2026-03-16
Improper catheterization procedures may lead to some complications. This article describes the causes and clinical manifestations of these complications, and proposes prevention and treatment measures, hoping to be helpful to patients.
II. Urinary Tract Infection
1. Causes of the incident
1.1 The doctor's aseptic technique did not meet the requirements, allowing bacteria to retrograde into the urethra and bladder.
1.2 As a invasive procedure, catheterization can often cause damage to the urethral mucosa, breaking the barrier function of the urethral mucosa.
1.3 The selected catheter was either too thick or too hard in texture.
1.4 The operator was not skilled, resulting in unsuccessful insertion of the catheter and repeated attempts.
1.5 As people age, men often experience prostate hypertrophy, which can lead to urinary retention and increase the chance of infection.
1.6 The selected catheter was contaminated by bacteria.
2. Clinical manifestations
The main symptoms are frequent urination, urgent urination, and painful urination. When the infection affects the upper urinary tract, chills and fever may occur, and there may be purulent secretions at the urethral opening. Urine tests may show red blood cells and white blood cells, and bacterial culture may yield positive results.
3. Prevention and Treatment
3.1 All items must be strictly sterilized. During catheter insertion, strict aseptic procedures must be followed, with gentle movements. Pay attention to disinfection of the perineum. Before inserting the catheter, 3-5 ml of 2% iodophor solution can be injected from the urethral opening to disinfect the distal end of the urethra and also serve as a lubricant.
3.2 Try to avoid using indwelling urinary catheters. For patients with urinary incontinence, absorbent perineal pads or urinary sleeves can be used.
3.3 Replace the old rubber catheters with silicone and latex catheters. Use sterile cotton containing 0.1% diethylstilbestrol as a lubricant to coat the catheter, which can alleviate urinary system irritation symptoms; coating the outside of the catheter with salicylic acid can inhibit Gram-negative bacteria and prevent bacteria and yeast from adhering to the silicone catheter, thereby preventing urinary tract infections.
3.4 When urinary tract infections occur, the catheter must be removed as much as possible, and appropriate antibacterial drugs should be used for treatment based on the patient's condition.
III. Urinary Tract Bleeding
1. Causes of the incident
1.1 Various factors that cause damage to the urethral mucosa can lead to urinary tract bleeding. In severe cases, they can even cause bleeding.
1.2 Disruption of the coagulation mechanism.
1.3 Drugs can cause congestion and edema of the urethral mucosa, making the urethra more prone to mechanical injury.
1.4 Patients with severe urinary retention who have increased bladder pressure due to prolonged retention, if they release a large amount of urine suddenly, the sudden reduction in bladder pressure can cause severe congestion and bleeding of the mucosa, resulting in hematuria.
2. Clinical manifestations
If there is gross hematuria or microscopic hematuria after catheterization, and it can be ruled out that the hematuria originates from the upper urinary tract, then it can be considered as a result of catheterization injury.
3. Prevention and Treatment
3.1 Urinary tract bleeding caused by catheterization almost always occurs on the basis of urethral mucosal injury. All measures to prevent urethral mucosal injury are also suitable for preventing urinary tract bleeding.
3.2 For patients with severe coagulation mechanism disorders, the condition should be corrected as much as possible before catheterization.
3.3 For patients with urethral mucosal congestion and edema, smaller caliber catheters should be selected. Adequate lubrication should be performed before insertion, and the operation should be gentle to avoid damage as much as possible.
3.4 After inserting the catheter, the drainage should not be done too quickly. The first drainage should not exceed 1000ml.
3.5 Microscopic hematuria generally does not require special treatment. If the hematuria is severe, appropriate hemostatic drugs can be used.
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