From the Guidelines
A straight catheter should be used in patients with acute urinary retention when the postvoid residual bladder volume exceeds 500 cm3, as detected by a bladder scanner, or when symptomatic with a volume greater than 300 cm3. To determine the need for straight catheterization:
- Use a bladder scanner to measure postvoid residual bladder volume
- Assess for symptoms such as bladder pain or fullness, persistent urge to void, new incontinence or leaking, or being only able to have frequent small voids
- Consider the patient's overall clinical condition and the potential risks and benefits of catheterization 1 The use of straight catheterization in this context is supported by the most recent evidence, which emphasizes the importance of appropriate indications for catheter use to prevent catheter-associated urinary tract infections 1. In patients with urinary retention, straight catheterization can help relieve retention, prevent bladder overdistension, and reduce the risk of urinary tract infections. Key considerations for straight catheterization include:
- Using sterile technique to minimize the risk of infection
- Inserting a catheter of appropriate size, such as a 14-16 French catheter
- Draining the bladder completely to relieve retention
- Removing the catheter immediately after draining to minimize the risk of infection
- Monitoring urine output after catheterization to assess for recurrent retention or other complications 1.
From the Research
Indicative Bladder Urine Volume for Straight Catheter Use
- The indicative bladder urine volume for straight catheter use in urinary retention is not explicitly stated in the provided studies.
- However, study 2 mentions that clean intermittent catheterization is an alternative to indwelling urinary catheterization for acute or chronic urinary retention with a postvoid residual greater than 300 mL.
- Study 3 provides criteria for appropriate urinary catheter use, including scenarios for urinary retention, but does not specify a particular bladder urine volume for straight catheter use.
Relevant Catheterization Guidelines
- Study 4 recommends performing clean intermittent catheterization at regular intervals during the day, with catheterization every 4-6 hours to assess bladder volume.
- Study 2 indicates that external urinary devices are suitable for urinary incontinence with a postvoid residual less than 300 mL, while indwelling urinary catheterization is indicated for severe urinary retention or bladder outlet obstruction.
Catheterization Complications and Considerations
- Study 5 outlines the procedure for safe removal of a urinary catheter and highlights potential complications, including healthcare-associated infection and trauma to the neck of the bladder.
- Study 6 explores the efficacy and safety of catheter clamping versus natural drainage in patients with neurogenic bladder, but does not provide specific guidance on bladder urine volume for straight catheter use.