A catheter is a thin, clean hollow tube which is generally made of spongy plastic or rubber. Catheterization means to introduce a catheter into a body cavity to inject or remove liquid. For example, people who are suffering from incontinence can use this simple process to empty their bladder. The whole procedure is called intermittent clean self- catheterization (ICSC). It gives the person control over their bladder and thus keeps them dry. ICSC also reduces the risk of infection and kidney damage by ensuring the bladder is emptied adequately at regular intervals and the equipment doesn't prohibit or interfere with a normal sexual relationship.
Conditions that may require urinary catheterization
Urinary catheterization can be helpful for people with bladder troubles, such as urinary retention or bladder obstruction. It may be recommended for people who have long-term chronic problems that prevent them from emptying their bladder in the normal way, for example, those who have spinal cord damage and pelvic nerve injure. It can be used on a impermanent basis to help people retrain their bladders to empty. Catheterisation may also be needed after certain kinds of surgery such as trans-urethral resection. An indwelling catheter is often used for the first few days after major surgery or to monitor fluid output in patients receiving intravenous fluids.
The four pieces of equipment required for ICSC include a catheter, something to clean yourself with (such as a wash cloth or cotton balls), a lubricant (such as water or a water-soluble gel) and a container to hold the drained urine if you are unable to get to the toilet. There is no single 'right' way to perform ICSC. Be guided by your doctor but general suggestions include:
- Have all the necessary equipment clean and ready.
- Wash your hands with soap and water. Dry them thoroughly before commencing ICSC.
- Clean the opening of the urethra with water using a face washer, cotton balls.
- Some people may like to smear the urethral opening with local anaesthetic cream.
- Place one end of the catheter into the toilet or container.
- Insert the lubricated catheter slowly and gently until urine starts to flow down the tube.
- Do not rush the procedure. It is important to completely empty the bladder.
- If urine stops flowing, try adjusting the catheter or moving your body into another position.
- Slowly rotate the catheter as you remove it from the bladder.
- Clean your equipment as directed after each use.
- Empty your bladder at least four times a day, or as directed by your doctor or trained continence professional.
Immediately after the procedure
Many people experience and disagreeable dragging sensation as the catheter is removed from the urethra but usually, ICSC is a safe and easy process if performed correctly and with clean equipment. The ICSC equipment is usually cleaned straight after the catheter is removed. Sterilization techniques vary but may include boiling the catheter, washing it in soap and water, or using disinfectant solution. Some people may prefer to bypass the cleaning stage altogether by choosing disposable single-use catheters.
Some of the complications of ICSC include:
- Injury to the urethra caused by rough insertion of the catheter
- Narrowing of the urethra caused by scar tissue
- Injury to the bladder caused by incorrect insertion of the catheter
- Urinary tract infections.
Other forms of treatment
Alternatives may include:
- ICSC performed four times per day is preferable to using chronic indwelling urinary catheters because of the reduced risk of complications.
- In some cases, male patients who are incontinent but not urine retentive may be able to wear a catheter attached to a condom.
- Continence training can help in some cases to re-establish bladder control.