TYPES OF TRANSURETHRAL CATHETERS

1, 2, & 3-Way | Tip Types | Balloons | Size

One, two, and Three way catheters

Transurethral catheters (Foley catheters) have one-way, two-way or three-way variations. The one-way catheter is a simple tube used to remove urine without securing the tube. This is used when someone is "straight catheterized." The two-way tubing has an outlet for urine and a conduit for water inflation of the catheter's balloon. This is the most commonly used catheter. The three-way tubing has an outlet for urine, an inlet for water inflation of the balloon, and an inlet for normal saline used for irrigating the urinary system most commonly for gross hematuria. There also exist whistle-tipped and multi-eyed variations. These tubes have larger and more draining holes, respectively, and are useful when blood clots are present. Most catheters are made of silicon, which is smoother than latex. Silicon catheters should be used in patients with an allergy to latex.

Robinson (standard) and Coude Tips Urethral catheters are also classified as either Robinson (standard) or Coude, based upon the design of the distal tip of the catheter. The Robinson catheter is a straight catheter with two to six holes at the tip. The Coude catheter is a tube that has an upward deflection at the distal 3 cm. This upward curve allows for easy passing over the median lobe of the prostate in patients with enlarged prostate glands. During insertion, the upward tip of the catheter is directed toward the roof of the urethra (at 12 o'clock ). To ensure the tip is directed upward during placement, the health care provider keeps the faint black line that runs along the catheter at 12 o'clock throughout the insertion

Balloons As mentioned above, two- and three- way catheters have balloons that are inflated, once the tip of the catheter is in the bladder, by injecting saline through the inflation port. Different catheters may have different balloon capacities (ranging from 5 cc to >30 cc) and should always be checked prior to inflation. When inflated, these balloons prevent the catheter from slipping out the bladder and urethra.

URINE COLLECTION DEVICES The distal ends of uretheral catheters have a port can be connected to a urine collection bag. There are many different types available, although all share the basic common features. Clear tubing is attached to the bag and inserts into the urine output port. A drainage port is found at the bottom of the bags that allows collected urine to be discarded. Many bags have graduations on them that facilitate tracking of the urinary output. "Leg bags" are available that allow outpatients (who require extended catheterization) to discretely wear the device.

List of Required Items

Commercial kits are available which contain all of the equipment needed to place a urethral catheter. These kits usually contain a standard-tip 14-16 Fr catheter, a urine collection bag, and the rest of the required supplies. Viscous lidocaine, which should be used when placing a catheter in a male patient (see Procedure section) is not included in the standard kit and must be obtained separately.