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URINARY TRACT MANAGEMENT IN SPINAL CORD INJURY: URINATION AND THE URINARY TRACT IN SCI: INDWELLING CATHETER

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   Any catheter which is inserted into the bladder and allowed to remain in the bladder is called an indwelling catheter. A common type of indwelling catheter is a Foley catheter. A Foley catheter has a balloon attachment at one end. After the Foley catheter is inserted, the balloon is filled with sterile water. The filled balloon prevents the catheter from leaving the bladder.

STAYING HEALTHY WITH A FOLEY CATHETER

DO

  • Drink at least 4000cc (4 quarts) of liquid a day to keep urinary output over two quarts. Check urine daily for color, odor, etc.
  • Keep urine pH at 5.5 or under
  • Check leg bag every 1-2 hours; if nothing is in it look for cause.
  • Take medication regularly as prescribed
  • Wash genital area twice daily, or more often if needed, especially around the catheter
  • Men: tape catheter on abdomen at night to prevent fistula
  • Use only sterilized equipment for irrigation and drainage
  • Use sterile technique for urinary procedures
  • Irrigate only with prescribed solution
  • Report signs of infection to your doctor
  • Have urinary work-up every six months to one year as ordered. This includes sonogram and cystogram, which are X-rays of urinary system (also blood tests and urine tests). Entire work-up usually can be done in a few hours as an outpatient.
  • If your catheter plugs, change it immediately. Pinch catheter between fingers daily to feel if there is grit inside. If there is, it is time to change the catheter.
  • Change catheter as often as recommended by your doctor (usually every 2-4 weeks) unless it plugs
  • If you notice eggshell-like particles in catheter tip, or in urine let your doctor know

DO NOT

  • Touch with your bare hands anything that will go into the catheter or directly into your bladder, i.e., tips of leg bag, irrigation syringe or solution.
  • Allow the night drainage tubing to be higher than your bladder. The urine drains back into bladder and can cause infection.
  • Let your bladder get too full from a plugged catheter, too full bag, etc.
  • Use a leg bag when in bed overnight.

TAPING A CATHETER (FEMALE)

WHY IS IT DONE?

  • To prevent the catheter from being pulled out of the bladder.

WHAT YOU NEED?

  • Paper tape

WHAT TO DO

  • Cut six-inch strip of one inch paper tape
  • Place tape down on catheter about 2-3 inches from the end
  • Secure both ends of the tape to the inner thigh. Alternate thighs to prevent skin irritation


TAPING A CATHETER (MALE)

WHY IS IT DONE?
To prevent:

  • Peno-scrotal fistula
  • Catheter from being pulled out of bladder

WHAT YOU NEED?

  • Paper tape

WHAT TO DO

  • Cut six-inch strip of one inch paper tape
  • Place the tape down on the catheter about 2-3 inches from the end
  • Secure both ends of the tape to the abdomen below the navel.

OTHER INFORMATION
    Taping the catheter while in a wheelchair can help prevent it from being pulled out
     It must be taped up at night, or when you are lying down for a long time.


STAYING HEALTH WITHOUT A FOLEY CATHETER

DO

  • Drink amount of liquid necessary to keep urine clear or light in color
  • Check urine daily for color, odor, and eggshell-like particles (call your doctor if these are seen in your urine).
  • Keep urine pH 5.5 or under
  • Take medication regularly as prescribed
  • Wash genital area twice daily or more often if needed. If you wear an external catheter, wash when changing the catheter and leave it off at least 15 minutes.
  • Empty bladder regularly, usually every 3-4 hours
  • Do intermittent catheterization as often as needed so that more than 300cc of urine do not accumulate. Catheterize for residual urine as often as ordered.
  • Use proper technique for urinary procedures. If you ever need to irrigate following catheterization, use only sterile equipment.
  • Have urinary work-up every six months to one year as ordered. This includes sonogram and cystogram, which are X-rays of the urinary system, as well as blood and urine tests, all of which can be done in a few hours as an outpatient.
  • If residual urine is ordered regularly, report any marked increase in amount to your doctor (i.e. 60cc or more)
  • Drink cranberry or prune juice to promote acidic urine and reduce the risk of urinary tract infections.


DO NOT

  • Let your bladder get too full of urine (not over 300cc). If your bladder is very small, the amount is less.
  • Leave external catheters on so long that skin gets irritated
  • Apply external catheters too tightly or sores will occur
  • Use permanent rubber externals as skin breakdown can occur
  • Apply external catheter over a sore
  • Stretch tape or overlap tape when applying the external catheter or it will act as a tourniquet and cause pressure sores
  • Decrease fluid intake -You may become dehydrated, prone to stones, UTI's (urinary tract infections), etc.

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