- Same as for Foley catheter placement (but typically used after failure of Foley placement) in a man with an enlarged prostate. Coude catheter navigates the S-shaped curve of the bulbous urethra, which is exaggerated in BPH.
- Almost never used in pediatric patients
- History of urethral strictures is contraindication - higher risk for false tracts
- Use Urojet lidocaine and inject tip into the meatus / distal urethra
- Insert with curved tip pointing up (cephalad). Pearl - If the balloon port or small knob at drainage end of the catheter is pointed up, the curved tip will be pointed up.
- Gentle but continuous pressure past the resistance point
- Advanced until the hub is at the glans with urine return through catheter. If no urine return, attempt urine aspiration.
- Inflate balloon (10 mL of saline) once urine return confirmed
Creation or extension of false tracts
Evaluation and treatment of acute urinary retention. J Emerg Med. 2008: 35:193-198