FOR DIFFICULT CATHETERIZATION

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When urethral catheterization proves difficult, bypass prostate swelling due to benign prostatic hyperplasia, prostate tumor, or external mass by using a 10-cc syringe to inject normal saline into the catheter lumen while pushing the Foley catheter at the same time.
—Dilip P. Ghodasara, MD, Charleston, W.Va.

I have never tried this trick. My favorite technique for difficult male catheterization is to lubricate the urethra with 10 cc of viscous 1% lidocaine. (This provides not only lubrication for the entire length of the urethra but also some anesthesia to prevent external sphincter spasm.) Always use a coudé tip catheter (usually 16F or 18F).
—David T. Noyes, MD (110-22)

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