Urinary Catheters: A Review

The purpose of the article is to review the history, the indications for and methods of urinary catheterization, types of urinary catheters and ancillary devices used, and the adverse effects of the procedure. Urinary catheters are used for diagnosing pathology in the lower urinary tract, to monitor urine output, and to relieve urinary retention. Their universal availability and ease of insertion too often leads to indiscreet and prolonged use. Condom catheters are a safer alternative in people able to void spontaneously. When prolonged catheterization is necessary, intermittent insertion minimizes irritation, local and ascending infection, and stone formation. Earlier catheter removals, use of smaller bore catheters and a closed drainage system and optimal hygienic techniques (hand-washing, sterile catheterization techniques) by health care workers are effective in minimizing the incidence of infection. Patient discomfort, catheter induced trauma to the lower urinary tract and abdominal wall, calculi, bladder spasms and contraction, and balloon problems are well known complications associated with catheter use. There is a growing trend towards avoiding routine peri-operative catheterization during laparoscopy, cesarean sections, and pelvic surgery. With family physicians increasingly involved in the multidisciplinary care of complex patients, they need to be aware of the current recommendations associated with the use of urinary catheters, and the problems associated with their insertion and maintenance.