Southeastern Gynocologic Urology

What is clean catheterization
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Clean intermittent self-catheterization is a technique performed by the patient to empty her bladder. It is often recommended for patients with incontinence or incomplete bladder emptying as a result of urinary outlet obstruction or neurogenic bladder disease. The patient inserts a clean short plastic or rubber catheter into the urethra (the tube that drains the bladder to the outside) at a specified time interval or with the sensation of urinary retention. Prophylactic antibiotics are usually not required (except in special circumstances). The risks associated with the technique are minimal, with infection occurring less than 3-4% with long-term use. In order to perform intermittent self-catheterization the patient must have manual dexterity and adequate mental ability. The patient is supplied with a short plastic or rubber catheter, a collection device, and a voiding diary to monitor voided volumes and catheterized residual volumes.

 

The bladder should be emptied every 3-4 hours or as needed at night. Spontaneous voiding should be attempted before each catheterization. The urethra does not need to be cleaned prior to catheter insertion. When residual volumes are less than 20% of voided volumes, intermittent self- catheterization can be discontinued. Please refer to the table below for specific instructions.

 

           

Instructions for Clean Intermittent Self- catheterization

 

  1. Wash your hands with soap and water.
  2. Use a clean (soap and water) catheter, with a water soluble lubricant if needed.
  3. Attempt to empty your bladder before catheterization.
  4. Position yourself lying in bed or straddling a toilet.
  5. Spread the labia with your fourth and index finger of one hand and use the middle finger to locate the urethra.
  6. Insert the catheter 1 -2 inches and drain until all urine flow stops.
  7. Measure and record the amount of urine (“residual”) obtained.

 

 

From Walters MD, Karram MM. Urogynecology and Reconstructive Pelvic Surgery. Mosby Inc. 2007. p. 494.

 

 

 

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