Urinary catheters are important pieces of medical equipment that can be used in a wide range of settings and situations, and it’s important for medical personnel to know exactly how to insert them. These pieces of tubing can allow patients to drain their bladders when it would otherwise be difficult or painful to do so, and both male and female patients may require catheter insertion. In this guide, we’ll take a step-by-step look at how to insert a catheter in females.

Who Can Insert a Catheter?

Before we look at exactly how to insert a catheter in a female patient, it’s important to understand who can carry out this procedure. There are multiple members of the typical hospital or medical team who can usually perform catheter insertion in females, including doctors, nurses, and EMTs. It’s useful to have several members of the team who can carry out this procedure so that there’s always someone on-call who can get the job done. Even patients may be taught how to insert their own catheters if they require long-term self-catheterization.

When Should You Insert a Female Catheter?

So, when are catheters needed and why would a female patient require a catheter to be inserted? Well, there are lots of different reasons for catheter usage and many situations may call for the presence of a catheter in a female patient. These tubes make it easy for the bladder to be drained of urine, so they’re commonly used in situations when a patient may find it difficult or painful to pass urine normally. However, there are also other situations in which a catheter may be needed. Here are some of the main cases for female catheterization:

• To allow urine to drain when there is an obstruction in the urethra 
• To help patients who have bladder weaknesses or difficulty urinating 
• To treat patients who suffer from incontinence or cannot control their urination 
• To deliver medicine to the bladder in order to treat certain conditions, like bladder cancer 
• To drain a patient’s bladder before or after an operation 
• To drain the patient’s bladder during childbirth after an epidural

What to Do Before Inserting a Female Catheter

Before you actually begin the process of preparing and inserting the catheter into the female patient’s body, it’s important to carry out a few extra steps to get everything ready. This includes preparing your various supplies and pieces of equipment, as well as preparing your patient and letting them know about the procedure. Here are some important things to do before you begin:

• Prepare the Supplies – For a catheter insertion, you’ll need to make sure you’ve got the right type and size of catheter for your chosen patient. You’ll also need to assemble some other key supplies like sterile gloves, Betadine swabs, and lubricant.
• Identify the Patient – It’s always important to ensure that you’re working with the right patient, so it’s best to carry out a simple ID check before you begin. To do this, you can either ask the patient to provide you with some information or check their wristband.
• Speak with the Patient – Provided that it’s possible to do so, it’s also wise to speak with the patient and talk to them about the procedure. Many patients are nervous about catheterization but you can help to put them at ease in this early stage.

Catheter Insertion in Female Patients (Step by Step)

Next, let’s go over the process of how to insert a catheter in a female patient. This guide will provide a step-by-step guide for female catheterization and is based on a typical female Foley catheter kit. Your kit might be slightly different, or you may have to make special adjustments to suit your patient, but the steps below can be used as a general guide for how to insert a catheter.

1. Wash Your Hands – Before you actually start touching the patient or touching any of the catheter equipment, it’s always good practice to wash your hands. This will help to get rid of any surface dirt and germs, minimizing the risks of contamination or microbes spreading around when you start interacting with your patient.  
2. Gather All of the Equipment – Next, you’ll need to gather all of your urinary catheter supplies. Usually, urinary catheters will come in boxed kits that you can simply unwrap with care, containing all the items you need to carry out the procedure. If you don’t have one of these kits, you’ll need to prepare a catheter tray and fill it with all of the various items that you need. Place the items near the patient’s bedside for easy access.
3. Speak with the Patient and Get Them Ready – The next step of the process is to speak with your patient. Verify their ID and chat with them about the procedure so that they know what to expect. After that, you can roll away the sheets or blankets and lift the patient’s gown to expose the genital region. You may also ask your patient to spread and bend their legs slightly to help you later on when it comes to accessing the area and inserting the catheter. 
4. Prepare the Supplies – Next, you can get the urinary catheter ready for insertion. First, put on some sterile medical gloves and make sure that you maintain sterility for the rest of the procedure, as infection is one of the most common problems that can occur with catheter insertion. If you do break sterility, take off the medical gloves and start over with a fresh pair. At this stage, you can also place a drape below the patient and a second holed drape over the patient’s genitals. You can also open the packet of Betadine swabs and place them in your tray, as well as squeezing out the lubricant into a recess in the tray.
5. Test the Balloon (Optional) – This step is optional, but it may be recommended depending on the policy of your hospital and the type of catheter kit you’re working with. It involves attaching the syringe of saline solution to the catheter tubing in order to test the balloon and make sure that it inflates correctly. You can then deflate the balloon and leave the syringe attached or remove it, depending on personal preference, before proceeding with the insertion process. 
6. Choose a Clean and Dirty Hand – From this point on, you’ll have to decide on one hand that will become contaminated and one hand that you will continue to use on the catheter itself. It’s usually standard procedure to select your non-dominant hand as your “dirty” hand, and this is the hand you’ll use to touch the patient’s body during the next steps. Make sure you do not touch any of the catheter tubing or other supplies with this hand again until the insertion is complete.
7. Clean the Patient – You can then use the Betadine swabs to clean the patient’s genital area. To do this, use your dirty hand to gently push the labia of the patient apart and then take a swab in your clean hand. Using a downward movement, rub the swab along one side of the vulva, and then dispose of it. Repeat the process with additional swabs along the other side and down the middle.
8. It is now time to insert the catheter. To do this, use your clean hand to pick up the catheter tubing and dip it into the lubricant, if you have not already done so. This will make it easier and more comfortable to insert into the patient. Keep your dirty hand on the patient’s body and keep the labia apart to make insertion easier. Push the catheter tubing gently and slowly into the urethra.
9. Push the Catheter Further – Continue to push the catheter further into the patient’s body until you see urine flow back into the tubing. This means that the tip of the catheter has reached the bladder, and at this point, you can just push it a little bit further and then stop. 
10. Inflate the Balloon – As soon as the catheter is in position, you can use the saline syringe to inflate the balloon, which you may have tested earlier on. The kit packaging or catheter tubing should tell you exactly how much saline you need to inject in order to fully inflate the balloon, which may be 5 or 10ml. As the balloon inflates, it helps to hold the catheter in position, allowing you to let go and complete the procedure.
11. Clear Away the Items – You may have some of the pieces of equipment around or on the patient’s bed at this stage, so you can take a moment to get rid of them and clear up the area. 
12. Attach the Tubing and Bag – You can then attach the tubing to the top of the patient’s leg, before attaching the catheter bag to the bed. The bag should be placed on a solid area of the bed so that it doesn’t move around much, and it should be positioned below the level of the patient’s hips to prevent any backflow.

Frequently Asked Questions

Is Inserting a Female Catheter Painful?

Yes, there is a risk that the patient may experience some pain or discomfort, especially at the moment of insertion. This should fade quite quickly once the catheter is in position, and anesthetic gel can be used in some cases to ease any pain for the patient. If pain continues once the catheter is in place, there may be cause to remove and reinsert the catheter.

Can a Female Catheter Be Inserted Incorrectly?

Yes, it is possible for female catheters to be inserted incorrectly, and this may cause damage inside the urethra or even damage the bladder in some way. This is why it’s so important to understand the procedure and carry it out correctly to reduce the risk to the patient.

How Far Should You Insert a Female Catheter?

In general, catheters only need to be inserted a few inches in female patients. This can vary, depending on factors like the age of the patient, but it shouldn’t usually be more than 3 or 4 inches.

Can Catheter Insertion Cause Damage or Bleeding?

Yes, there is a risk of bleeding during both catheter insertion and catheter removal. This kind of bleeding may be caused due to improper insertion and damage to the inside of the urethra. Scarring may also occur.

Should You Use Sterile Gloves When Inserting a Female Catheter?

Yes, it is crucial to wear sterile gloves and maintain sterility as much as possible during any kind of catheter insertion. The risk of infection is high during catheterization, so it’s key for medical personnel to minimize the risk and prevent any germs passing from their own hands into the patient’s body or onto the catheter tubing. 

What Other Supplies Are Necessary When Inserting a Female Catheter?

You may require a range of other items when inserting a female catheter in addition to the tubing itself, including a syringe, some sterile gloves, Betadine swabs, medical wipes, and more.