Clean intermittent self-catheterization

Definition

Intermittent catheterization is the temporary placement of a catheter (tube) to remove urine from the body. This is usually done by placing the catheter through the urethra (the tube that leads from the bladder to the outside opening) to empty the bladder.

Alternative Names

Self-catheterization; CISC; CIC; Intermittent catheterization

Information

INTERMITTENT CATHETERS:

Some people may need a catheter occasionally. Intermittent catheterization may be necessary for:

• Anyone who is unable to properly empty the bladder
• People with nervous system (neurological) disorders
• Women who have had certain gynecological surgeries

The goal of intermittent catheterization is to:

• Completely empty the bladder
• Prevent further bladder or kidney damage
• Prevent urinary tract infections

Most people can learn how to perform this procedure.

To perform clean intermittent self-catheterization (CISC), the person must learn the basic location of the important parts of the urinary system.

The person must also be physically able to reach the urethra, and to move the equipment as necessary. People who are unable to see the urethra may be taught how to feel for the proper location of the urethral opening.

Catheters that are used for CISC are slightly different from the catheters used for long-term catheterization. A long-term catheter is held in place by a balloon. CISC catheters do not have this balloon.

CISC catheters may be made of a clear plastic or a softer rubber material. These catheters also come in a variety of sizes.

Although some catheters are disposable, some CISC catheters may be reused.

HOW TO PERFORM CISC (MEN):

1. Assemble all equipment: catheter, lubricant, drainage receptacle (container).

2. Wash your hands thoroughly with soap and water and clean the penis and opening of the urethra.

3. Lubricate the catheter using water-based lubricants only.

4. Hold the penis on the sides, perpendicular to the body.

5. Begin to gently insert and advance the catheter.

6. You will meet resistance when you reach the level of the prostate. Try to relax by deep breathing, and continue to advance the catheter.

7. Once the urine flow starts, continue to advance the catheter another 1 inch. Hold it in place until the urine flow stops and the bladder is empty.

8. Remove the catheter in small steps to make sure the entire bladder empties.

9. If the catheter is disposable, discard it right away. If it is reusable, rinse the catheter completely and dry the outside. Store the catheter in a clean, dry, secure location.

10. Record the amount of urine obtained, as instructed by your health care provider.

HOW TO PERFORM CISC (WOMEN):

1. Assemble all equipment: catheter, lubricant, drainage receptacle.

2. Wash your hands thoroughly with soap and water and clean the vulva and opening of the urethra.

3. Lubricate the catheter using water-based lubricants only.

4. Locate the urethral opening. The opening is located below the clitoris and above the vagina.

5. Spread the lips of the vagina (labia) with the second and fourth finger, while using the middle finger to feel for the opening.

6. Begin to gently insert the catheter into the opening. Guide it upward as if toward the belly button.

7. Once the catheter has been inserted about 2 - 3 inches past the opening, urine will begin to flow.

8. Once the urine flow starts, continue to advance the catheter another 1 inch and hold it in place until the urine flow stops and the bladder is empty.

9. Withdraw the catheter in small steps to make sure the entire bladder empties.

10. If the catheter is disposable, discard it right away. If it is reusable, rinse the catheter completely and dry the outside. Store the catheter in a clean, dry, secure location.

11. Record the amount of urine obtained, as instructed by your health care provider.

Some women may perform CISC standing up with one foot on the toilet. This position is also recommended when there is a question about the cleanliness of the toilet, such as in public facilities.

You may reuse a CISC catheter for 2 - 4 weeks. It may be helpful to soak the catheter in a white vinegar solution once a week to control odor and remove thick mucus deposits. Your health care provider may recommend other cleaning or sterilization techniques if you often get infections.

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References

Selius BA, Subedi R. Urinary retention in adults: diagnosis and initial management. Am Fam Physician. 2008;77:643-650.