导尿术是临床最常用的基础操作。男性因尿道解剖特点更易发生困难导尿，盲目操作可诱发医源性尿道损伤及远期尿道狭窄，而目前国内尚缺乏统一规范。该共识基于GRADE证据分级体系，结合国内外循证医学证据及国内临床诊疗现状，明确了男性困难导尿的标准化定义与三级临床分级标准，系统梳理了前列腺增生、尿道狭窄、骨盆外伤、医源性操作等危险因素；规范了术前评估和分层操作流程，依次推荐常规导尿、弯头导尿管应用、导丝引导、内镜辅助、耻骨上穿刺造瘘等递进式处置方案；细化了出血、假道、感染、继发尿道狭窄等并发症的防治策略，并提出医护分层培训、操作质控与会诊制度。共识强调，非泌尿外科人员遇到置管阻力、出血等高危情况时需及时转诊至专科，避免反复暴力置管。本共识旨在为各级医院医护人员处理男性困难导尿提供相对统一、具有可操作性的参考，有助于规范临床处置流程，减少不当操作导致尿道损伤的风险。

Urethral catheterization is one of the most fundamental routine clinical procedures. Males are more prone to difficult catheterization due to the anatomical characteristics of the urethra. Blind manipulation may cause iatrogenic urethral injury and long-term urethral stricture, yet unified domestic standards are currently absent in China. Based on the GRADE evidence grading system, combined with domestic and international evidence-based medical data and the actual clinical practice in China, the consensus on the management of difficult male urethral catheterization has been formulated. This consensus clarifies the standardized definition and three-tier clinical grading criteria for difficult male urethral catheterization, and systematically sorts out risk factors including benign prostatic hyperplasia, urethral stricture, pelvic trauma and iatrogenic manipulation. It standardizes preoperative assessment and tiered procedural workflows, and recommends a stepwise management algorithm consisting of conventional catheterization, coude catheterization, guidewire-assisted catheterization, endoscopic-guided catheterization, and suprapubic puncture cystostomy. Strategies for the prevention and treatment of complications such as hemorrhage, false passage, infection and secondary urethral stricture are elaborated in detail, and tiered training for medical staff, procedural quality control and consultation protocols are also proposed. The consensus emphasizes that non-urological practitioners shall promptly refer patients to specialized urologists when encountering high-risk scenarios such as catheter resistance or hematuria, to avoid repeated forceful catheterization. This consensus provides unified, actionable guidance for medical staff at all levels of medical institutions to manage difficult male urethral catheterization, standardizes clinical workflows, and lowers the risk of urethral injury caused by inappropriate catheterization operations.