I am officially scarred for life. I have now crossed over to the dark side after watching a difficult Foley catheter insertion in action. Medical students and residents don't do a lot of nursing related procedures these days. There just isn't a lot of time to be a doctor and a nurse. It's been years since I've watched a urinary catheter placed, let alone a difficult one. In fact, I can't say I've ever seen a difficult Foley catheter inserted. That is, untiil now. How do some hospitals manage difficult Foley catheters in the hospital setting? They call the cath man, of course!
He's a guy that travels the city for the urologists and inserts difficult Foley catheters at all hours of the day and night. Whether you're in the ER or the ICU, the general medical floor or the telemetry unit, he's the man you want for your difficult bladder catheter insertions.
I just happened to walk in on the cath man as he was preparing his field of intervention. I could hear a bunch of metal instruments clanking in some sterile towels. Then I saw them; Huge dilators for the meatus. The meatus is the opening of the penis. He showed me a Lidocaine cream he uses to numb up the penis. Then I saw him insert a series of large metal rods into the penile meatus. "Holey crap", I thought to myself. Is that how it's done? Eventually he passed the Foley catheter right in. No problem at all. Of course you aren't going to have a problem when your meatus is the size of Texas.
Cath man said that men who have had Foley catheters in the past often develop stenosis of their meatus. This is one more reason why inserting Foley catheters for convenience should be banned for good. Unfortunately, many patients will continue to get convenience catheters.
As it becomes harder and harder to have bedside nursing, I suspect more and more patients will get convenience cathethers. That might mean more and more men will suffer from stenosis of their meatus, leading to complications if and when they actually need a Foley catheter inserted. But it's a good thing we have a cath man to rescue us! If I ever need a Foley catheter inserted, I'm personally calling the cath man myself.