Catheters are essential medical devices that are used to help drain urine out of a patient’s bladder when it may be difficult, painful, or impossible for the patient to pass urine naturally. There are a lot of medical conditions that can call for the use of a urinary catheter, including the likes of incontinence or a swollen prostate, and it’s key for medical personnel to know how to insert a catheter. In this guide, we’ll provide step-by-step instructions for catheter insertion in males.

Who Can Insert a Catheter?

There are many medical professionals who can be trained in catheter insertion and who will be capable of inserting a catheter into a patient. The likes of doctors, nurses, and EMTs, for example, may all be trained in catheter insertion, and it’s important for many members of the medical team to have this skill, as catheter insertion can be a crucial step in patient treatment. It’s even possible for patients to be taught to insert their own catheters at home, if they are living with conditions that require long-term catheter usage.

When Should You Insert a Male Catheter?

As mentioned above, there are many situations in which a urinary catheter can be used in male patients. It can be a useful tool to aid in alleviating some of the symptoms of certain conditions for patients, as well as being used prior to or after certain forms of surgery to allow the patient to pass urine without needing to leave their hospital bed. Here are some of the main instances when urinary catheter should be used:

• To treat patients who have some sort of obstruction or blockage within the urethra that makes it hard or painful for them to urinate 
• To help patients who are suffering from issues like incontinence or bladder weakness 
• To drain the bladder before or after certain forms of surgery 
• To deliver medicine to the bladder to treat certain conditions, like bladder cancer

What to Do Before Inserting a Male Catheter

Before we get to the step-by-step process of actually inserting the catheter into the male patient, it’s important to ensure that you’ve carried out all of the necessary preparation. By preparing the supplies and the patient, the process will be able to go much more smoothly. Here are some key things to do before you begin:

• Prepare the Supplies – Catheter insertion requires not only the catheter itself, but also some additional supplies, such as a syringe, medical wipes, cleaning clothes, gloves, and so on. Ensure that you prepare all the essentials before starting the process. 
• ID the Patient – It’s important to ensure that you’re working with the correct patient for catheterization, so nurses and doctors should always verify the identification of their patient before they begin by asking for two pieces of information, like name and date of birth.
• Speak with the Patient – As long as it’s possible to do so, it’s also a good idea to communicate with the patient before the process begins to explain to them what will happen and what the catheterization will involve.

Catheter Insertion in Male Patients (Step by Step)

Next, let’s take a look at exactly how to insert a catheter in a male patient. This guide will provide multiple instructions for the process in a simple step-by-step format, covering the basic process for general catheterization. Remember that the specifics of your situation may be different, so you may have to make some slight alterations based on the patient or the specific kind of catheter you’re working with.

1. Wash Hands

Before you begin interacting with the patient or preparing any of the necessary supplies for the catheter insertion process, it’s important to wash your hands. Use soap and warm water or other cleaning solutions to help get rid of any dirt or germs from your hands. This will help to minimize the risks of infection later on during the procedure.

2. Gather the Supplies

Next, collect all of your urinary catheter supplies. Often, urinary or Foley catheters will come in packaged kits that contain all of the necessary items you need to use during the insertion process, like the catheter tubing itself, a pair of sterile gloves, a urine collection bag, and so on. Gather the various items and place them on a stand near the patient’s bed so that you have easy access. 

3. Prepare the Patient

The next step is to prepare the patient. You should verify the patient’s identity and speak with them to explain the process. You should also ask the patient to lie flat on their back in a comfortable position. Ideally, it helps if the patient can bend the knees and spread the legs slightly, but this may not always be possible. You should then pull back the sheet and any coverings to expose the patient’s penis. 

4. Prepare the Supplies

Next, you can start preparing the urinary catheter. You’ll need to be sterile during this process, so the first thing to do is put on your sterile medical gloves and try to avoid touching anything that may not be sterile, like the bedsheets, table, and so on. If any contact does occur, you’ll need to change gloves. You should also take this time to verify that the appropriate type and size of catheter for the patient you’re working with, and you can apply a sterile drape below the patient and a second holed drape over the penis. You should also open the packet of Betadine swabs and place them in your tray, as well as opening the packet of lubricant and squirting it out into the tray.

5. Test the Balloon (Optional)

Next, you may wish to test the balloon of your Foley catheter before insertion. To do this, you’ll need to take the saline syringe and connect it to the appropriate part of the catheter tubing. Then, hold the end of the tubing in one hand and gently push the syringe’s plunger with the other. Watch to see if the balloon at the tip of the catheter inflates. This will help you verify that the balloon is working as intended, and you can then draw the saline back out to deflate the balloon. Some kits may recommend testing the balloon, but others won’t. Check the instructions with your kit to verify.

6. Decide on a Clean and Dirty Hand

At this stage of the procedure, you will begin touching the patient’s body and one of your hands will become contaminated or “dirty”. You need to decide which hand you will use to touch the patient (usually the non-dominant hand) and make sure to keep that hand away from the catheter supplies for the rest of the procedure.

7. Clean the Penis

Using your dirty hand, grasp the penis and gently lift it upwards, so that it’s pointing towards the ceiling, if possible. You can then use your clean hand with the Betadine swabs to clean it. Begin by using one swab around the outside of the penis, and the discard it. Then repeat the process with additional swabs, cleaning all around the glans of the penis with each swab. 

8. Lubricate and Insert the Catheter

The next step is to actually insert the catheter into the patient’s body. Before you begin, place the tip of the catheter in the lubricant that you poured into the tray earlier. Continue to keep the penis held in your dirty hand as you approach and ask the patient to breathe in and prepare for some mild discomfort. You can then push the catheter slowly and gently in through the urethral opening.

9. Push the Catheter in

Continue to push the catheter slowly into the patient’s body until you see urine flow through the tube. This means that the tip of the catheter has reached the bladder. At this stage, you should push the catheter just slightly further (about 1 inch) into the body and then stop.

10. Inflate the Balloon

Once the catheter is in position, you can use the attached saline syringe to inflate the balloon. The kit should tell you exactly how much saline to inject in order to fill the balloon, which should usually be between 5 and 10ml. The balloon will then inflate, which helps to hold the catheter in place. After that, you can remove the syringe.

11. Clear Away the Items

At this stage, certain items that you used during the insertion may be on or around the bed. You can get rid of them to clear the area, and you can now use both hands to do this, as you should not need to touch the patient’s penis again.

12. Attach the Tubing and Bag

You may then wish to attach the tubing on top of the patient’s leg, as well as making sure that the bag is attached to the bed. Ensure that it is placed onto a solid part of the bed and situated below the level of the patient’s hips to prevent any backflow or discomfort.

Frequently Asked Questions

Is Inserting a Male Catheter Painful?

It can be an uncomfortable and mildly painful experience for the patient to have a catheter inserted, but this discomfort should subside once the catheter is in place. If pain persists, the catheter may have been inserted incorrectly and it may need to be removed and reinserted.

Can a Male Catheter Be Inserted Incorrectly?

Yes, it is possible for catheters to be inserted incorrectly, and this can lead to risks and complications such as damage and scarring along the urethra or damage to the bladder itself. This can cause pain and discomfort for the patient.

How Far Should You Insert a Male Catheter?

This will depend on the patient, but in general, male catheters should be inserted around seven to nine inches. The simplest way to check for the right distance is to insert the catheter gradually until urine begins to flow through the tube, then push it one final inch and stop.

Can Catheter Insertion Cause Damage or Bleeding?

Yes, there is a possibility of damage and even bleeding due to improper insertion of a catheter. If the catheter is inserted incorrectly, it can damage the urethra or even the bladder, and this may lead to bleeding and scarring.

Should You Use Sterile Gloves When Inserting a Male Catheter?

Yes, it is recommended to use sterile gloves when carrying out any kind of catheterization. This will help to reduce the risk of any microbes being transferred from your hands onto the catheter tube and then inserted into the patient’s body. This is very important, as infection is one of the most common complications associated with catheter insertion.

What Other Supplies Are Necessary When Inserting a Male Catheter?

There are various items and pieces of equipment that you may need when inserting a catheter into a male patient. This includes the catheter itself, a syringe to inflate or deflate the catheter balloon, some sterile gloves, gauze, wash cloths, and a catheter bag.