catheters & urine samples
It is a story we hear time and time again. An intact boy ends up in the hospital and the doctors want to insert a catheter. The doctor either believes, 1. they have to retract to insert the catheter, or 2. they say they won't retract but then they do retract. Make sure you are educated on this issue and how to handle it before you are in this situation.
Catheterization without foreskin retraction (Carmack A., MD, Milos M., RN, Canadian Family Physician)
“In boys with intact prepuces and physiologic phimosis, catheterization without retraction minimizes potential long-term problems and is an effective technique. Understanding how to catheterize without direct vision of the meatus and discarding the initial urine if culture is desired allow this procedure to be performed with high validity and minimal risk of iatrogenic problems for the child.”
What is the right way to catheterize an intact boy? (Doctors Opposing Circumcision)
“Fortunately, forced retraction of the foreskin or complete exposure of the glans are not necessary for catheterizing a boy or for cleaning the area in preparation for the catheter. The foreskin can safely be gently manipulated to allow cleaning and exposure of the meatus, but this should never be done beyond the level of natural separation. Using a gentle touch and stopping at the earliest sign of resistance will avoid any harm. For a boy who does have a loose foreskin, retraction helps assure a sterile area for the catheterization. Otherwise, if the foreskin is tight or adhered, only easily visible surfaces need be cleaned.”
Video: Catheterization of the Urethra in Male Children (University Hospitals of Geneva, University of Geneva, Switzerland)
“A physiological phimosis is frequently present during childhood and the foreskin should never be forced to retract.”