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Many medical professionals are misinformed when it comes to the proper techniques of testing intact boys with catheters. So, what's the proper procedure?

For a variety of reasons, sometimes it is medically necessary to test urine. But with misinformation surrounding the proper care of the intact penis, it is important to know a few facts before having your intact son tested. 

First of all, it is likely that a catheter is not even necessary. There are a few techniques that allow urine testing without the need for a catheter, such as a sterile urine bag or a "clean catch". Both of these techniques can be performed at home or at the hospital/doctor's office. 

"Clean Catch"
  • involves 'catching' a sample of clean urine from an infant or young child as they urinate
  • give your son a drink or breast feed to help fill the bladder
  • clean the outside of the child’s genital area with soap and water (no soap underneath the foreskin, however)
  • leave your child’s diaper off and wait for him to urinate- quickly catch a small amount in a sterile container (from your doctor)
  • on the container write your child’s first name, surname, date of birth, and the date and time you collected the sample
  • it is important that the urine sample is fresh when tested so deliver it to your laboratory within two hours or put it in the fridge (not the freezer) until you can deliver the sample
  • it can be difficult to time when a young child urinates, so several attempts may be needed
Urine Bag Collection
  • you attach a plastic bag, which has a sticky strip, over your baby’s genital area after cleaning very well with soap and water (again, do not use soap underneath the foreskin)
  • for boys, the entire penis can go in the bag and you can put a diaper on over the bag
  • urine collects in the bag when your child urinates; sometimes it can take several attempts to get some urine
  • transfer the urine sample from the bag into the sterile container (from your doctor)
  • on the container write your child’s first name, surname, date of birth, and the date and time you collected the sample
  • it is important that the urine sample is fresh when tested so deliver it to your laboratory within two hours or put it in the fridge (not the freezer) until you can deliver it; don’t leave the bag on your baby overnight
  • a bag urine sample can be contaminated by germs from the skin; which might make it look like your child has a UTI (urinary tract infection) even if they don’t. In some situations (for example if your child is only mildly unwell) a repeat bag urine collection can be used to confirm whether a UTI is actually present
Testing With a Catheter
  • if a catheter is necessary, know that there is absolutely NO MEDICAL REASON to retract your son's foreskin to insert a catheter
  • talk to the hospital staff and make certain that they know not to retract
  • a catheter can be inserted when the foreskin is pulled back just enough to see the meatus (urinary opening). If the foreskin's opening is too small to retract far enough to see the meatus, a catheter can be inserted through the foreskin's opening and into the meatus "by feel"
  • if it makes you feel more comfortable, offer to be the one that handles his penis during catheter insertion. You can bring your own sterile gloves, and gently open his foreskin (about as much as when he urinates) so the catheter can be inserted by a nurse or doctor
If you're interested in more detailed information, or something to print and give to a medical professional, please see this article:

"Urine Samples and Catheter Insertion for Intact Boys"
http://www.drmomma.org/2011/12/urine-samples-and-catheter-insertion.html

Read more about forced retraction and why it is dangerous:
Only Clean What Is Seen - Reversing the Epidemic of Forcible Foreskin Retractions


 


Comments

08/10/2011 13:16

Thanks so much for publishing this good advice. I have seen one too many medical professionals damage a boy by forcibly retracting his foreskin all the way back while inserting a catheter. Not only is this cruel, wrong, and legally actionable, but if you think about it it probably makes the catheter harder to insert because the narrow foreskin opening is pulled back beyond the glans and then sits there constricting the whole penile shaft including the urethra. Talk about a counter intuitive move! I hope all nurses and docs who deal with intact boys will read this and follow its great advice.

Reply
Beth
08/20/2011 22:20

Thank you so much for writing this! On the day you wrote this, my son was taken to the emergency room after having medical issues. The Dr. came in and told me that he had no clue why I wasn't forcibly retracting my son to clean him and that is was necessary. He said that they had to retract him for a cathader. I was so overwhelmed and am now furious. I will be contacting the people in charge and they will be receiving information! This is why we NEVER go to the Dr. How can I be more informed than a Dr. who has gone to school?!?!?

Reply
Christina
10/20/2011 17:14

Can you point me to peer reviewed literature to support this.
I firmly agree with the point of view, but a point of view will only go so far to change hospital policy. Evidence based, peer reviewed, published material carries more weight.

Thanks

Reply
Danielle Netherton
11/28/2011 19:15

I only wish I knew this before my son was left in a paraphimotic state following his catheter. I'm so sad everytime I think about it that I didn't protect him. All I can think about is whether or not he will have lasting probelms due to this assault on his body. :*(

Reply
Sally
12/28/2011 22:28

Danielle - Don't beat yourself up about this. I pray your son will have no lasting affects - physically or emotionally from this event. In Jesus' name, Amen.

He'll be okay...kids are so resilient. Please don't let this ruin you as a person and as a mom. It wasn't your fault.

Reply
Danielle
01/16/2012 19:24

Thank you sally. I was very hard on myself but 21 months later im doing much better. Being an intactivist has helped me to heal in a way.
Saving other babies has helped me with the guilt I feel sometimes.

05/04/2012 05:08

I am visiting this site first time & it has awesome information about health. I have come to know a lot of information after visiting this site. Keep this sort of posting in future as well.....

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