Male Foley Catheter Placement and Removal for Surgery

Case Overview

Foley catheter insertion is a fundamental medical procedure that is routinely performed across a wide range of clinical specialties. The placement of a Foley catheter remains one of the most commonly executed interventions in the field of medicine. Since the Foley catheter was first introduced in the 1920s, no significant improvement has been made in the methodology.¹

Foley catheter placement is a common medical procedure performed to assist in bladder drainage and management. This procedure is indicated for a variety of reasons, including the need to monitor urine output during surgery, the management of urinary retention or incontinence, and the facilitation of accurate measurement of urine output in critically ill patients. The procedure is often performed before surgical interventions to ensure the bladder is emptied, reducing the risk of complications such as bladder distension or injury during the operation. The Centers for Disease Control and Prevention (CDC) report that urinary catheterization is performed on 15–25% of hospitalized patients at some point during their stay. Furthermore, 5–15% of patients admitted to nursing facilities require long-term urinary catheterization, necessitating regular catheter changes.²

This video provides an in-depth demonstration of the proper technique for inserting a Foley catheter in a male patient. The Foley catheter is inserted using a strict aseptic technique. The sterile catheter package is opened, and the clinician is wearing sterile gloves to maintain a fully sterile field. The patient’s genital area is draped to prevent any risk of contamination. The penis is thoroughly cleansed, with the left hand designated as the non-sterile non-dominant hand and the right hand maintaining sterility. For uncircumcised patients, the prepuce should be retracted during this stage. Particular care is taken to meticulously clean the urethral meatus to ensure a sterile procedure. The lubricated catheter is gently inserted into the urethra, with care taken to maintain a straight orientation of the catheter during advancement. Another option could be injecting the lubricant into the urethra through the urethral meatus. Once the catheter is fully inserted, the retention balloon is inflated with sterile water or saline to secure the device in place. If the patient is uncircumcised, the prepuce should be brought back at this stage. Proper positioning of the catheter is essential to ensure patient comfort and facilitate urine drainage.

Throughout the entire process of Foley catheter insertion and removal, strict adherence to aseptic technique and a focus on patient comfort and safety are of the utmost importance. Proper care and maintenance of the Foley catheter are crucial to prevent the development of complications, such as urinary tract infections (UTIs), which are the cause of 40% of all hospital-acquired infections and 80% of all nosocomial urinary tract infections (UTIs) and catheter-related bladder discomfort (CRBD).^3,4 The catheter should be secured in place to prevent accidental dislodgement, and the drainage bag should be positioned below the level of the bladder to promote proper urine flow. Regular cleaning of the external portion of the catheter and the surrounding skin is also necessary to maintain good hygiene and prevent infection.

When it is time to remove the catheter, a standard protocol is followed. Regardless, the balloon is fully deflated, and the catheter is gently withdrawn in a straight motion. Finally, the used catheter is discarded appropriately.

Foley catheterization is a critical component of the care provided to patients undergoing surgical interventions. The procedure requires careful attention to detail and the implementation of proper sterile techniques to ensure patient safety and optimal outcomes. This video provides a step-by-step demonstration of Foley catheterization in a male patient, highlighting the importance of this procedure for medical personnel.

Statement of Consent

The patient referred to in this video article has given their informed consent to be filmed and is aware that information and images will be published online.