Urinary Catheterization: a Paradigm Shift in Difficult Urinary Catheterization.
BACKGROUND
The urinary catheter is an ancient device for urinary drainage in patients. Placement of a urethral catheter is a common medical procedure that may have led to morbidity and mortality. Urethral catheterization is commonly performed by a nurse. Difficult catheter placement generates urology consultation. Difficult catheterization with a vision-guided urinary catheter may provide expedited and successful catheter placement by nursing personnel.


METHODS
A PubMed.gov and Ovid Medline search for articles on history of urinary catheter, difficult urinary catheterization, iatrogenic urethral injury, iatrogenic urethral injury and CAUTI, management of iatrogenic urethral injury, and techniques for urinary catheter placement was performed.


RESULTS
The history of urinary catheters is reviewed. Technical advances in the last century are discussed. Indications for catheter placement are included. Outcomes and cost of complications of urinary catheters are discussed relative to present practice quality standards. Review of difficult urinary catheterization management algorithms developed with urological catheter improvements during the last decade is analyzed. Educational and technological advances to improve outcomes of urinary catheter use are addressed.


CONCLUSIONS
Provider attention to issues of urinary catheterization is enhanced by education and additional skills for catheterization. Physician and nurse providers can use current technology with preparation to improve the catheterization care of patients.
Division of Urology, Department of Surgery, Texas A&M University Health Science Center College of Medicine/Baylor Scott & White Health, 2401 South 31st Street, Temple, TX, 76508, USA.
Kristofer R
KR
Wagner
Division of Urology, Department of Surgery, Texas A&M University Health Science Center College of Medicine/Baylor Scott & White Health, 2401 South 31st Street, Temple, TX, 76508, USA.
Erin T
ET
Bird
Division of Urology, Department of Surgery, Texas A&M University Health Science Center College of Medicine/Baylor Scott & White Health, 2401 South 31st Street, Temple, TX, 76508, USA. King.Coffield@BSWHealth.org.
K Scott
KS
Coffield
D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control*; D014521:Urethra / Q000293:injuries*; D014522:Urethral Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D014546:Urinary Catheterization / Q000592:standards*; D062885:Urinary Catheters
Difficult catheter placement; Direct vision catheter; Infections; Urethral injury complications; Urinary bladder drainage
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