What is a Foley Catheter?

Foley Catheter Information

A Foley Catheter Properly Placed Into the Bladder. © ADAM

What Is a Foley Catheter?

A Foley catheter is an indwelling urinary catheter. Named for Frederic Foley, the surgeon who first designed the catheter, the Foley is a hollow, flexible tube that is inserted into the bladder through the urethra.

For patients who are unable to empty their bladder for a wide variety of reasons that including having anesthesia during surgery or a problem with the bladder itself, the foley allows urine to drain continuously.

While urine would normally collect in the bladder, then be released during urination, the foley allows it to be constantly drained from the bladder.  The urine is collected in a bag and emptied as needed.

How a Urinary Catheter Works

The Foley catheter is inserted into the urethra, the tube that carries urine out of the body.  It is gently pushed up the urethra until it reaches the bladder.  A hole in the bladder end of the tube allows urine to flow out of the bladder, through the urethra and out of the body into the collection bag.

Once the top of the foley tubing reaches the bladder, a balloon is inflated with sterile water to keep the tube in place. The catheter is intended to remain in place for several hours or longer. It is important that a catheter only remain in place as long as it is necessary, as the risk of infection increases the longer the catheter is in place.

A catheter is not a substitute for good nursing care, nor is it a substitute for frequent trips to the restroom.

Foley catheters are not appropriate as a treatment for incontinence.  For example, patients who have joint replacements have catheters placed before surgery and will typically have it remain in place for up to a few days after surgery if they are unable to get on the bedpan without having pain and are unable to walk to the bathroom.

Foley Insertion

Foley catheters are commonly placed prior to surgery, to keep the bladder empty during and after the procedure. During the procedure the patient is unconscious and unaware of the need to urinate. After the procedure, however, it may not be safe for the patient to walk. They may be too sick to take care of their own bathroom needs or their surgeon may feel that a catheter is best for their particular recovery.

The insertion of the Foley is typically done by a nurse, and may be done before or after anesthesia is given, but typically prior to the first incision if the patient is having surgery. Hospitals vary in their protocols. For most, the placement of an indwelling catheter is considered standard for surgical procedures that are expected to last one hour or longer; when the patient will be going to the ICU after surgery; when the procedure involves the urinary tract; or when the patient will be unable to walk after the procedure. The urine collection bag attached to the foley helps track urine output during surgery and during a stay in the hospital.

The catheter is inserted using sterile technique, which means the catheter itself is sterile. The skin is prepared with a solution to remove germs and sterile gloves are worn by the nurse.

The catheter is coated with a sterile lubricant to make insertion easier and to avoid irritating the inside of the urethra. Sterile technique is used to help prevent urinary tract infections (UTIs), the most common complication associated with urinary catheter use.

Insertion of a Foley should not be painful; nor is it painful to have have one in place. Some patients describe having a Foley in place as a mild irritation. The catheter may interfere with your normal sensation of needing to urinate. You may feel as though you need to use the restroom even though the catheter keeps your bladder empty.

Foley Catheter Care

Once the catheter is in place, a patient may walk, but great care should be taken not to pull the tube out of place. Something as simple as tripping or stumbling can result in the tube being pulled out, so care should be taken whenever a catheter is in place.

Removing the catheter without deflating the balloon is not only very painful, it can cause permanent damage to the urethra. Frequently, the Foley tubing is taped to the patient's thigh to prevent accidental removal and trauma.

When a Foley is in place, excellent hygiene is essential for preventing a UTI. The portion of the tube that touches the body should be thoroughly cleaned during bath time and any time it is soiled. In addition, special soaps or cleansers may be used on the genitals to minimize the risk of infection after surgery.

Urinary Catheter Risks

An indwelling urinary catheter is intended to stay in place for an extended period of time, ranging from hours to weeks. In some patients, the catheter stays in even longer, but this is rare.  Most hospitals have programs and policies that require catheters to be removed as soon as possible to reduce the risk of infection occurring.

Some patients experience urinary retention after surgery, which may make a catheter necessary even if the patient did not need one during the procedure. Patients may also experience urinary retention after the removal of a Foley catheter.

In the past, patients who are allergic to latex would have issues with catheters of all types, as they often contained latex. Currently, most major brands of catheters have no latex component at all, eliminating this risk in almost all cases. Patients with latex sensitivity or allergies should notify their healthcare team prior to treatment, as there are many other potential sources of latex that should be avoided.

Straight Catheters

A Foley is a urinary catheter that is meant to be in place for a period of time. The Foley catheter should not be confused with a straight catheter, which is inserted once and discarded after the bladder has been emptied.

Sources:

Medline Plus. Urinary Catheters. Accessed September, 2011. http://www.nlm.nih.gov/medlineplus/ency/article/003981.htm

Continue Reading