Intermittent Self Catheterisation

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What is intermittent self catheterisation?

Intermittent self catheterisation (also called clean intermittent self catheterisation) is the practice of passing a catheter (small tube) through one’s urethra (the pipe from which the urine flows from the body) to help complete emptying the bladder.

Why do I need intermittent self catheterisation?

Intermittent self catheterisation is needed in patients who have difficulty emptying their bladder. This can happen for a short term after continence operations (operations carried out to stop leakage of urine on coughing and sneezing). It can also happen on long term basis in patients with neurological conditions that affect bladder nerve supply, such as after spinal cord injury.

Intermittent self catheterisation is a better alternative to an indwelling catheter (a small tube that stays in place) as it allows the bladder to recover and regain its ability to empty itself. It is also less inconvenient in relation to ambulation (movement) and sexual intercourse.

How is intermittent self catheterisation performed?

A nurse or continence advisor will explain this to you. You will be shown how to pass the catheter with the aid of a mirror. You will then be shown how to do this by sensation digitally (using your fingers) without having to use the mirror.

You must clean your hands each time before you perform intermittent self catheterisation.

You hold the catheter like a pen in your dominant hand and separate the labia with the other hand. You pass the catheter in until urine starts to come out. You now hold the catheter steady and can let go of your labia, to free your other hand.

Make sure the catheter’s funnel shaped end is over the toilet or in a jug, so as to avoid soiling your clothes or the floor. You may push it a little bit further to ensure its tip is in the bladder, to ensure that the bladder is empty.

You may find it useful to block the funnel shaped end of the catheter with your finger, as you withdraw the catheter at the end, to avoid drops of urine soiling your clothes or the floor.

You can now wash or dispose of the catheter accordingly. The catheter should not be flushed away, as it can block the toilet. Do not forget to wash your hands at the end.

How often do I use a new catheter?

This varies according to indication and risk of infection. Most of the time, a new catheter is used every day.

How do I know that it is working for me?

Patients performing intermittent self catheterisation as a temporary measure can use a chart to monitor the amount of urine they pass and the amount they drain using the catheter.

When the amount of urine passed through the catheter consistently falls below 100mls, they can discontinue using the catheter at that time of the day.

Patients performing intermittent self catheterisation as a temporary measure, usually have a follow up appointment with their doctor, or nurse, after 6 weeks to check their progress. The majority will have stopped using the catheter altogether by then.

Is there anything I should not be doing?

Absolutely not, you should be able to do everything as usual without any problem.

You should be able to go shopping and travel without any restriction, as long as you keep the catheter with you and are able perform intermittent self catheterisation.

Are there any problems or complications?

You might find it difficult at the beginning but this is usually due to being tense. You may notice small spots of blood in the urine in the early days but this should settle. The procedure should not be painful.

If you feel any burning during micturition (peeing) or think you have a fever (raised temperature), you should contact your doctor or contact us at the hospital to get a sample of your urine checked for infection. Any such infection will be treated with antibiotics, whilst you continue intermittent self catheterisation.

When having your periods, you should wash the genital area with mild soap before each catheterisation. You can change your tampon as well to avoid blood getting on the catheter.

During pregnancy you can still perform intermittent self catheterisation, but as the baby grows you may need to use a longer length catheter.

How do I get fresh catheters?

The nurse or continence advisor who shows you how to perform intermittent self catheterisation will give you a stock to start with and will explain to you how to obtain further supply of catheters. Follow the advice of the nurse or continence advisor regarding storage of the catheters. They usually come in small boxes with clear instructions.

Who can I contact with any concerns or questions?

If you have any problems or questions, please use the contact numbers below to speak to the urogynaecological team.

Useful resources

Healthline: clean intermittent self-catheterisation

Bladder and Bowel community website: conservative treatment