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Indications for indwelling urinary catheter use
1. Before placing an indwelling catheter, please consider if these alternatives would be more appropriate:
- Bedside commode, urinal, or continence garments: to manage incontinence.
- Bladder scanner: to assess and confirm urinary retention, prior to placing catheter to release urine.
- Straight catheter: for one-time, intermittent, or chronic voiding needs.
- External “condom” catheter: appropriate for cooperative men without urinary retention or obstruction.
2. Before placing an indwelling catheter, does the patient have one of the following appropriate indications* for placing indwelling urinary catheters?
- Acute urinary retention: e.g., due to medication (anesthesia, opioids, paralytics), or nerve injury
- Acute bladder outlet obstruction: e.g., due to severe prostate enlargement, blood clots, or urethral compression
- Need for accurate measurements of urinary output in the critically ill
- To assist in healing of open sacral or perineal wounds in incontinent patients
- To improve comfort for end of life, if needed
- Patient requires strict prolonged immobilization (e.g., potentially unstable thoracic or lumbar spine, multiple traumatic injuries such as pelvic fracture)
Selected peri-operative needs:
- Urologic surgery or other surgery on contiguous (adjacent) structures of the genitourinary tract
- Anticipated prolonged duration of surgery (Note: catheters placed for this reason should be removed in PACU)
- Large volume infusions or diuretics anticipated during surgery
- Need for intraoperative monitoring of urinary output
*For full text of these guidelines please see this link.