An important reference article entitled “Catheterization without foreskin retraction,” co-authored by urologist Adrienne Carmack MD and Marilyn Fayre Milos RN, has been published in the March 2017 issue of Canadian Family Physician.
The article is a valuable resource for parents whose genitally intact sons may be in need of catheterization, as well as for updating health professionals on proper catheterization technique of intact boys, and informing changes in clinical guidelines.
The article describes the technique of catheterization “by feel” in the patient with a non-retractable foreskin. High validity of urine specimens using this technique may be obtained by discarding the initial flow of urine (potentially containing preputial or periurethral flora) and sending the latter urine flow for culture. The article also discusses the normal developmental state of physiological phimosis, emphasizes the rationale for avoiding forcible retraction, and presents alternatives for several situations potentially requiring catheterization.
Additional information on catheterization of intact boys without foreskin retraction may be found in a video from the University Hospitals of Geneva, Switzerland.
CITATION: Carmack A, Milos MF. Catheterization without foreskin retraction. Can Fam Physician. 2017;63(3):218-220.