Intermittent catheterization (IC) is a safe and effective technique that involves temporarily inserting a thin, hollow tube, called a catheter, through the urethra to drain urine from the bladder. Unlike an indwelling catheter, which stays in place, an intermittent catheter is removed immediately after the bladder is emptied. This procedure is typically necessary when the bladder cannot empty completely on its own, a condition known as urinary retention, or in cases of neurogenic bladder dysfunction. Learning to self-catheterize helps prevent complications like urinary tract infections (UTIs) and kidney damage, significantly improving a person’s quality of life and independence.
Gathering Supplies and Preparation
Before beginning the procedure, gather all necessary supplies on a clean surface. You will need the catheter itself, which a healthcare provider will have determined the correct size for, typically measured on the French scale. Catheters are available as standard non-coated types, which require a water-based lubricating jelly, or as hydrophilic catheters, which are pre-coated and activated by water or saline for a slick surface. Never use petroleum-based jellies, as these can damage the catheter material and increase the risk of infection.
Hand hygiene is the first and most important step in preparation, requiring a thorough wash with soap and water for at least 20 seconds. You should also have a mild soap or an antiseptic wipe available to clean the genital area immediately before insertion. A collection container, like a urinal or a measuring hat, is needed if you are not performing the procedure directly over a toilet. Setting up in a private, well-lit space, such as a bathroom, ensures a comfortable and clean environment for the process.
Detailed Step-by-Step Guide to Self-Catheterization
The first step is finding a comfortable and stable position that allows easy access to the urethra. Many people prefer sitting on the toilet, while others find it easier to stand with one foot propped on a stool or the toilet seat. A small mirror can be helpful during the initial learning phase to visualize the anatomy. With practice, however, most people are able to locate the opening by touch alone.
Use your non-dominant hand to gently separate the labia, exposing the urethral opening located just above the vaginal opening. Clean the area with an antiseptic wipe or washcloth, wiping once from front to back to avoid introducing bacteria. Hold the catheter a few inches from the tip and, using slow, gentle, and steady pressure, begin to insert the lubricated tip into the urethra.
The female urethra is short, requiring insertion of only about two to three inches before reaching the bladder. Advance the catheter until urine begins to flow, which confirms correct placement. Once the flow starts, advance the catheter another half-inch to ensure the tip is fully positioned for complete drainage. Allow the urine to drain completely into the toilet or collection container; leaning forward or coughing gently can help expel any remaining urine.
If you encounter slight resistance during insertion, which may occur as the catheter passes through the sphincter muscle, pause and take a few deep breaths to relax the pelvic muscles. Apply gentle, continuous pressure, or try coughing lightly to help the catheter pass into the bladder. Never force the catheter, as this can cause trauma to the urethra. If the catheter accidentally enters the vagina, immediately remove it, discard it, and start over with a fresh, clean catheter to prevent introducing bacteria into the urethra.
Once the flow of urine has stopped, slowly and smoothly begin to withdraw the catheter. If urine starts to flow again during removal, stop pulling and allow the remaining urine to drain before continuing to withdraw the catheter completely. Immediately discard the catheter if it is a single-use type. If using a reusable model approved by your healthcare provider, set it aside for cleaning. Finally, wipe the area clean from front to back and wash your hands again.
Hygiene, Care, and Catheter Maintenance
Meticulous hygiene is paramount, as the primary risk associated with self-catheterization is the introduction of bacteria into the urinary tract. The procedure should always begin and end with a thorough handwashing session using soap and water. Before insertion, the genital area must be cleaned with an antiseptic wipe or mild soap to minimize the number of microbes near the urethral opening.
Many catheters are designed for single use only and should be immediately disposed of after one procedure. This practice is strongly recommended because it significantly reduces the likelihood of bacterial contamination. If you have been instructed to use a reusable catheter, a specific cleaning protocol must be followed after each use.
Reusable catheters must be washed immediately after use with mild soap and warm water, both inside and out. Rinse them thoroughly under running water. After rinsing, the catheter should be dried completely on a clean towel or allowed to air-dry before being stored. Keep the catheter in a clean, dry container, such as a dedicated plastic case, between uses to maintain its cleanliness and integrity.
When to Contact a Healthcare Provider
While self-catheterization is a safe procedure, it is important to monitor for signs of potential complications that require medical attention. The most common concern is a urinary tract infection (UTI). Contact your provider if you experience symptoms like a fever or chills. Other signs of a possible infection include urine that appears cloudy, has a foul odor, or if you feel a persistent burning sensation during urination or the procedure.
You should also seek medical consultation if you notice persistent or heavy bleeding from the urethra that is more than just minor spotting. Inability to pass the catheter into the bladder after several gentle attempts also requires professional help, as forcing the catheter can cause injury. Severe lower abdominal pain or bladder spasms that are not relieved by emptying the bladder warrant an immediate call to your healthcare team.