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Urinary Incontinence and Foley Catheters

Thomas Horton


Types of UI Mechanism Associated Symptoms

Incompetent urethral sphincter


UI with physical exertion

(cough, laughter, sneeze)


↑ bladder contraction from detrusor instability

(infection, stone, T2DM, caffeine, meds, BPH

Frequency, nocturia, sudden urge
Overflow ↓ contractility/outlet obstruction (BPH, anticholinergic medications, T2DM, pelvic trauma, spinal cord disease, MS, polio) Hesitancy, weak stream, sense of incomplete emptying
Functional Physical, emotional, or cognitive disability Depression, pain, evidence of physical, sensory, or cognitive impairment


  • Medication Reconciliation:
    • Alcohol, α-Adrenergic agonists, α-Adrenergic blockers, ACE inhibitors, Anticholinergics, Antipsychotics, Calcium channel blockers, oral estrogen, GABAergic agents, NSAID’s, narcotics
  • Order Hemoglobin A1C, Electrolytes (particularly calcium), UA
  • Rule out retention using PVR
  • Rectal exam to rule out fecal impaction


  • Skin care for urinary incontinence:
  • Barrier creams: Venelex, petroleum, zinc oxide
  • Diapers only when up out of bed
  • Chucks while in bed (don’t hold moisture up close to the skin like diapers do)
  • Offer toileting Q1-2hours
  • Indications for a foley:
    • Inability to void
    • Need for accurate UOP monitoring when patient unable to comply
    • Urinary Incontinence AND open sacral or perineal wound
    • Perioperative Use
    • Comfort care at end of life