# Foley catheter insertion questions **URL:** \ **Category:** Factual Questions\ **Created:** [October 6, 2015, 2:35pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715 "2015-10-06T14:35:52Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![kaylasdad99](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kaylasdad99/32/3398_2.png) [@kaylasdad99](https://boards.straightdope.com/u/kaylasdad99)\ **Post date:** [October 9, 2015, 2:41am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/21 "2015-10-09T02:41:44Z")
> [@gotpasswords](#): > > It’s like a reservoir tip condom but heavier material with a sticky portion so it doesn’t just slide off. The open-ended tip is sized to plug into tubing for collection. > > The big functional difference is that an external or Texas catheter leaves urination under your control. A Foley goes into the bladder so you have no control - it just keeps on draining. > > AFAIK, there’s not much call for them in a typical hospital setting. Probably more common at nursing or convalescent homes for guys who can’t get out of bed but still have bladder control. Ah. I suspected it might be something like that. I once assisted my friend’s wheelchair-ridden nephew with removing one on an occasion when his PCA was late showing up for work. Is Texas catheter its real name, or a slang term? BTW, mine came out within eighteen hours of surgery, and as far as peeing is concerned, I’m back to normal, tyvm. ---
**Author:** ![gotpasswords](https://avatars.discourse-cdn.com/v4/letter/g/c57346/32.png) [@gotpasswords](https://boards.straightdope.com/u/gotpasswords)\ **Post date:** [October 9, 2015, 4:19pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/22 "2015-10-09T16:19:39Z")
It’s a brand name of Kendall, now Covidien. Not easy to find why someone called it “Texas” but one of the popular theories among nurses is it’s a ploy to make the wearer feel better because their penis isn’t just big, it’s Texas-big. Another is that the thing resembles a cowboy hat. ---
**Author:** ![Isilder](https://avatars.discourse-cdn.com/v4/letter/i/cc9497/32.png) [@Isilder](https://boards.straightdope.com/u/Isilder)\ **Post date:** [October 10, 2015, 11:38am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/23 "2015-10-10T11:38:06Z")
> [@kaylasdad99](#): > > If the urethra accordions down, does this potentially make for a tortuous path And it would also mean that when you urinate, your penis would stick out like a party horn… no inside the penis, the urethra is merely a lining inside the corpus spongiosum, See [http://www.nucleuscatalog.com/anatomy-of-the-penis/view-item?ItemID=9446](http://www.nucleuscatalog.com/anatomy-of-the-penis/view-item?ItemID=9446) ---
**Author:** ![TreacherousCretin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treacherouscretin/32/476_2.png) [@TreacherousCretin](https://boards.straightdope.com/u/TreacherousCretin)\ **Post date:** [October 10, 2015, 5:16pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/24 "2015-10-10T17:16:27Z")
> [@Isilder](#): > > And it would also mean that when you urinate, your penis would stick out like a party horn… Doesn’t everybody’s? ---
**Author:** ![Bill\_Door](https://avatars.discourse-cdn.com/v4/letter/b/50afbb/32.png) [@Bill\_Door](https://boards.straightdope.com/u/Bill_Door)\ **Post date:** [October 10, 2015, 11:05pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/25 "2015-10-10T23:05:44Z")
I just had a Foley inserted back in June. I’d had some Achilles tenon surgery under a spinal, and hadn’t managed to urinate in the time allotted. The recovery nurse told me that if I wasn’t able to pee on my own by 3:00 PM I was getting a catheter. Great I say, now I’ve got to perform under pressure. Going in, not so bad. Coming out, I think she thought she was starting a chainsaw. One hand on the handle, one hand on the pull cord, one foot bracing the pistol grip, and PULL. ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [October 11, 2015, 12:00am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/26 "2015-10-11T00:00:08Z")
A lot of nursing techniques seem to rely on the idea that if it’s gonna hurt, better to surprise the patient for a half-second, then start slow and give them a chance to beg for mercy when the job’s barely 5% done. See also Moms & Bandaids. ---
**Author:** ![Red\_Stilettos](https://avatars.discourse-cdn.com/v4/letter/r/fbc32d/32.png) [@Red\_Stilettos](https://boards.straightdope.com/u/Red_Stilettos)\ **Post date:** [October 11, 2015, 3:07am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/27 "2015-10-11T03:07:35Z")
> [@gotpasswords](#): > > It’s like a reservoir tip condom but heavier material with a sticky portion so it doesn’t just slide off. The open-ended tip is sized to plug into tubing for collection. > > The big functional difference is that an external or Texas catheter leaves urination under your control. A Foley goes into the bladder so you have no control - it just keeps on draining. > > AFAIK, there’s not much call for them in a typical hospital setting. Probably more common at nursing or convalescent homes for guys who can’t get out of bed but still have bladder control. I’ve always heard these called condom catheters, for obvious reasons. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [October 11, 2015, 4:04am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/28 "2015-10-11T04:04:11Z")
If you can’t pee under your own power for some reason, then a condom-catheter isn’t going to help much. ---
**Author:** ![Shinna\_Minna\_Ma](https://avatars.discourse-cdn.com/v4/letter/s/f08c70/32.png) [@Shinna\_Minna\_Ma](https://boards.straightdope.com/u/Shinna_Minna_Ma)\ **Post date:** [October 11, 2015, 9:00am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/29 "2015-10-11T09:00:43Z")
I had some heart surgery done several years ago, and the anesthesiologist came into my room the night before and asked if I had any questions. I told him I didn’t care what needles they poked me with, but that Foley better go in well after I was unconscious. He just smiled and said, “Don’t worry, we wouldn’t have it any other way.” ---
**Author:** ![Irishman](https://avatars.discourse-cdn.com/v4/letter/i/b487fb/32.png) [@Irishman](https://boards.straightdope.com/u/Irishman)\ **Post date:** [October 12, 2015, 3:47pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/30 "2015-10-12T15:47:23Z")
> [@Isilder](#): > > no inside the penis, the urethra is merely a lining inside the corpus spongiosum, > > See > [http://www.nucleuscatalog.com/anatomy-of-the-penis/view-item?ItemID=9446](http://www.nucleuscatalog.com/anatomy-of-the-penis/view-item?ItemID=9446) That doesn’t really address the question, which is how the tube adjusts to allow varying length. I think the answer is similar to how the stomach and bladder adjust to allow different volumes. Certain tissue stretches. I think it invoices lots of layers that slice with respect to each other. The other possibility is that the overall growth variation is not that much compared to the total length of the tube, so you get a bit of sliding around. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [October 12, 2015, 3:56pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/31 "2015-10-12T15:56:01Z")
> [@](#): > > I think it invoices lots of layers that slice with respect to each other. Man, I’d hate to have to be the one to deliver that bill. ---
**Author:** ![Irishman](https://avatars.discourse-cdn.com/v4/letter/i/b487fb/32.png) [@Irishman](https://boards.straightdope.com/u/Irishman)\ **Post date:** [October 12, 2015, 9:53pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/32 "2015-10-12T21:53:19Z")
Stupid autocorrect. Slide. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [October 12, 2015, 11:37pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/33 "2015-10-12T23:37:46Z")
And I assume “involve” rather than “invoice”. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [October 13, 2015, 12:04am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/34 "2015-10-13T00:04:35Z")
I think what the OP is asking is, “what happens if I get an erection while I’ve got a Foley that was placed while I was flaccid?” The answer is: nothing much. Your penis will slide over the Foley catheter just fine. It’s held into your bladder with a little balloon, so that end won’t move, but if you were to take a sharpie marker and mark the catheter where it exits the meatus, you’ll find that sometimes you can see the line, sometimes you can’t. Your penis grows and shrinks all day and night and don’t give the catheter no never mind. > [@Cub\_Mistress](#): > > I’ve inserted foleys in varying states from flaccid to full erection. Not much difference to me. The most difficult is the poor little old men with nothing but a button left, there is nothing to hold onto while trying to insert. I don’t do a whole lot of Foleys in home care, but I do a few. Got one fella with absolutely no external penis at all. He’s got simply massive hernias, as well as scrotal edema, and his penis is lost inside there somewhere. I feel just awful, but I cannot change his Foley. He has to go to the urologist for it, and they do it under ultrasound guidance because there’s no straight line access. Needless to say, they can only be so “sterile” with that insertion, and he gets a lot of UTIs. I don’t know why they don’t just do a urostomy for the poor guy (except of course he’s a terrible surgical candidate). ☹ > [@Senegoid](#): > > If you can’t pee under your own power for some reason, then a condom-catheter isn’t going to help much. Right. Foleys are for when you can’t pee, although they’ll use them short term in the hospital when they’d rather you just not get out of bed to pee or they need a really accurate measure of your urine output. Condom caths are for when you can pee just fine, but can’t get to a toilet, commode or urinal. I’ve never found a man that likes a condom/Texas/external catheter. They seem like a good idea, and everyone wants to try them, but with all that growing and shrinking that penises like to do, they are a total bitch and a half to keep on, even with all the securing devices we try. They’re supposed to be measured for, but it’s almost impossible to measure a penis once and have a consistent size. 40% of condom catheters users will develop a UTI, 15% some sort of skin breakdown ranging from sores to gangrene, and a bit over 1% will develop a kidney stone with condom catheter use. Texas catheter is a real name, on the packaging and everything. [Dover Texas Male External Catheter](https://www.healthykin.com/p-3112-dover-texas-male-external-catheter.aspx?gclid=Cj0KEQjwtO2wBRCu0d2dkvjVi5cBEiQAMEIVGTRB1sghIkevqIPnPSGjCxfF_8WfD9WrkKHVJOaCpZwaAvsY8P8HAQ). [Argyle Male external Texas catheters](http://www.stlmedical.com/store/urinary-external-catheters/SH730200.html?gclid=Cj0KEQjwtO2wBRCu0d2dkvjVi5cBEiQAMEIVGQ9DvCBpBn4iN9tbswuLcF7qkUSf5iw_MZHM16SC3w0aAtws8P8HAQ). [External Male Catheter Texas Catheter Sherwood Davis & Geck](http://www.andersonmedicalsupply.com/shop/texas-catheter-external-male-catheter/). ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [October 13, 2015, 1:14am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/35 "2015-10-13T01:14:46Z")
> [@WhyNot](#): > > … 40% of condom catheters users will develop a UTI, 15% some sort of skin breakdown ranging from sores to gangrene, and a bit over 1% will develop a kidney stone with condom catheter use. … Remind me not to develop urinary system problems. :eek: Curiosity requires me to ask about the complication rates for Foleys. 40% UTI rates sound pretty bad, but might not be (much?) when compared to the alternative. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [October 13, 2015, 1:30am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/36 "2015-10-13T01:30:03Z")
> [@LSLGuy](#): > > Remind me not to develop urinary system problems. :eek: > > Curiosity requires me to ask about the complication rates for Foleys. 40% UTI rates sound pretty bad, but might not be (much?) when compared to the alternative. Yeah, if you wear a Foley long enough, it’s pretty much a given that you’ll get a UTI. > [@](#): > > Once a catheter is placed, the daily incidence of bacteriuria is 3-10%. Between 10% and 30% of patients who undergo short-term catheterization (ie, 2-4 days) develop bacteriuria and are asymptomatic. Between 90% and 100% of patients who undergo long-term catheterization develop bacteriuria. [Catheter-Related Urinary Tract Infection (UTI): Transmission and Pathogens, Guidelines for Catheter Use, Diagnosis](http://emedicine.medscape.com/article/2040035-overview) “Bacteriuria” means they can find bacteria in your urine, although you may not have the symptoms of an infection. I’m actually not finding information readily available on symptomatic bacteriuria, or UTI. If anyone here has an uptodate subscription, I’m sure it’s somewhere behind the paywall here: [UpToDate](http://www.uptodate.com/contents/catheter-associated-urinary-tract-infection-in-adults) ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [October 13, 2015, 4:28am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/37 "2015-10-13T04:28:42Z")
Are there any specifically preferred antibiotics for treating UTI’s? I’ve ready that fluoroquinolones (e.g., Cipro or Levaquin) are commonly given as a resort of _first_ choice, despite their tendency to produce serious and irreversible adverse reactions (like serious brain damage and other neurological problems). I’ve heard that other antibiotics like Keflex can be used as well, and are much safer, but for some reason those aren’t tried first. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [October 13, 2015, 4:42am UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/38 "2015-10-13T04:42:28Z")
> [@Senegoid](#): > > Are there any specifically preferred antibiotics for treating UTI’s? I’ve ready that fluoroquinolones (e.g., Cipro or Levaquin) are commonly given as a resort of _first_ choice, despite their tendency to produce serious and irreversible adverse reactions (like serious brain damage and other neurological problems). I’ve heard that other antibiotics like Keflex can be used as well, and are much safer, but for some reason those aren’t tried first. For most garden variety UTIs, I see Bactrim prescribed most often, with Cipro a distant second. (And I see Bactrim a lot, as in, repeatedly, for the same patient, which makes me crazy, as it seems pretty clear that if you’ve got a recurrent UTI, maybe the bacteria are resistant to the dang antibiotic, ya think? Can we try something else? No? Okay, let’s use what didn’t work the last three times…) For catheter associated UTIs, it’s usually Levaquin. I don’t know why, though. Outside my pay grade. 🙂 ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [October 13, 2015, 4:00pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/39 "2015-10-13T16:00:50Z")
> [@pianodave](#): > > … > “Wait! Can I shower first?” > > I went in the shower and the water did its magic. … I’m not male, as evidenced by the following: when in the hospital for my son’s delivery, their lousy technology forced me to be stuck in bed for continuous monitoring. I needed to pee -and if anyone has ever tried to do that on a bedpan (when they won’t let you sit up, no less) it just will not happen. I suggested she turn on the sink and leave the room. The sound was sufficient inspiration that the cath was unneeded at that point (it was required later, and whatever the epidural’s failings regarding pain relief, at least THAT part was masked). My husband had surgery on another orifice nearby. That commonly causes the sphincters to say 'oh HELLS no, I’m not opening up" despite not being subject to any direct trauma. He was told “if you can’t pee, come to the ER”. Well, things were not happening - and I suggested running the sink nearby and sticking his hand under warm water (in the hopes that the summer-camp legend of hand in warm water would work). Whatever the reason, he soon felt relief. ---
**Author:** ![pianodave](https://avatars.discourse-cdn.com/v4/letter/p/e79b87/32.png) [@pianodave](https://boards.straightdope.com/u/pianodave)\ **Post date:** [October 13, 2015, 8:01pm UTC](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715/40 "2015-10-13T20:01:37Z")
> [@Mama\_Zappa](#): > > I’m not male, as evidenced by the following: when in the hospital for my son’s delivery, their lousy technology forced me to be stuck in bed for continuous monitoring. I needed to pee -and if anyone has ever tried to do that on a bedpan (when they won’t let you sit up, no less) it just will not happen. > > I suggested she turn on the sink and leave the room. The sound was sufficient inspiration that the cath was unneeded at that point (it was required later, and whatever the epidural’s failings regarding pain relief, at least THAT part was masked). > > My husband had surgery on another orifice nearby. That commonly causes the sphincters to say 'oh HELLS no, I’m not opening up" despite not being subject to any direct trauma. He was told “if you can’t pee, come to the ER”. Well, things were not happening - and I suggested running the sink nearby and sticking his hand under warm water (in the hopes that the summer-camp legend of hand in warm water would work). Whatever the reason, he soon felt relief. It’s not a summer-camp legend. For whatever reason, water works. I’m not ashamed to say I will fill a cup with water and stick my hand in if I’m having trouble going. But for me, at least, any shred of dignity I had went out the window after the accident. I just do what I need to do. My girlfriend (at 14 years of age) had to help her ailing mother go to the bathroom at one point, wiping her, etc. I always think people who have this experience have an advantage. It teaches you about the messiness of life, and the earlier you can develop a sense of humor about it, the better. I would want to be cared for in my old age by someone who is not disgusted by or freaked out by bodily functions. We’re all pretty similar, you know? [Previous page](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715.md?page=1) [Next page](https://boards.straightdope.com/t/foley-catheter-insertion-questions/733715.md?page=3)