Summary of Key Points for OSCEs
Know the Relevant Anatomy
It is vital that you understand the anatomy very well, or else you may find yourself in the embarrassing situation of catheterising the wrong meatus, both in the exam as well as in real life! It is obvious where the urethra is in males, but to the unfamiliar candidate it is sometimes unclear on a female manikin where the catheter should go. Figure 57.1 illustrates the anatomy of the female genitalia.
Figure 57.1 Anatomy of the female genitalia – many students and junior doctors have been embarrassed by catheterising the incorrect meatus.
Indications and Contraindications
| Indications | Contraindications |
| Monitoring urine output, e.g. fluid resuscitation, fluid balance measurements, sepsis, etc. | Patient refusal |
| Relieving urinary retention | Urethral trauma |
| Urinary incontinence | Active urinary tract infection |
| Immobility, e.g. low Glasgow Coma Scale score, coma, lower limb fractures, cerebrovascular accidents, postoperatively, etc. | |
| Cystograms and other urology investigations |
Potential Complications
| Early complications | Late complications |
| Pain or discomfort on insertion | Paraphimosis if foreskin is not replaced |
| Local tissue trauma, e.g. premature inflation of the balloon, causing prostatic or urethral trauma |
