JAMA Clinical Reviews From the JAMA Network: Comprehensive Review of Foley Catheter Management
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Jun 12, 2025 Anne P. Cameron and Glenn T. Werneburg, esteemed urologists from the University of Michigan, delve into Foley catheter management. They share insights on evidence-based guidelines for catheter selection and infection prevention. The discussion highlights critical errors that can lead to urethral trauma and emphasizes diagnosing catheter-associated UTIs effectively. They also tackle urinary retention in surgical settings and critique outdated practices like intermittent clamping. Lastly, they address the complications of long-term catheterization and the importance of patient-centered decision-making.
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Proper Catheter Selection & Culturing
- Choose the correct catheter type and size tailored to patient anatomy to reduce trauma and pain during insertion.
- Use a new catheter to obtain urine cultures for accurate diagnosis of catheter-associated infections.
Use Smallest Appropriate Catheter
- Use the smallest appropriate catheter size, generally 14 French for females and 16 French for males.
- Smaller catheters reduce irritation and the risk of long-term urethral strictures.
Avoid Routine Bladder Irrigation
- Avoid bladder irrigation unless absolutely necessary to maintain a closed system and reduce infection risk.
- Irrigation is typically only warranted for catheter obstruction from blood clots or debris.