What Is a Clean Intermittent Self-Catheterization?
Each time you urinate you’re exercising your bladder
muscles. However, some people’s bladder muscles don’t work as well as others’.
When this is the case, your doctor may recommend clean intermittent self-catheterization.
This painless procedure helps you empty your bladder of urine. It can be
performed at home.
What Conditions Require This Treatment?
Clean intermittent self-catheterization is recommended when
you have a condition that affects your ability to empty your bladder properly.
“Clean” refers to the fact that the procedure requires clean techniques, such
as washing your hands and skin before insertion to prevent infection.
Some people who may require clean intermittent
who have had gynecologic surgeries
with nervous system disorders
who can’t empty their bladders
If you can’t fully empty your bladder, you’re at greater
risk of urinary tract infections, which can ultimately damage your kidneys. The
use of clean intermittent self-catheterization can help prevent a urinary tract
How Is the Procedure Performed?
While many types of catheters are intended to stay in for
days or weeks, a catheter used for clean intermittent self-catheterization is used
several times a day to empty the bladder. The catheter is attached to a plastic
bag that can be used to measure the amount of urine. The process of clean
intermittent self-catheterization for women is different from the process for men.
You must first wash your hands and the area around your urinary
opening to prevent infection. You also must be able to identify the urinary meatus
(opening where urine flows). You need to lubricate the tip of
the catheter and insert it into the urinary meatus. When the catheter is
properly inserted, urine will flow into the catheter’s bag. Allow all urine to
drain. When the urine stops flowing, slowly and gently remove the catheter. Measure
and record the amount of urine in the bag and then empty the bag. Clean the
catheter and urine collection device with mild soap and hot water immediately
after use. Rinse the materials and air dry. Store the materials in a clean, dry
First wash your hands and cleanse the area around the top of
your penis to reduce bacteria and risk for infection. Lubricate the first
several inches of the catheter tip. Insert the catheter into the urinary
opening of your penis until 8 or 9 inches of the catheter have been inserted. You
may feel some resistance after inserting 6 inches of the catheter. This not
uncommon, as this is the location of the urinary sphincter muscles. Take a few
deep breaths and increase the pressure while continuing to insert the catheter.
Make sure the urine has stopped flowing, and you’ve completely emptied your
bladder. Then slowly remove the catheter. Measure and record the amount of
urine in the bag, and then empty the bag. Clean the catheter and urine
collection device with mild soap and hot water immediately after use. Rinse the
materials and air dry. Store the materials in a clean, dry container.
As mentioned, each time you’re finished using
the catheter, always wash it with soap and hot water, and store it in a clean,
dry container. You should replace your catheter every two to four weeks, according
to the National Institutes of Health
If your catheter becomes hardened, discolored, brittle, or too soft for
insertion, discard it.
Your doctor will likely recommend how often you should
perform clean intermittent self-catheterization. A typical schedule is every 6 hours
and just before you go to bed. If you’re urinating more than 400 mL at a time
with clean intermittent self-catheterization, you may need to increase the
frequency to prevent infection, according to the NIH.
How Is the Procedure Monitored?
Your doctor will likely ask you to keep a record of your
daily liquid intake and output while you’re performing clean intermittent
self-catheterization. Intake includes anything you drink, such as water, juice,
soda, tea, alcoholic beverages, and coffee. Be sure and drink between 2,000 mL and
2,500 mL (or 8.5 to 10.5 cups) of fluid, preferably water, per day.
If your kidneys are working properly, you should flush out
the same amount of fluid as you take in over the course of the day. If your
recorded output doesn’t match up with your intake, notify your doctor.
What Are the Side Effects?
Catheterization can involve some discomfort as the catheter
is inserted into the bladder. It will take practice to become more comfortable
with the process. At first, you may require assistance from a medical provider
or loved one.
Always notify your doctor if you experience pain during
catheterization. Also report any abdominal or lower back pain or burning
sensations. These can be symptoms of a urinary tract infection.