Urinary Catheterisation of Male and Female Patients in Secondary care - LTHT ONLY - ( Adults only )

Publication: 18/06/2003  
Next review: 08/09/2023  
Clinical Guideline
ID: 200 
Approved By: Trust Clinical Guidelines Group 
Copyright© Leeds Teaching Hospitals NHS Trust 2020  


This Clinical Guideline is intended for use by healthcare professionals within Leeds unless otherwise stated.
For healthcare professionals in other trusts, please ensure that you consult relevant local and national guidance.

Adult Urinary Catheterisation

Urinary Catheterisation: Females
Urinary Catheterisation: Males
Appendix 1 - Urethral Catheterisation Workbook

Background and indications for standard operating procedure/protocol

General points

  1. This SOP applies only to the acute insertion of a permanent urinary catheter and does not include the use of intermittent self catheterisation
  2. If a patient has ever had a positive MRSA urine, they should be treated as positive for future catheterisation attempts


  1. A careful clinical assessment is required in all patients prior to catheterisation.
  2. The main indications for urethral catheterisation are as below:
    1. Acute (painful) retention of urine: All cases require discussion with a urologist
    2. Chronic (painless) retention of urine: All cases require discussion with a urologist
    3. Monitoring of urinary output, where it is essential to the care of the patient (e.g. peri-operatively, critical care, polytrauma)
    4. Severe urinary incontinence, where other methods of urinary control have failed.
    5. To improve comfort in the end of life care as needed

All cases require multidisciplinary assessment prior to catheterisation.

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Procedure method (step by step)


  1. Urethral catheterisation should be undertaken by either practitioners who are competent to undertake this procedure or “trainee” practitioners under the direct supervision of a competent practitioner.
  2. Urethral catheterisation should not be undertaken by non-urologists when there has been recent prostatic or urethral surgery. Referral to the Urology department is appropriate.
  3. In cases of possible or definite urethral trauma (e.g. in association with a pelvic fracture) the role of urethral catheterisation should be discussed with the on-call urologist before any catheterisation attempt.


  1. For most patients a 12-14 Fr 2-way Foley catheter should be used. Ideally the catheter should be a silicone catheter.
  2. In patients with significant haematuria, a 18-22 Fr 3-way irrigating catheter should be inserted. All cases require discussion with a urologist.

Failed attempt at catheterisation
If two attempts by a competent practitioner are unsuccessful, there should be a discussion with the Urology team


  1. A Catheter Insertion Record should be completed for all patients who have a catheter inserted and kept in their medical records.
  2. A copy should be faxed to the district nurses if the patient is discharged with a catheter insitu (Doc.WUN1004).
  3. A catheter passport is available and should be completed for all patients discharged from LTHT with an indwelling catheter regardless of length of time catheter is intended to be insitu (Doc. WNA1328)

Further step by step information and training material

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Record: 200

To standardise and optimise the procedure urethral catheterisation

Clinical condition:
Target patient group: All patients who require urinary catheterisation
Target professional group(s): Secondary Care Doctors
Secondary Care Nurses
Allied Health Professionals
Adapted from:

Evidence base


V. Geng, H. Cobussen-Boekhorst, J. Farrell, M. Gea-Sánchez, I. Pearce, T.Schwennesen, S. Vahr, C. Vandewinkel; (2012) Evidence-based Guidelines for Best Practice in Urological Health Care Catheterisation, Indwelling catheters in adults, Urethral and Suprapubic; European Association of Urology Nurses. The Netherlands
R. Addison, S. Foxley, C. Mould, W. Naish, H. Oliver, J Sullivan, S Thomas, J Reid, K Logan OBE, S Jones, A Phillimore, and A Vaughan;(2012)Royal College of Nursing Catheter care RCN guidance for nurses. Royal College of Nursing, London

Approved By

Trust Clinical Guidelines Group

Document history

LHP version 1.0

Related information

Appendix 1 - Urethral Catheterisation Workbook

Equity and Diversity

The Leeds Teaching Hospitals NHS Trust is committed to ensuring that the way that we provide services and the way we recruit and treat staff reflects individual needs, promotes equality and does not discriminate unfairly against any particular individual or group.