Intermittent Self-Catheterization (ISC) involves temporarily inserting a thin, flexible tube into the bladder to drain urine when the bladder cannot fully empty on its own. This condition can lead to infections or kidney damage. ISC is a safe and effective way to manage bladder function and improve quality of life. Although this guide provides detailed steps, ISC should only be performed after receiving comprehensive, hands-on training from a qualified healthcare professional, such as a specialist nurse or urologist. This training ensures the proper technique, catheter type, and schedule are correct for individual needs.
Essential Preparation and Supplies
Gathering all necessary supplies is the first step toward safe catheterization. Required items include the prescribed catheter, water-soluble lubricating jelly (if not pre-lubricated), an antiseptic wipe or mild soap and water for cleaning, and a container or toilet for urine collection. Hands must be washed thoroughly with soap and water for at least 20 seconds and dried completely to prevent microorganism transfer. Maintaining a clean technique is important for lowering the risk of urinary tract infection (UTI).
Establish a comfortable and accessible position, such as sitting on the toilet, standing, or lying down, depending on mobility and preference. Prepare the catheter according to the manufacturer’s directions. Hydrophilic types may require activation with water to become slippery. If using a non-coated catheter, apply a generous amount of water-based lubricant to the tip and the first several inches of the insertion end to minimize friction and prevent urethral injury. Avoid touching the part of the catheter that will be inserted into the urethra to maintain sterility.
Step-by-Step Insertion for Male Anatomy
Begin by cleaning the tip of the penis (glans) using a circular motion with a mild soap or an antiseptic wipe, moving from the urethral opening outward. If uncircumcised, retract the foreskin before cleaning the meatus. Hold the penis straight up and away from the body, typically at an angle between 60 and 75 degrees, which helps straighten the urethra’s natural curves.
Hold the penis steady with the non-dominant hand and gently introduce the lubricated catheter tip into the urethral opening using the dominant hand. Advance the catheter slowly and smoothly, without forcing it, until it moves about 6 to 8 inches into the urethra. Resistance may be felt at the midpoint where the catheter meets the external sphincter muscle or the prostate gland. Applying gentle, steady pressure while taking a deep breath or coughing can help the muscle relax, allowing the catheter to pass.
Once the catheter is past the point of resistance, advance it further until urine begins to flow, indicating the tip has entered the bladder. Push the catheter in about one to two inches more to ensure all drainage holes are inside the bladder wall. Gently lower the penis to allow the urine to drain completely into the toilet or collection container. Wait until the flow has stopped entirely; pressing gently on the lower abdomen can help ensure the bladder is fully emptied.
Step-by-Step Insertion for Female Anatomy
The insertion process requires locating the urethral opening, which is positioned just above the vaginal opening and below the clitoris. Achieve a comfortable position, such as sitting on the toilet with legs spread or lying down with knees bent. Initially, a mirror can be helpful to identify the anatomy, though consistent use is discouraged to build confidence in the touch technique.
Separate the labia with one hand, exposing the urethral opening. Clean the area with a front-to-back motion using a soapy cloth or antiseptic wipe. Repeat this step with a clean, wet cloth to remove all soap residue and prevent irritation. While keeping the labia separated, gently insert the lubricated catheter into the urethral opening.
Advance the catheter slowly until urine begins to flow, which typically occurs after insertion of about 3 to 4 inches. Once flow begins, advance the catheter an additional one inch to ensure the drainage eyes are fully inside the bladder. If the catheter is accidentally inserted into the vagina, discard it immediately and use a new, sterile catheter to prevent infection. Hold the catheter in place until the flow of urine stops completely, and gently pressing on the lower abdomen can assist in achieving full drainage.
Post-Procedure Care and Monitoring
After the bladder is completely emptied, remove the catheter slowly and gently to avoid irritating the urethral lining. If urine flow restarts during withdrawal, pause until the flow stops again to ensure all residual urine is drained. If the male patient is uncircumcised, the foreskin must be immediately returned to its normal position over the glans.
Single-use catheters should be placed into a disposal bag and discarded in the household trash. Reusable catheters require thorough cleaning with soap and warm water, followed by rinsing and air-drying on a clean surface before storage. Wash hands again with soap and water after managing supplies.
Users should monitor their health for signs of potential complications that require prompt medical attention. These signs include persistent pain or burning during catheterization or urination, fever or chills, cloudy or foul-smelling urine, or significant or prolonged bleeding. If an individual is unable to insert the catheter after a few gentle attempts, or if the bladder feels full but no urine drains, they should contact a healthcare provider immediately.