Foley catheters are thin, flexible tubes that are inserted through the urethra and into the bladder to drain urine. Used frequently in healthcare facilities after surgical procedures, they provide an invaluable service to patients who need help draining their bladder in the short or long term. In this article, we will explore the function, uses, types and care of Foley catheters.

What is a Foley Catheter?

A Foley catheter is a hollow tube made of silicone rubber or latex that is inserted into the bladder through the urethra to drain urine. At one end, the tube is attached to a drainage bag to collect urine. The other end of the catheter has a small balloon near the tip that is inflated once inside the bladder with a small amount of sterile water. The balloon holds the catheter securely in place and prevents it from slipping out.

Typical sizes range from 12 to 26 French, which refers to the diameter of the catheter. Smaller sizes are used for children and larger for adults. Foley catheters are designed to stay in place for short or extended periods of time depending on the condition and needs of the patient. Modern catheters are also coated with antimicrobial agents to help prevent urinary tract infections.

Uses of Foley Catheters

Foley catheters are commonly used after surgical procedures involving the prostate, bladder, uterus or rectum to allow proper drainage of urine and accurately measure fluid intake and output. They are also frequently utilized in healthcare facilities for:

- Patients who cannot control their bladder due to illness, injury or effects of anesthesia.

- Monitoring urine output in critical care settings.

- Managing urinary retention when patients cannot empty their bladder.

- Patients undergoing radiation therapy or chemotherapy to the bladder or pelvis.

- Long-term management of chronic urinary problems or incontinence.

- Palliative care for terminally ill patients.

- Neurogenic bladder issues from conditions like spinal cord injury.

Proper Placement and Care of Foley Catheters

To insert a Foley catheter, the nurse or doctor first performs hand hygiene and dons gloves. Lubricating jelly is then applied to the tip before inserting it slowly into the urethra. Gentle pressure is applied until urine begins to drain, indicating proper placement in the bladder. The balloon is then inflated with sterile water and secured.

Proper care involves connecting the catheter to a closed drainage system, keeping the collection bag below bladder level, and recording intake and output amounts. The catheter site should be cleaned daily with soap and water to prevent infection. Regular replacement is also important, typically every 30 days for short-term use or sooner if any signs of blockage or infection arise.

Types of Foley Catheters

There are different types of Foley catheters tailored for specific needs:

- Intermittent catheters - Designed for temporary use only and removed once drainage is complete.

- Indwelling catheters - Left in place for extended periods, usually 7-14 days. Require more sterile precautions.

- Pediatric catheters - Smaller sizes for infants and children. May have specialized valves to prevent reflux.

- Coude tip catheters - Soft, pre-curved tip ideal for male patients to ease passage around prostate.

- Large bore catheters - Wider lumen for patients with urinary retention or clots.

- Antimicrobial catheters - Coated with silver, minocycline or other agents to decrease infection risk.

Potential Complications

While very useful, Foley catheters also carry risks if not inserted or cared for properly:

- Urinary tract infections (UTIs) are common if sterile technique is breached during insertion or care. UTIs can lead to sepsis if untreated.

- Displacement or kinking of the tube can obstruct drainage and potentially damage the urethra during removal.

- Bladder spasms may occur due to the irritation of the balloon or improper urine flow through the catheter.

- Urethral injuries such as swelling, trauma or false passages can happen during insertion, especially in males.

- Catheter-associated bladder or kidney damage from long-term indwelling use is also possible.

When managed carefully under a doctor's supervision, Foley catheters provide an invaluable service to healthcare. By following sterile technique insertion and proper ongoing care, patients can benefit from drainage while minimizing infection risks. With the multiple types available, there is often a catheter suitable for an individual's specific needs.

In conclusion, Foley catheters play an important role in modern medicine by providing temporary bladder drainage assistance during surgery recovery, critical illness monitoring, and long-term management of various urological conditions. Though not without risks if mishandled, they afford patients improved outcomes and comfort when used judiciously under medical oversight. Continued innovation also aims to further reduce infection rates from these indispensable urinary devices.