Self-Catheterization (Clean Intermittent Catheterization)

Overview

Self-catheterization is a method for emptying the bladder when difficulties in urination arise, and it is performed by the individual themselves. Urine drains from the catheter into a toilet or collection container. Once the bladder is empty, the catheter is removed. This process is typically repeated several times a day, usually every four to six hours.

Individuals with bladder control issues or certain medical conditions may require self-catheterization to empty their bladder. This technique, also referred to as clean intermittent catheterization (CIC) or intermittent self-catheterization (ISC), entails inserting a thin, hollow tube into the bladder through the urethra at regular intervals throughout the day.

Your healthcare provider will instruct you on the proper use of a catheter. Various sizes and types of catheters are available, and the choice depends on individual needs. Additional supplies, such as lubricants and antiseptic towelettes, are generally required to facilitate the process. It is crucial to maintain clean hands while inserting the catheter to prevent infection.

Reasons for undergoing the procedure

Various health conditions can hinder the complete emptying of the bladder. The likelihood of requiring a catheter for bladder control issues increases if you have:

• Bladder surgery
• Central nervous system tumors (such as astrocytoma)
• Enlarged prostate or prostatitis
• Injury or complications from surgery
• Multiple sclerosis (MS)
• Neurogenic bladder due to conditions like cerebral palsy, Parkinson’s disease, spina bifida, or spinal cord injuries
• Severe constipation
• Stroke
• Urinary incontinence, urinary retention, or urethritis

Risk

Although self-catheterization is generally safe, it carries a risk of infection, making it crucial to adhere to proper care instructions. The potential risks associated with self-catheterization include:

• Urinary tract infection (UTI)
• Bladder infection, perforation, or spasms
• Kidney infection
• Urethral scarring or damage

Procedure

Self-catheterization provides a method for individuals with specific medical conditions to empty their bladders. This process involves using a catheter—a thin, flexible tube—to drain urine directly from the bladder at regular intervals throughout the day. The urine flows through the catheter into a toilet or collection container.

Individuals may need to self-catheterize due to urinary incontinence or leakage, while others might require it following surgery or due to other medical conditions that hinder complete bladder emptying. Failing to adequately drain the bladder can result in:

• Urinary tract infections (UTIs)
• Bladder damage
• Kidney issues

Before the procedure

Your healthcare provider will guide you through the self-catheterization process, which becomes easier with practice. Before you begin, make sure to:

• Wash your hands thoroughly with soap and water.
• Clean your genitals using soap and water or an antiseptic towelette to reduce the risk of infection.
• Carefully remove the catheter from its package while ensuring it remains clean. Avoid touching anything other than the catheter after washing your hands.
• Apply a water-based lubricant (such as K-Y Jelly®) to the tip and the top two inches of the insertion end of the catheter. Some catheters may come pre-lubricated.

During the procedure

The procedure for self-catheterization involves the following steps:

• Ensure your hands are clean.
• Position yourself on the toilet (you may prefer standing or squatting). Individuals with a vagina may find it helpful to use a mirror initially to locate the urethral opening.
• Gently insert the lubricated end of the catheter into your urethra using firm, gentle pressure.
• Hold the other end of the catheter over the toilet bowl or a collection container.
• Advance the catheter slowly until it reaches your bladder and urine begins to flow out of the tube.
• Continue inserting the catheter for another inch or two.
• Keep the catheter in place until your bladder is completely empty. You might need to gently press on your abdomen or lean forward to ensure all urine is expelled.
• Withdraw the catheter slowly and gently in a downward motion.
• Wash your hands once more.

Your healthcare provider can advise you on how often you should empty your bladder, with most individuals performing this procedure four to six times a day, or approximately every four to six hours.

It’s common to experience a learning curve with self-catheterization. You may feel uncertain during your first attempts, but with practice, it should become easier. If you find it challenging, don’t hesitate to reach out to your healthcare provider for assistance.

After the procedure

Cleaning up properly is crucial for preventing infection. Always ensure that you wash your hands thoroughly after completing the self-catheterization process. Since catheters are designed for single use, they can be disposed of in the trash after each use.

Outcome

Self-catheterization is a safe and effective way to manage bladder health. It’s important to allow urine to flow freely from your body, as not fully emptying your bladder can lead to serious health issues, including infections and kidney damage. While it may feel intimidating at first, becoming proficient in self-catheterization can significantly improve your quality of life by easing concerns related to incontinence and other urinary challenges.

If you experience any of the following symptoms, it’s crucial to reach out to your healthcare provider:

• Bladder spasms (sudden, painful cramps accompanied by urine leakage)
• Blood in your urine (hematuria)
• Difficulty inserting the catheter
• Unusually small amounts of urine when emptying your bladder
• Pain during urination (dysuria)
• Symptoms of a urinary tract infection, such as fever, pelvic pain, or urine leakage
• Skin irritation or sores at the catheter insertion site