![]() 4 Repeated and unsuccessful attempts at blind urinary catheterization result in stress and pain for the patient, injury to the urethra, potential urethral stricture requiring surgical reconstruction, and problematic subsequent catheterization. 4 Such measures could result in up to 38,000 preventable infections and 9,000 preventable deaths related to these infections per year. 3 The National Quality Forum, a nonprofit organization that develops national priorities and goals for performance improvement to enhance the quality of healthcare, estimated that 17% to 69% of catheter-associated urinary tract infections may be prevented with recommended infection control measures. 1, 2 Methods to reduce the incidence of infection are particularly relevant since the Centers of Medicare and Medicaid Services (CMS) under rule CMS-1533-FC no longer reimburse for catheter-associated urinary tract infections. Even routine urinary catheter placement may cause trauma and poses a risk of infection. 1 Solutions to problematic urinary catheterization are not well known and when difficult catheterization occurs, the risk of failed catheterization and concomitant complications increase. Male catheterization, in particular, can be difficult, especially in patients with enlarged prostate glands or other potentially obstructive conditions in the lower urinary tract. This algorithm will aid healthcare personnel in decision making and has the potential to improve quality of care of patients.Īcute urinary retention (AUR) and other genitourinary conditions often lead to difficult catheterizations. In addition, for progressive clinical practice, an algorithm for the management of difficult urinary catheterizations that incorporates technology enabling direct visualization of the urethra during catheter insertion is presented. Best practice methods for blind catheter placement are summarized in this review. Improved techniques for catheter placement are essential for all healthcare personnel involved in the management of the patient with acute urinary retention, including attending emergency physicians who often are the first physicians to encounter such patients. Improper insertion of catheters also can significantly increase healthcare costs due to added days of hospitalization, increased interventions, and increased complexity of follow-up evaluations. Repeated and unsuccessful attempts at urinary catheterization induce stress and pain for the patient, injury to the urethra, potential urethral stricture requiring surgical reconstruction, and problematic subsequent catheterization. Solutions to problematic urinary catheterization are not well known and when difficult catheterization occurs, the risk of failed catheterization and concomitant complications increase. Routine urinary catheter placement may cause trauma and poses a risk of infection.
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