[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Procedures](https://durgical.com/en/nursing/areas/procedures/) › Urinary catheterization # Urinary catheterization - Procedure A sterile catheter is passed through the urethra into the bladder to drain urine, only for a valid indication and with sterile technique. Updated Nov 5, 2026 ## Key points - Before inserting, confirm an accepted indication: incontinence alone is not one. - Insertion in hospital: hand hygiene, aseptic technique, sterile gloves, drape and equipment, and single-use lubricant. - Use the smallest catheter that drains well; in adults a 14 Fr is usually enough. - Inflate the balloon only once urine flows and the catheter is in the bladder; never pre-inflate it. - Secure the catheter to the thigh and keep the bag below the bladder, off the floor. On this page - The basics Key points - What it is - Indications - Equipment - Step by step (and why) - Next step: when to call for help - Memory aid - Clinical Complications - Safety Contraindications and precautions - Study Test yourself - Connections Connections ## What it is Urinary catheterization passes a catheter through the urethra into the bladder. It can be intermittent (the bladder is drained and the catheter removed) or indwelling (the catheter stays in, held by a balloon inflated inside the bladder and connected to a closed drainage bag). Indwelling catheters are the main cause of healthcare-associated urinary tract infection, so the 2009 CDC guideline asks for insertion only for an accepted indication, with aseptic technique and sterile equipment, and removal as soon as the catheter is no longer needed. When feasible, intermittent catheterization is preferred to an indwelling catheter. ## Indications - Acute urinary retention or bladder outlet obstruction. - Accurate measurement of urine output in critically ill patients. - Perioperative use for selected surgery (urological, prolonged, or needing output monitoring), with early removal. - Helping open sacral or perineal wounds heal in incontinent patients. - Prolonged immobilization (for example, unstable spine or pelvic fractures) and comfort at the end of life. - Not indications: replacing incontinence care, getting a urine culture from a patient who can void, or prolonged postoperative use without a reason. ## Contraindications and precautions - Look for alternatives: intermittent catheterization, an external catheter in cooperative men without retention, or a bladder scan to measure residual urine. - Ask about allergies (latex, antiseptics), urological or gynaecological surgery, prostate problems and previous difficult catheterizations. - Urethral strictures or other structural problems of the urethra or bladder: the catheter may not advance; do not force it, and ask. - Get help to position a patient who is confused, weak, has a hip or pelvic fracture or limited mobility. - Respect privacy, any request for a same-sex nurse and a possible history of trauma. ## Equipment - Sterile catheterization kit: drape, gloves, gauze or cotton balls, antiseptic or sterile solution for cleaning, single-use lubricant. - A catheter of the right size and a syringe of sterile water for the balloon, at the volume printed on the catheter. - A closed drainage bag, ideally pre-connected and sealed to the catheter. - Clean gloves and supplies for perineal care beforehand. - A securement device, good lighting and a waste container. ## Step by step (and why) - Check the order and indication, identify the patient and explain — a catheter without an indication adds infection risk with no benefit. - Give perineal care with clean gloves, then perform hand hygiene — it reduces germs near the meatus before the sterile kit is opened. - Position the patient (women supine with knees bent; men supine) and cover what is not exposed — it improves the view and protects privacy. - Open the kit as a sterile field and put on sterile gloves — insertion in hospital requires aseptic technique. - Lubricate the catheter tip and clean the meatus with the sterile dominant hand — lubricant reduces urethral trauma. - Insert the catheter gently while the patient breathes deeply, without forcing — forcing can injure the urethra or prostate. - When urine flows, advance a little further before inflating the balloon — so the balloon sits in the bladder, not the urethra. - Inflate to the stated volume and pull back gently to resistance; if it hurts, deflate and advance — pain on inflation suggests the urethra. - Secure the catheter to the thigh with slack and hang the bag below the bladder — it prevents urethral traction and backflow. - Record the date, size, balloon volume, urine appearance and tolerance — it supports follow-up and the daily review of need. ## Complications - Catheter-associated urinary tract infection: the most common complication, rising with each catheter day. - Urethral trauma, bleeding or a false passage from forcing the catheter or inflating the balloon in the urethra. - In women, a catheter in the vagina: no urine flows; leave it as a landmark, use a new kit and retry at the meatus. - Bladder spasms or ongoing pain despite good drainage. - Blockage or kinking with retention and bladder distension. ## Next step: when to call for help - If the catheter will not pass after a second gentle attempt (for example, an enlarged prostate), stop and report; a curved-tip catheter or the doctor may be needed. - Report pain that does not settle, frank bleeding, or a balloon that cannot be inflated without pain. - Report cloudy, foul-smelling, bloody or purulent urine, or a temperature of 38 °C or more, chills or new confusion. - Report output below the order's alert threshold after checking for kinks and the position of the bag. ## Memory aid «Only if, sterile, small, secured, low»: valid indication, sterile technique, smallest size, catheter secured, bag below the bladder. ## Test yourself Think of the answer, then tap the question to see it. ## Why is urinary incontinence alone not an indication for an indwelling catheter? Because a catheter does not replace nursing care and raises the risk of urinary tract infection; the CDC guideline lists it as an inappropriate use. ## Which catheter size is preferred in an adult? The smallest one that drains well, usually 14 Fr, to reduce trauma to the urethra and bladder neck. ## When is the balloon of an indwelling catheter inflated? After urine flows and the catheter has been advanced a little further. Never before insertion, and it is deflated if the patient feels pain on inflation. ## What should you do if no urine flows when catheterizing a woman? The catheter is probably in the vagina: leave it as a landmark, take a new kit, clean again and insert into the urethral meatus. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/urinary-catheterization/) ## Connections ## Related 5 - [Indwelling catheter care and removal](https://durgical.com/en/nursing/indwelling-catheter-care-and-removal/) - [Clean and sterile technique: medical and surgical asepsis](https://durgical.com/en/nursing/clean-and-sterile-technique-medical-and-surgical-asepsis/) - [Setting up a sterile field and putting on sterile gloves](https://durgical.com/en/nursing/setting-up-a-sterile-field-and-putting-on-sterile-gloves/) - [Preventing healthcare-associated infections: the care bundles](https://durgical.com/en/nursing/preventing-healthcare-associated-infections-the-care-bundles/) - [Urinary elimination: retention, incontinence and bladder scanning](https://durgical.com/en/nursing/urinary-elimination-retention-incontinence-and-bladder-scanning/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Guideline for Prevention of Catheter-Associated Urinary Tract Infections (2009)](https://www.cdc.gov/infection-control/hcp/cauti/index.html) (Centers for Disease Control and Prevention (CDC), HICPAC, 2009); [Nursing Skills, 11.4: Inserting and Managing Indwelling Urinary Catheters](https://med.libretexts.org/Courses/University_of_South_Carolina_Upstate/Nursing_Skills_(OpenRN)/11%3A_Facilitation_of_Elimination/11.04%3A_Inserting_and_Managing_Indwelling_Urinary_Catheters) (Open RN, Chippewa Valley Technical College (via LibreTexts), 2021); [Nursing Skills, 11.8: Applying the Nursing Process to Catheterization](https://med.libretexts.org/Courses/University_of_South_Carolina_Upstate/Nursing_Skills_(OpenRN)/11%3A_Facilitation_of_Elimination/11.08%3A_Applying_the_Nursing_Process_to_Catheterization) (Open RN, Chippewa Valley Technical College (via LibreTexts), 2021); [Detectar, prevenir y reducir infecciones asociadas con la atención en salud. Paquetes instruccionales, versión 2.0](https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/CA/Detectar-Infecciones.pdf) (Ministerio de Salud y Protección Social de Colombia, 2015). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/urinary-catheterization/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/urinary-catheterization/