How to deal with patients who still leak urine despite having an indwelling urinary catheter?

1. Health education and psychological care

Provide explanations and knowledge education to patients so that they can relax and actively cooperate. Explain to patients the purpose and care of indwelling urinary catheters, and teach patients how to clamp or open urinary catheters according to individual conditions.

2. Reasonable selection of urinary catheters

Through observation in clinical practice, it is believed that for first-time indwelling urinary catheters, elderly men generally use F18-20 balloon urinary catheters, and elderly women generally use F16-18 balloon foley catheters.

The choice of urinary catheter model is also related to the patient's gender and age. For male and female patients of the same age group, male patients use slightly larger product specifications, especially older male patients who use larger specifications.

3. Choose a high-quality urinary catheter

Before indwelling a urinary catheter, you must carefully check the quality of the urinary catheter, inject 0.9% saline into the balloon, observe whether there is water leakage, and test the size, shape, thickness of the balloon wall, and whether there are any deformities.

4. Strictly implement correct operating procedures

Use a disposable balloon catheter from a regular manufacturer. Use moderate and even force when injecting normal saline. At the same time, pay attention to pressure changes and patient complaints to avoid balloon rupture or damage to the urethra during catheter insertion.

5. Treatment of urinary catheter obstruction

For patients with an indwelling urinary catheter, always check whether the urinary catheter is compressed or twisted, and keep the urinary catheter and urine bag below the level of the bladder to maintain smooth drainage. In order to prevent stones from blocking the urethral opening, patients can drink 800 to 1200 ml of boiled water on time every day. They can also inject normal saline into the urinary catheter to clean the debris in the urinary catheter.

6. Treatment of urethral relaxation

When catheterizing, it is advisable to choose a catheter with a larger model and a thicker lumen, which can prevent urine from overflowing and ensure the smoothness of the urinary catheter. You can also use gauze pulling method. In addition, the patient can be assisted to lie on his or her side to reduce urine outflow.

7. Dealing with improper amount of water injected into the air bag

When the urinary catheter model is appropriately selected and objective factors related to urine leakage are eliminated, the focus is on adjusting the amount of water injected into the air bag. The standard for the amount of water injected into the airbag is 10 to 15 ml in the nursing technical operating procedures and scoring standards. ​

8. Handling improper pipe clamping time

For awake patients who feel the need to urinate, those who use diuretics or large amounts of infusion should appropriately shorten the urination time, but must ensure that the bladder has a certain capacity before urinating to prevent bladder atrophy.

In clinical work, there are many related factors that cause urinary leakage during the indwelling urinary catheter in elderly patients, and different prevention and treatment strategies are chosen for patients with different situations.