A straight, or intermittent, catheter is a thin, flexible tube temporarily inserted into the bladder to drain urine. This procedure is commonly used when a female patient cannot fully empty her bladder due to conditions like urinary retention, neurogenic bladder dysfunction, or for the collection of a sterile urine specimen. The process, known as intermittent self-catheterization (ISC), allows individuals to manage bladder function, helping prevent complications such as urinary tract infections (UTIs) and potential kidney damage. This guide is for informational purposes only; always consult a licensed healthcare provider for personalized instruction and a prescription for the correct catheter type and size.
Preparation and Necessary Supplies
The process begins with meticulous preparation to ensure a clean, safe procedure and minimize the risk of introducing bacteria into the urinary tract. Before touching any supplies, thoroughly wash your hands with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer.
The required materials are often contained within a single sterile catheterization kit. Supplies include the prescribed straight catheter, water-soluble lubricating jelly, antiseptic wipes or solution, clean towels or pads, a urine collection container, and sterile or clean gloves. Confirm that the catheter size, usually expressed in French units (Fr), is correct, as determined by a healthcare professional.
Organize all items on a clean, easily accessible surface. If using a catheter that is not pre-lubricated (hydrophilic), apply a generous amount of the water-soluble lubricant to the tip and the first few inches of the catheter. This preparation ensures the catheter is ready for smooth insertion once the physical cleaning steps are complete.
Detailed Catheterization Procedure
The physical procedure requires the patient to be positioned correctly to allow for clear visualization and access to the urethra. The patient should lie on her back with her knees bent and legs spread apart, a position known as dorsal recumbent. If self-cathing, sitting on a toilet with hips slightly forward or using a mirror may be helpful when first learning the technique.
Before insertion, the area around the urethral opening must be cleaned with an antiseptic solution or wipe to reduce microbes. Using the non-dominant hand, gently spread the labia to expose the urethral opening; this hand must remain in place throughout the cleaning and insertion. Using a single antiseptic wipe or cotton ball for each stroke, wipe from front to back, moving from the top (clitoris area) toward the anus, and discard each wipe after one use.
The urethral meatus, the small opening through which urine passes, is located just above the vaginal opening and below the clitoris. Once the area is clean, take the lubricated catheter with the dominant hand, holding it a couple of inches from the tip. Gently and slowly insert the tip of the catheter into the urethral opening, aiming slightly upward, until urine begins to flow.
Once urine flow starts, advance the catheter approximately one to two additional inches to ensure the tip is fully positioned within the bladder. The catheter must be held securely in place while the bladder empties completely into the designated collection container or the toilet.
To promote complete bladder emptying, gently press on the lower abdomen over the bladder area, which can help expel any residual urine. When the flow of urine has completely stopped, the catheter can be gently and slowly removed. Rotating the catheter slightly as it is withdrawn helps ensure no urine remains in the bladder.
Aftercare and Safety Monitoring
Once the catheter is removed, aftercare involves managing used materials and ensuring patient comfort. Disposable catheters and any single-use items from the kit should be discarded following local waste disposal guidelines. If a reusable catheter is used, it must be thoroughly washed with soap and water, rinsed well, and allowed to air dry on a clean surface before being stored in a clean container for future use.
The patient should wash the genital area again with a clean, wet cloth or wipe to remove any residual antiseptic or lubricant. This helps prevent skin irritation and promotes comfort after the procedure. All equipment, including the urine collection container, should be cleaned after each use to maintain hygiene.
Ongoing safety monitoring is important, especially for individuals performing intermittent catheterization regularly, as there is a risk of infection or trauma. Watch for signs of a possible urinary tract infection (UTI), such as fever, chills, cloudy or foul-smelling urine, or burning pain during urination. Persistent pain, difficulty inserting the catheter, or the presence of blood in the urine are signs that require prompt medical attention.