Pemasangan Kateter Urethra
Pemasangan Kateter Urethra
Urethra
dr. Bobby Hery Yudhanto, SpU
email : bobby_fkua@yahoo.com
Indikasi
A. Diagnostik
Mengukur residual urine post miksi karena tidak adanya usg untuk
pemeriksaan
B. Investigasi
Pemeriksaan urodinamik
Pemeriksaan sistogram
C. Terapi
1.
2.
3.
4.
5.
6.
7.
8.
Anak-anak: 30 cm
B. Material
1.
Latex (rubber)
Soft and flexible
All rubber uncoated: short-term use up to 4 weeks
Does not have a smooth surface, causing high surface friction
2.
3.
Silicone elastomer-coated
Less prone to encrustation
Compatible with the urethral mucosa
Can remain in situ for up to 12 weeks
4.
Hydrogel-coated
Absorb fluid, thus form a hydrophilic slippery cushion between
urethra and catheter surface reducing trauma
Resists encrustation and bacterial colonisation
Can remain in situ for up to 12 weeks
Silver-alloy coated: can reduce infections in the short-term
5. Silicone
100% latex free: used in those with latex allergy
Thin-walled
Have wider drainage lumens
Compatible with the urethral mucosa
Lack flexibility
High surface friction
Can remain in situ for up to 12 weeks
Can be hydrogel coated
Council tip: have a small hole at the tip, which allows them to
be passed over a wir
D. Lumens
1. One lumen
Nelaton catheters : a simple straight tube with (a) hole(s) at the end. These are mainly
used for CISC. These catheters do not normally have an inflatable balloon.
Malcot or DePezzer catheters : These have a triangular-/mushroom-looking tip
designed for suprapubic catheterization or to drain urine from the renal pelvis. They
are without a balloon, and therefore will stay in position because the tip will fold out
once the stick inside the lumen of the catheter is retracted.
2.
Two lumens
Foley catheters: Two-way catheters with a tube and a balloon at the end to keep them
from falling out of the bladder.
3.
Three lumens
Hemostatic catheters: Three-way catheters are generally thicker than the previous two
catheters with an extra small separate channel. This allows fluid/irrigant to pass to the
tip of the catheter and into the bladder to flush it and wash away blood and small clots
through the primary arm that drains into a collection device.
4.
Four lumens
Three of the four lumens act as drainage conduit, inflation and deflation valve, or
continuous irrigation port while the fourth lumen provides irrigation or aspiration of the
operative site (e.g., following a transurethral resection of the prostate).
Types of large-diameter catheters. A, Conical tip urethral catheter, one eye. B, Robinson
urethral catheter. C, Whistle-tip urethral catheter. D, Coud hollow olive-tip catheter. E,
Malecot self-retaining, four-wing urethral catheter. F, Malecot self-retaining, two-wing
catheter. G, Pezzer selfretaining drain, open-end head, used for cystotomy drainage. H,
Foley-type balloon catheter, one limb of distal end for balloon inflation (i), one for
drainage (ii). I, Foley-type, three-way balloon catheter, one limb of distal end for balloon
inflation (i), one for drainage (ii), and one to infuse irrigating solution to prevent clot
retention within the bladder (iii).
B. Obat
a. Aquadest
b. Bethadine
c. Alkohol 70 %
Persiapan
Gentle / lembut
Asepsis &antiseptic
Asepsis & antisepsis penis dengan betadine dan kassa steril mulai glans penis hingga
seluruh penis sampai pada pangkalnya
Pasang duk bolong steril, sehingga hanya penis yang tampak dan daerah sekitar penis
tertutup
Pegang penis dengan kasa steril menggunakan jari telunjuk dan ibu jari tangan kiri
Pasang klem penis di sulkus koronarius selama 5-10 menit atau ditekan dengan jari
tangan kiri
Labia mayora dibuka dengan ibu jari dan telunjuk tangan perawat yang
dibungkus dengan kapas savlon, bersihkan vulva sekurang - kurangnya
tiga kali
Spasme buli-buli
Bakteriuria Persisten
Paraphimosis
Perawatan Kateter
1. Penjelasan kepada penderita atau keluarganya tentang :
2.
Kegagalan Kateterisasi
Dapat disebabkan oleh :
1. Kesalahan tehnik tidak mengikuti protokol yang telah diberikan.
MIsalnya tidak melakukan anestesi lokal dengan lubrikasi yang
cukup sehingga tindakan tersebut sangat nyeri dan terjadi
spasme yang berkepanjangan dari diafragma urogenital
2. Terdapat striktura urethra yang berat sehingga kateter
terkecilpun tidak bisa melewati striktur
3. Terdapat batu urethra yang impacted
4. Terdapat kontraktur leher buli-buli
Terima Kasih