Self-Catheterization (Clean Intermittent Catheterization)

What is self-catheterization?

Self-catheterization is a way to empty your bladder when you have difficulty urinating. As the name suggests, you perform the procedure yourself.

Self-catheterization, also called clean intermittent catheterization (CIC) or intermittent self -catheterization (ISC), involves inserting a thin, hollow tube called a catheter into the bladder through the urethra (the tube from which the urine exits your body). Urine drains out of the catheter into a toilet or container. When your bladder is empty, you slip out (remove) the catheter. You repeat these steps at regular intervals (intermittently) several times a day.

What are the types of urinary catheterization?

There are several ways to use a catheter to empty the bladder:

• Indwelling: A sterile tube called a Foley catheter stays in the bladder. The tube is inserted through the urethra, or in some cases directly into the bladder from the lower abdomen (supra-pubic catheter). The catheter attaches to a drainage bag that collects urine throughout the day and night. A balloon in the tip of the catheter keeps the catheter from slipping out of the bladder. Depending on your mobility and situation, the drainage bag may attach to a bed, your leg, or clothes.
• Condom: Males can slip a condom-like device over the penis. The device has a tube that drains urine into a bag.
• Self (clean intermittent): You or a caregiver insert a catheter into the bladder at regular intervals throughout the day. Urine drains through the catheter into a toilet, collection bag or container.

Who might need self-catheterization?

Certain health problems can make it difficult to empty your bladder. Bladder control issues that could require a catheter are more likely if you have:

• Bladder surgery.
• Central nervous system tumors (astrocytoma).
• Enlarged prostate (benign prostatic hyperplasia).
• Multiple sclerosis (MS).
• Neurogenic bladder caused by cerebral palsy, Parkinson’s disease, spina bifida or spinal cord injuries.
• Stroke.
• Urinary incontinence, urinary retention or urethral strictures, and urinary fistulas.
• Severe constipation.

How should I prepare for self-catheterization?

Your healthcare provider will show you how to perform self-catheterization. The process gets easier with practice. Before performing self-catheterization, you should:

• Try to urinate the regular way.
• Wash your hands with soap and water.
• Wash your genitals with soap and water or an antiseptic towelette. This step lowers infection risk.
• Remove the catheter from its package being careful to keep it very clean.
• Apply a water-based lubricant on the tip and top two inches of the insertion end of the catheter if needed. Some catheters come pre-lubricated.

How do I perform self-catheterization?

Regardless of gender, the steps for performing self-catheterization are generally the same. Females may find it helpful at first to use a mirror to find the urethral opening where urine comes out. To perform self-catheterization:

• Sit on the toilet (females may prefer to stand or squat over the toilet).
• Use firm, gentle pressure to insert the lubricated end of the catheter into the urethra.
• Hold the other end of the catheter over the toilet bowl or container.
• Slowly slide the catheter until it reaches the bladder and urine starts to flow out of the tube.
• Continue inserting the catheter another inch or two.
• Hold the catheter in place until the bladder empties.
• Slowly and gently slide out the catheter.

What should I do after finishing self-catheterization?

Cleanup is an important step to preventing infection. Always wash your hands when you finish in the bathroom. The catheters are all single-use, please dispose of it in the trash.

How often do I need to perform self-catheterization?

Your healthcare provider can help determine how many times a day you need to empty your bladder. Most people complete the process four to six times a day or every four to six hours.

What are the potential risks or complications of self-catheterization?

Inserting a catheter can raise the risk of introducing infection-causing bacteria into the body, but having an indwelling Foley catheter presents even a higher risk. So if possible, CIC is a better option than an indwelling Foley. With any type of catheter, you have a higher chance of having a:

• Bladder infection, perforation or spasms.
• Kidney infection.
• Urethral scarring and strictures.
• Urinary tract infection (UTI).

When should I call the doctor?

You should call your healthcare provider if you experience:

• Bladder spasms (sudden painful cramps and unexpected leaking of urine).
• Blood in urine (hematuria).
• Difficulty inserting the catheter.
• Unusually small amounts of urine when emptying your bladder.
• Painful urination (dysuria).
• Signs of urinary tract infection (fever, pelvic pain, urinary leakage).
• Skin rash or sores at the site of insertion.