Hematuria is a frequent condition with important health and economic consequences. There is a need for nurses and urologists to improve their assessment acknowledgments and skills about this multifaced entity. The aim of this paper is to review all current knowledge about the best way to manage this important problem including a prioritized list of steps taken to stop or diminish bleeding, to assess whether a catheter is blocked, to solve all related problems and maintain catheter patency for continuous bladder irrigation. There is a lack of written information and basic formation trainning about the steps that should be done in case of hematuria and, notoriously, the best way to perform a bladder washout in an effective way.

Male urethral catheterization may be difficult in patients with enlarged prostate glands or other potentially obstructive conditions as urethral stenosis, after prostatic TUR undermining bladder neck, old and recent false passages, sphincteric spasm among others. Alternative techniques or tricks to surpass problematic urinary catheterization are usually known by experienced nurses and physicians. If repeated catheterization attempts are done, the risk of failing and complications appearing increase significantly. Improper insertion of catheters also may increase healthcare costs due to prolonged hospitalization, immediate and/or delayed surgical interventions transforming a minor technique into a huge problem for the patient, doctors, and healthcare system. Improved techniques for catheter placement are essential for all healthcare personnel involved in the management of the patient needing a urethral catheterization, including nurses and doctors from both primary and hospital medicine. The aim of this article is to show some tips and tricks that may be helpful for the blind placement of urethral catheters. The phrase "primum non nocere" acquires its maximum meaning in this context. Sanitary personal must be prudent in the number of attempts, have a clear strategy of what can be done in each moment and know how to stop or seek help in case of not being able to probe the patient in 2 or 3 attempts. If all these recommendations fail a urologist have to be required to place a catheter in a safe way including the use of endoscopic optic devices.

Objective: Thousands of patients must carry Foley catheter during their hospital stay or at home. Sometimes it is impossible to remove it, due to the inability to deflate the balloon. There is no clear protocol about what to do, who should do it and in what order. We present a proposal for action to face this type of situation. Material and methods: We searched the databases of medical publications (Pubmed, Medline, Embase) using the following keywords: Bladder catheter removal, Non-deflatable, retained catheter, obstructed catheter. Results: Twentyfour articles that fulfilled the requirements of the search were detected. Only ten which propose stteped actions were finally included for review. Discussion: The only standardized proposal for action was published 17 years ago and it has never been updated, probably because these problems are considered "isolated cases". We review the knowledge on the subject and propose an action algorithm that would reduce costs and avoid displacement if this situation arises.