in plastic garbage bag.

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