What are the indications and technique for bladder catheterization in children?
Indications and contraindications
Complications
Choice of catheter
Technique
Post-care
Bladder catheterization is indicated to obtain a sterile urine sample for analysis and culture, to accurately monitor hydration status, and to decompress the bladder.
Complications of bladder catheterization include hematuria, infection, urethral or bladder trauma, and formation of an intravesical knot in the catheter.
Fractures, confirmed urethral trauma, or the presence of blood in the urinary meatus are contraindications for bladder catheterization.
The choice of catheter depends on the age of the child, with 5 Fr for children under 6 months, 8 Fr for children from 6 months to adolescence, and 10 Fr for adolescents.
The technique involves preparing the urethral opening using a sterile technique, gently pulling the penis to straighten the urethra in boys, exposing the urinary meatus in uncircumcised infants, and carefully inserting a lubricated catheter into the urethra. Once the sample is obtained, the catheter should be removed carefully and the skin cleaned with iodine.