Download

Download Full Text (286 KB)

Publication Date

5-2025

Abstract

Background: Urinary catheterization, a common pediatric procedure, requires the use of topical anesthesia but some studies suggest no benefit of lidocaine gel over non-anesthetic gel. It is challenging to counsel patients about this procedure as the experience of catheterization in the literature is based on observation in pre-verbal and nonverbal children rather than self-report.

Design/Methods: We included 8- to 21-year-old subjects undergoing urinary catheterization in the Emergency room or inpatient setting and used a written survey to record their experience. The survey included questions with a 5-point Likert scale. Procedural pain was measured using the Numerical Rating Scale (NRS-11), where 0 is no pain or hurt and 10 is the most or worst pain. Pain scores of 1-3, 4-6 and 7-10 were classified as mild, moderate, and severe pain, respectively. We excluded patients with developmental delay, altered sensorium, bladder surgery, chronic intermittent catheterization, neurogenic bladder, and non-English speaking subjects.

Results: We recruited 44 patients in the study with a mean age of 14.9 years (SD 2.7), with slightly more females (54.5%) than males (45.5%). Ethnicity distribution included Caucasian (56.8%), African American (18.2%), Hispanic (11.4%), Asian (4.6%) and Other (9.1%). Most subjects underwent straight catheterization (72.7%) while the rest had an indwelling urinary catheter (27.3%). Urinary catheterization was done mostly for retention (50.0%), followed by diagnostic indication to help with ultrasound (40.9%) or urinalysis (6.8%) and acute kidney injury (4.5%). Interestingly most subjects reported anxiety but not embarrassment with the procedure (Fig 1). Only 19 subjects (43.2%) reported the use of numbing gel with catheterization and most felt that it helped them. With catheter placement, moderate or severe pain was reported by 75% (Figure 2). With catheter removal, moderate or severe pain was reported by 60.9% (Figure 2). The duration of pain with placement or removal was less than 2 minutes in over half the subjects. Finally, most subjects reported greater pain with catheterization than with a blood test or intravenous catheter placement (Figure 3).

Conclusion: Pediatric patients report significant pain with urinary catheterization although it is brief. Most subjects reported lack of use of numbing gel which may be from lack of awareness or lack of use. Subjects who reported use of numbing gel found it helpful. Our study findings will help providers counsel patients on what to expect with urinary catheterization.

Document Type

Poster

A study on the self-reported experience of acute urinary catheterization in children and adolescents

Share

COinS