Medication
Medication Summary
The goals of pharmacotherapy are to reduce morbidity and prevent complications.
Local Anesthetics, Amides
Class Summary
The use of a urethral anesthetic in female patients is controversial. The decision to anesthetize the urethra should be made in conjunction with the patient. Local anesthetics block the initiation and conduction of nerve impulses.Anesthetics used for the urethra include lidocaine.
Lidocaine [Xylocaine]
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Lidocaine inhibits depolarization of type C sensory neurons by blocking sodium channels. Use the commercial applicator or a syringe with no needle to instill 5 mL of 2% lidocaine gel into the urethra. Place a finger on the meatus to help prevent spillage of the anesthetic lubricant. Allow 2-3 minutes for the anesthetic to take effect before proceeding with the urethral catheterization.
Hold the catheter with the sterile hand, or leave it in the sterile field. Remove the cover to expose the tip. Apply a generous amount of either a nonanesthetic lubricant or the remaining lidocaine gel.
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Commercial urinary catheterization kit.
Preparatory solution in commercial urinary catheterization kit.
Urinary catheterization kit. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Urinary catheterization supplies. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Urinary catheter tip. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Urinary catheter urine collection bag. Image courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Urinary catheterization. Video courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Taping of urinary catheter. Video courtesy of Michel Rivlin, MD, and G Rodney Meeks, MD.
Female urinary organs, anterior view.
Author
Chief Editor
Edward David Kim, MD, FACS Professor of Urology, Department of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center
Edward David Kim, MD, FACS is a member of the following medical societies: American Society for Reproductive Medicine, American Urological Association, Sexual Medicine Society of North America, Society for Male Reproduction and Urology, Society for the Study of Male Reproduction, Tennessee Medical Association
Disclosure: Serve[d] as a speaker or a member of a speakers bureau for: Endo, Antares.
Acknowledgements
Andrew K Chang, MD Associate Professor, Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center
Andrew K Chang, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Luis M Lovato, MD Associate Clinical Professor, University of California, Los Angeles, David Geffen School of Medicine; Director of Critical Care, Department of Emergency Medicine, Olive View-UCLA Medical Center
Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Acknowledgments
The authors and editors of Medscape Reference gratefully acknowledge the assistance of Lars Grimm with the literature review and referencing for this article. They also thank Michel Rivlin, MD, and G Rodney Meeks, MD, for the videos and several of the images in this article.