For a variety of different reasons, many people are unable to empty their bladders by voluntarily urinating. A large number of conditions can be associated with the inability to empty, including diabetes and spinal cord problems, such as tumors or multiple sclerosis. These patients have either a complete inability to empty their bladder, and no urine drains from the bladder, or have incomplete emptying. This poses a problem for patients because urine that sits in the bladder is prone to becoming infected or, depending on the extent of incomplete emptying, may cause kidney damage. Patients who experience this may be forced to rely on clean intermittent catheterization (CIC) to empty their bladder.
What is CIC?
CIC is a technique that has been utilized since the early 1970s and is a safe and effective means for patients to empty their bladder. CIC involves a patient placing a catheter into their urethra and draining the bladder until it is empty. Although it sounds like a difficult skill to master, most patients are able to do so with minimal teaching from a skilled urological health care practitioner.
Although originally intended to be a sterile technique, over time it has been proven that this can be done in a “clean” manner, without any increase in infectious complications.
How to clean your CIC
1. Wash your hands thoroughly with soap and water.
2. Males who are uncircumcised are encouraged to pull the foreskin back and similarly cleanse the opening of the urethra, the meatus.
3. Females need to spread their labia, and similarly cleanse the meatus.
4. A lubricated catheter is then advanced until urine begins to flow.
5. After the urine stops, the catheter is then slowly withdrawn until there is no further flow of urine, and the catheter is then removed.
How often should I change my catheter?
Most patients will catheterize themselves three to four times daily. If they find themselves incontinent of urine between catheterizations, then the frequency of the catheterization can be increased. Patients who urinate spontaneously between catheterizations may be able to do this less frequently. Some patients may need to perform this once daily, but the frequency of catheterization should be discussed with your urologist.
Catheters for intermittent catheterization are intended for multiple uses. After completing the procedure, the catheter should be cleansed with soap and water, dried and then stored until needed again.
There have been some reports of patients cleaning their catheters by heating them in a microwave; however, I have found this to significantly decrease the lifetime of the catheter. Over time, depending on the composition of the catheter that is used, the catheters will either become flimsy or brittle and should be discarded. Catheters should definitely last a week, and many patients can use them for prolonged periods.
Many times, you may find television commercials (especially on cable channels late at night) for companies that sell catheters to patients who need them for CIC. These commercials advocate daily use of the catheters. Remember that this recommendation is not based on medical evidence, but rather is being touted by companies who profit from the sale of catheters.
Risks of using CIC
Several difficulties can occur to patients who perform CIC. If difficulty is experienced while passing the catheter, or bleeding occurs, the patient needs to reach out to their urologist. Patients who perform CIC often are incorrectly informed (usually by non-urologists) that they have urinary tract infections. Most often, these are not infections, especially if they are not experiencing symptoms, and these patients should be encouraged to consult with their urologists prior to beginning any treatment for an infection.
Published On: June 29, 2014