pediatrics
How To Catheterize the Bladder in a Male Child
Tips and Tricks for Bladder Catheterization: Male Child
If the foreskin cannot be fully retracted, do not force it. A little gentle retraction may be enough to adequately see the meatus. Remember to hold the sides of the penis and not directly underneath; the urethra runs through here and you may compress the area, making it difficult to advance the catheter. Do not proceed with continued attempts at catheter placement if significant resistance is met or if the catheter feels as if it is buckling inside and not advancing. If the catheter appears to be in the correct position but urine does not return, lubricant may be obstructing the drainage of urine. With the catheter held in the current position, flush the catheter with normal saline to dislodge the lubricant and see if urine returns prior to proceeding with the remaining steps. If the catheter appears to be in the correct position but urine does not return and there is the possibility of anuria due to dehydration, consider providing hydration (appropriate to patient's clinical condition) before the procedure is attempted again. Consult urology for any issues with catheter placement or guidance on catheter size and style in select clinical scenarios. In certain situations where a catheter cannot be placed, a suprapubic percutaneous aspiration may be indicated. 