Using the urinary catheter and other devices

In diagnosing and managing urinary tract disease, instrumentation should be used only when absolutely necessary. The catheter is probably the urologic instrument most widely used by nonurologists. It can be used to relieve urinary retention, calibrate the urethra, search for obstruction, obtain urine for study, and instill medication into the urethra or bladder. If a catheter cannot be passed because of stricture, passage of a filiform may be attempted. In severe stricture, suprapubic puncture catheterization may be necessary, followed by further instrumentation. Urinary flow rate determinations should be made on all patients given physical examinations. This can be easily done by having the patient void into a plastic cup with a 7/32-inch hole punched in the bottom. If urine does not collect in the cup, the patient has a poor flow rate. A stopwatch may also be used for flow rate determination. Results of cystography, cystometry, and urethral profile studies add to the physician's diagnostic capability in dealing with lower urinary tract disease.