Coude catheter: Difference between revisions

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==Indications/Contraindications==
==Indications/Contraindications==
#Same as for Foley catheter placement (but typically used after failure of Foley placement) in a man with an enlarged prostate.
#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
#Almost never used in pediatric patients
#History of urethral strictures is contraindication - higher risk for false tracts


==Procedure==
==Procedure==
#insert with curved tip pointing up (cephalad)
#Use Urojet lidocaine and inject tip into the meatus / distal urethra
#gentle but continuous pressure past the resistance point
#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.
#advanced until the hub is at the glans (with urine return through catheter)
#Gentle but continuous pressure past the resistance point
#inflate balloon (10 mL of saline)
#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


==Complications==
==Complications==
creation or extension of false tracts
Creation or extension of false tracts


==Source==
==See Also==
*[[Urinary retention]]
*[[Traumatic foley catheter removal]]
 
==References==
<references/>
Evaluation and treatment of acute urinary retention. J Emerg Med. 2008:  35:193-198
Evaluation and treatment of acute urinary retention. J Emerg Med. 2008:  35:193-198


[[Category:Procedures]]
[[Category:Procedures]]
[[Category:GU]]
[[Category:Urology]]

Revision as of 23:09, 4 November 2018

Indications/Contraindications

  1. 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.
  2. Almost never used in pediatric patients
  3. History of urethral strictures is contraindication - higher risk for false tracts

Procedure

  1. Use Urojet lidocaine and inject tip into the meatus / distal urethra
  2. 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.
  3. Gentle but continuous pressure past the resistance point
  4. Advanced until the hub is at the glans with urine return through catheter. If no urine return, attempt urine aspiration.
  5. Inflate balloon (10 mL of saline) once urine return confirmed

Complications

Creation or extension of false tracts

See Also

References

Evaluation and treatment of acute urinary retention. J Emerg Med. 2008: 35:193-198