A Better Way to Insert Urethral Catheter with Guide-Wire

Levy and Charkin described the longitudinal cut at the tip of the catheter to allow the guide-wire to pass through for rail-roading into the bladder. This method maintains the manufactured conical shape of the catheter tip, hence the ease of advancement. However, the longitudinal cut to the tip of the catheter can potentially cause the catheter to bivalve and split, which can lead to urethral trauma.

An alternative technique, using a 14-gauge (Brown) intravenous cannula needle threads through the side drainage hole of the urethral catheter and then punctures the centre of the tip of the catheter to form a track; the guide-wire is subsequently passed retrograde through the intravenous cannula needle. The needle is removed which allows the guide-wire to pass into the central catheter drainage lumen. After lubricating the guidewire and the urethral catheter with lignocaine gel, the catheter is passed into the bladder over the guide-wire. From our experience, this method is easy to use, and also maintains the integrity of the shape of the catheter with no risk of the above complication.