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.