If you have been told you need to do intermittent self-catheterization, it is because your bladder does not empty completely or perhaps it does not empty at all. There are many causes for this problem: stroke, spinal cord injury, diabetes, spina bifida, and obstruction to the outflow of urine are the most common reasons. Sometimes after an operation on the colon such as a colostomy, the bladder does not empty well and patients may need to catheterize themselves for several weeks or months until the bladder begins to function normally again. It is also not unusual for a woman to need to do intermittent self-catheterization after a bladder neck sling operation. This may be required for several days, weeks, or months. Sometimes this procedure is taught to patients prior to their surgery.
When you are catheterizing yourself or regularly catheterizing someone in your home, it is not necessary to use sterile procedure. Cleanliness is all that is necessary, unless your doctor tells you otherwise and there is a medical reason for sterility. Research has shown that if the bladder is emptied regularly and completely before it gets overstretched, there is little likelihood of infection.
The doctor or nurse who has told you that you need to catheterize and who has taught you the procedure, will tell you how often you should drain your bladder with the catheter. As a general rule, you will want to be on a schedule during the day in which you drain the bladder before it has more than 12 oz. (360 ml.) to 13 oz. (390 ml.). It is very important to avoid bladder over-distension in order to facilitate the return to normal bladder function. Thus, if your catheterized volumes are above 400 ml, it will be necessary to increase the frequency of the catheterization.
Self-catheterization sounds frightening to many people. It seems as if it would be painful or embarrassing. In fact, it is amazingly easy and there is rarely any discomfort. You need to relax and take some deep breaths before you start.
Self-Catheterization for Women
Female patients require the following equipment for intermittent self-catheterization:
You may catheterize yourself while standing over the toilet, sitting on the commode, sitting in a wheelchair, reclining in a reclining chair, or lying in bed. If you cannot get up close to a toilet or a place to drain the urine, there are long extension tubes to attach to the catheter.
The procedure for women is as follows:
1. Wash your hands with soap and water. You may wash the catheter at the same time by wrapping it around your hand. Rinse well and shake any excess water out of the catheter.
2. Spread the labia (lips) away from the vagina and urethral opening with your non-dominant hand (the hand you do not write with or use to feed yourself) and wash yourself from front to back with the other hand.
3. Continue to hold the lips open with your non-dominant hand. With the other hand, grasp the catheter 2" to 3" from its tip and dip the catheter tip into the lubricating jelly or run water over it Insert the tip of the catheter into the urethra. At first, a mirror will be helpful to locate the urinary opening; but try not to depend on it. Slowly and gently advance it until it reaches the bladder and urine begins to drain out. Leave the catheter in place until all urine stops draining. Slowly pull the tube out, stopping whenever urine begins to drain again. Allow the urine to drain completely before beginning to pull the tube out again.
4. Once the catheter is removed, run tap water through it and wash your hands and the catheter with soap and water. Rinse the catheter and your hands well. Dry your hands, shake the catheter, and then place it in its bag or pouch for the next use.
Self-Catheterization for Men
Male patients require the following equipment for intermittent self-catheterization:
You may catheterize yourself while standing over the toilet, sitting on a commode, sitting in a wheelchair, reclining in a chair, or lying in bed. If you cannot get up close to a toilet or a place to drain the urine, there are long extension tubes to attach to the catheter.
The procedure for men is as follows:
1. Wash your hands with soap and water. You may wash the catheter at the same time by wrapping it around your hand. Rinse your hands and the catheter with running water. Dry your hands and shake excess water out of the catheter.
ANSWERS TO FREQUENTLY-ASKED QUESTIONS
What if I see blood?
Should I boil or microwave my catheters?
How many catheters do I need?
Is this expensive?
What if I leak urine in between?
Are there symptoms or signs of trouble I should watch out for?
Andrew L. Siegel, M.D.
Hackensack University Medical Plaza