CONT 019 V2 06/2021 Pathway For The Initial Catheterisation

cont 019 v2 06/2021 pathway for the initial catheterisation of male patients with acute urinary retention (aur) in the community

CONT 019 V2 06/2021
Pathway for the initial Catheterisation of Male Patients with Acute
Urinary Retention (AUR) in the community
*
Patient contacts GP/Shropdoc or WMAS
*
GP undertakes basic assessment over the phone to establish facts
*
GP to exclude any of the following contra indications to
catheterisation, for AUR in the community,
Post radical prostatectomy within the last three months
Transurethral resection of the prostate (TURP)
Open or endoscopic prostatectomy
bladder neck incision within the last eight weeks
optical urethrotomy
recurrent episodes of Acute Urinary Retention
Undiagnosed haematuria
Clot retention
Systemically unwell
Known pathology of lower urinary tract eg Cancer
Urethral Stricture
*If none of the above contra indications apply then please continue
with pathway*



In Community Nursing Hours
GP refers to community nurse via Single Point of Referral (SPR) or
directly to community nursing team
Out of Community Nursing Hours
GP refers to Shropdoc Nurses or Rapid Response or Shropdoc
catheterises

*
Patient visited at home within two hours from when referral to
Community Nurse, initial assessment undertake. Confirm painful,
acute urinary retention by taking history and undertake an
ultrasound scan of the bladder. Nurse to document time of arrival.
*
Limitations to AUR listed below
Trans-urethral resection of the prostate (T.U.R.P)
Bladder neck incision
Optical urethrotomy, more than eight weeks ago
Open or endoscopic prostatectomy
Post radical prostatectomy undertaken more than three months ago.
Cognitive dysfunction where the patient’s ability to manage a catheter
is significantly compromised.
Previous urethral trauma or fractured pelvis.
Previous difficult catheterisation.
Clinical judgement should be used and medical advice sought as
required
*
Clinical judgement should be used and medical advice sought as
required.


*
Undertake examination. If phimosis, trauma to external genitalia
or blood at external urethral meatus contact:
*
GP to arrange admission to secondary care.
If unable to catheterise contact GP to arrange admission to secondary
care
One failed attempt only

*
Obtain informed consent
*
Catheterise patient using size 16ch all silicone, standard length
catheter
*
Record urine drained
If no further urine drains after initial inflation of catheter balloon
or symptoms persist contact GP to arrange admission to secondary care
Pathway for the initial Catheterisation of Male Patients with Acute
Urinary Retention (AUR) in the community … continued

See TWOC Pathway
371286.doc
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