Coude catheter

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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

Authors:

Neil Young