Foley catheterisation involves inserting a flexible tube (catheter) through the urethra into the bladder to drain urine. It’s commonly used for:
- Urinary retention (e.g., BPH, post-surgery)
- Monitoring urine output (ICU, surgery)
- Incontinence management (if other methods fail)
- Bladder irrigation (e.g., hematuria)
1. Types of Foley Catheters
| Type | Features | Common Use |
| Standard Latex | 2-way (drainage + balloon) | Short-term use |
| Silicone | Less irritation, longer-term | Allergy to latex |
| 3-Way Catheter | Extra port for irrigation | Post-TURP, hematuria |
| Coude Tip | Curved tip for strictures | Enlarged prostate |
Sizes:
- Men: 14–18 Fr
- Women: 12–16 Fr
- Pediatrics: 6–10 Fr
2. Step-by-Step Foley Insertion
Supplies Needed:
✔ Sterile Foley catheter kit
✔ Sterile gloves, drapes
✔ Antiseptic (chlorhexidine/betadine)
✔ 10-20 mL sterile water (for balloon inflation)
✔ Lubricating jelly (2% lidocaine jelly preferred for men)
Procedure:
For Women:
- Position: Lithotomy (supine, knees bent).
- Clean: Labia → urethral meatus (wipes: front-to-back).
- Insert: Advance the catheter 2–5 cm until urine flows.
- Inflate the balloon (5–10 mL sterile water), then gently pull back.
For Men:
- Position: Supine, penis held upright.
- Clean: Glans → urethral meatus (circular motion).
- Insert: Advance 15–25 cm (resistance at prostate may require gentle pressure).
- Inflate the balloon, then secure.
⚠️ Never inflate a balloon unless the urine return is confirmed (risk of urethral trauma).
3. Post-Insertion Care & Maintenance
- Secure the catheter to the thigh/abdomen (prevents traction injury).
- Keep bag below bladder (no backflow).
- Daily hygiene.
- Change catheter:
- Latex: Every 2–4 weeks
- Silicone: Every 4–12 weeks
- However, it should be changed sooner if it becomes clogged, painful or infected or if the closed system is compromised.
4. Complications & Management
| Complication | Signs/Symptoms | Action |
| UTI | Fever, cloudy urine, dysuria | Antibiotics, culture |
| Trauma/False Passage | Pain, bleeding, no urine | Stop, consult urology |
| Blockage | No drainage, distended bladder | Flush with saline |
| Catheter-Associated UTI (CAUTI) | Fever, foul-smelling urine | Remove/replace catheter, antibiotics |
| Balloon Deflation Failure | Unable to remove | Cut valve, or urology consult |
5. When to Remove a Foley?
- No longer medically needed (e.g., post-op recovery).
- Signs of infection (CAUTI).
- Malfunction (leakage, blockage).
Removal Steps:
- Deflate the balloon completely (aspirate all water).
- Gently pull out the catheter.
- Monitor for urinary retention post-removal.
Key Takeaways:
✅ Use sterile technique to prevent infections.
✅ Confirm urine flow before inflating the balloon.
✅ Secure the catheter properly to avoid trauma.
✅ Remove ASAP when no longer needed (reduces UTI risk)
