extract from the Nursing Times
As every nurse is likely to insert a urethral catheter at some point, they need to be surethat they are using a catheter of the correct length.
Catheters are commonly used in acute care, in patients’ own homes, in social care and in nursing homes. They are manufactured in a range of different gauges and three lengths: female length (20-26cm), standard length (40-45cm) and paediatric (30-31cm).
The sex difference in urethral lengths means that, should the shorter female length catheter be used in males, the inflation of the balloon with water occurs within the male urethra rather than the bladder. This can cause severe urethral trauma and result in pain and haemorrhage, or longer term effects such as urethral strictures, retention or incontinence.
Clinical practice differs between healthcare settings. Some areas will stock only standard length catheters and use different gauges for male and female patients. In other areas, the use of shorter female length catheters, which have no clinical imperative, are used for patient dignity issues such as concealing catheters under skirts.
Between January 2006 and March 2009, the National Patient Safety Agency received 114 reports of serious harm from errors where shorter female catheters had been inserted in males. The result was a range of serious outcomes for the patients, including cases of acute renal failure or impaired renal function. Some patients required additional medical or surgical procedures to correct thetrauma.
In April 2009, the NPSA issued a Rapid Response Report (RRR) on the risks of female catheters causing urethral trauma in men, with the aim of making practice safer.
Examples of actual incident reports: Patient catheterised on admission by staff nurse. No urine seen or drained over a few hours. A doctor informed and he was unable to remove the catheter or deflate the balloon. A urologist was then called, who deflated the balloon with a needle through the penis. Large clots were passed. The patient had been catheterised with a female catheter.
Admitted patient had a female length catheter in male patient. The patient wasadmitted with acute renal failure. He wasrecatheterised with an appropriate catheter and conservatively managed. Renal function recovered.
Patient presented to A&E with urine retention. He had had a female catheter fitted the previous day by his district nurse.
He said that she told him she had no male catheters and asked if he minded having a female one.Frances Wood, clinical reviewer, NPSA
But man and woman are social categories, and regarding trans women as "male" and treating them as such is to opposing trans equality, isn't it?