Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Diagnostic evaluation.• Temporary relief of urinary retention. +++ Absolute + • Suspected urethral injury (eg, blood at meatus, laceration).• Unable to identify urethra (eg, labial adhesion).• Neutropenia. ++Table Graphic Jump Location|Download (.pdf)|Print• All equipment should be latex free. Allergy to latex is common, particularly in certain populations (such as patients with meningomyelocele.)+ • Catheter.• Feeding tube (4–5F).• Urinary catheters (6F and up).• Sterile collection cup.• 10% povidone-iodine (or equivalent).• Castile soap.• Sterile gloves, drapes, and gauze.• Lidocaine (2%) anesthetic jelly or water-based lubricant.• Catheter sizing estimates:• Infant: 5F feeding tube or 6F catheter• Toddler: 6–8F catheter• Older child: 8F catheter• Adolescent: 8–10F catheters ++Table Graphic Jump Location|Download (.pdf)|Print• Always choose the smallest catheter that will work; a catheter that is too small might kink and one that is too large will cause unnecessary pain. + • Urethral trauma.• Hematuria.• Pain (common).• Psychological stress (common, as child is restrained for procedure).• Catheter mishaps (eg, knot forms in bladder) (very rare). + • Because spontaneous voiding may occur during skin preparation or as the procedure is initiated, have a sterile container available to collect the urine.• When labial adhesions are present, holding the child in a frog-leg position and rocking the hips back and forth may line up the opening in the adhered labia with the urethral opening.• Cotton gauze pads are useful to hold the penis or to apply traction to the labia once the skin has been prepared and is slippery.• Remember that many of the newer, non-latex gloves fit poorly, making holding a slippery skin surface nearly impossible; wear tightly fitting non-latex gloves when possible.• Although 1 study showed that pain was reduced by applying lidocaine topically and injecting anesthetic into the urethra, this does not represent typical use of lidocaine jelly in clinical practice. + • Keep the patient covered until ready to begin.• Good lighting is helpful. + • The child is placed supine.• The female patient is placed in the frog-leg position.• The male patient is placed with legs extended. + • Catheterization requires the passage of a tube through the urethra into the urinary bladder.• In girls, the urethra is a short tube that opens just rostral to the vaginal introitus and is often obscured in younger girls by vaginal tissue (Figure 31–1). + • A common problem with catheterization of young females results from confusion and erroneous passage of the catheter into the vagina (Figure 31–2). + • In boys, the urethra begins at the meatus and passes down through the penile shaft and into the urinary bladder after passing through the prostate gland (Figure 31–3). + • ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.