Urethral Catheterization: Pros and Cons
Urethral catheterization is a routine procedure performed with a thin plastic tube inserted via urethra into the bladder for the purpose of urine drainage, obtaining a sterile urine specimen or instilling medications or irrigations into the urinary tract. Urethral catheterizations are categorized into one time use, referred to as intermittent, or for long term use, called indwelling.
Intermittent urethral catheterization is recommended for patients undergoing major abdominal surgery, for cases of acute urinary obstruction or swelling when a patient is unable to urinate. Along with obvious pros of immediate urinary relief, urethral catheterization if performed incorrectly carries some serious side effects like urethral perforation, bleeding and infection risks.
Long-term urethral catheterization is recommended for both male and female patients with chronic urge incontinence problems and bladder leakage due to various medical conditions. A urine receptacle system is attached to the catheter tube and then taped to a patient’s leg. Most of the patients with the long history of weak bladder that does not respond well to other treatments can benefit from this therapy.
However, a lot of complications associated with the long term usage of urethral catheterization were noted in patients like increased risk of urinary tract, bladder and kidney infections, urethral perforation and bleeding.
In a case when regular urethral catheterization is contraindicated, or a patient is unwilling to have a permanent urinary catheter, a suprapubic catheter can be inserted surgically. A thin bladder catheter is inserted through the skin just above the pubic bone and guided into the bladder with the help of ultrasound. A suprapubic catheter is used for chronic urinary retention, prostate swelling, kidney stones that cause full obstruction and cancer cases.
Both urethral and suprapubic catheterizations put patients at increased risk of infections and used only when absolutely medically necessary.