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Bladder catheterization is a commonly performed procedure in all hospitals. It can be performed by external, urethral, and suprapubic techniques. It is associated with complications including but not limited to urinary tract infection which is the most common hospital-acquired infection. This activity describes in detail the working knowledge for urethral catheterization, which is the most commonly used method worldwide and highlights the role of an interprofessional healthcare team in improving care for patients who undergo urethral catheterization. Objectives: Describe the process involved in bladder catheterization Identify the indications for bladder catheterization. Outlines the complications associated with bladder catheterization. Explain the importance of improving care coordination amongst the interprofessional team to improve outcomes for patients with bladder catheters. Access free multiple choice questions on this topic.

Urinary bladder catheterization is performed for both therapeutic and diagnostic purposes.[1][2]. Based on the dwell time, the urinary catheter can be either intermittent (short-term) or indwelling (long-term). There are three types of urinary catheters based on the approach of insertion. External catheters adhere to the external genitalia in men or pubic area in women and collect the urine. They are useful for the management of urinary incontinence. Urethral catheters are inserted through the urethra, with the tip advanced into the base of the bladder. Suprapubic catheters are inserted into the bladder surgically via a suprapubic approach. Urethral catheterization is most commonly performed in routine clinical practice and is discussed in this article.[2]

Complications of urethral catheterization include: Urinary tract infection (UTI) is the most common complication that occurs as a result of long term catheterization.[7] The normal urinary flow prevents the ascension of microbes from the periurethral skin avoiding the infection. Alteration of the defensive mechanism from the catheter results in an increased risk of UTIs.[3]  Escherichia coil and Klebsiella pneumonia are the most common organisms implicated in UTIs.[3] Recurrent UTIs are associated with increased antibiotic resistance. A chronic bladder infection can occur from urinary (10-100 ml) stasis at the base of the bladder, which is obstructed by the balloon of the catheter.[16] Pain due to traction on the drainage bag.[8] A transitory stinging sensation is common in men that often occurs during lubrication and can be minimized by cooling the gel to 4°C.[8] Paraphimosis[8] Urethral injury[17] Catheter obstruction can occur due to the sediment buildup in patients with subclinical bacteriuria. Flushing can often relieve the blockage. If unsuccessful catheter replacement may be required.[18] Urine leakage from the urethral meatus extrinsic to the catheter may occur as a result of bladder spasms. These spasms can be painful and can be alleviated with anticholinergic medications like oxybutynin. A negative effect on the quality of life, especially for patients with longterm indwelling catheters.[6] Due to these complications, indications for the bladder catheterization must be carefully reviewed before the procedure.

A myriad of clinical conditions may require bladder catheterization. While a physician or a nurse can place the catheter in most cases, consultation with urology is necessary for specific patients. The nurses are essential members of the interprofessional group, as they will predominantly perform the procedure. They also monitor the catheter and assist with the education of the patient and family as needed. The pharmacist will ensure that the patient is not on any medication that can precipitate urinary retention. The physical therapist also plays a role in early mobilization, voiding exercises, and rehabilitation. Interprofessional communication and care coordination among health professionals are vital to enhancing patient-centered care and improve outcomes.