Intermittent self-catheterization (ISC), often referred to as clean intermittent catheterization (CIC), involves the temporary insertion of a thin, flexible tube into the bladder to drain urine. This method is employed when the bladder cannot empty itself completely (urinary retention) or when managing a neurogenic bladder. Regular and complete bladder drainage is important for maintaining kidney health and reducing the risk of infection. This guide details the process but is not a replacement for hands-on training provided by a qualified healthcare professional.
Preparation and Necessary Equipment
Before beginning, gather all necessary supplies to ensure a smooth and sanitary procedure. The catheter type and size will have been prescribed by a physician. Catheters are generally available as straight, requiring separate lubricant, or as hydrophilic, which have a special coating that becomes slippery when activated by water. Female-length catheters are typically shorter, often around six inches, and are sized using the French scale (Fr), where a larger number indicates a wider diameter.
Other items needed include mild, fragrance-free soap and clean water, a receptacle for collecting urine, and sterile, water-soluble lubricating jelly if using a non-coated catheter. Begin by thoroughly washing your hands with soap and water for at least 20 seconds to minimize the introduction of bacteria. Position yourself comfortably, such as sitting on the toilet or lying down with your knees bent, ensuring the urethral opening is easily accessible.
Step-by-Step Technique for Self-Catheterization
The first step involves carefully preparing the genital area to reduce the risk of infection. Using your non-dominant hand, gently separate the labia. With your dominant hand, use a clean cloth or wipe with soap and water to cleanse the area, always wiping from front to back. This directional cleaning prevents bacteria from contaminating the urethral opening.
Next, apply water-soluble lubricant liberally to the tip and the first few inches of a straight catheter, or activate the coating on a hydrophilic catheter per the manufacturer’s instructions. Identifying the urethral opening can be challenging initially, as it is located just above the vaginal opening and below the clitoris. A small, hand-held mirror can be helpful until you become familiar with the precise location by feel.
Once the opening is located, relax and take a deep breath before gently inserting the lubricated catheter tip. Slowly slide the tube into the urethra with steady, gentle pressure, ensuring you do not force the catheter if resistance is met. Continue to advance the catheter until urine begins to flow, indicating the tip has reached the bladder. Once flow starts, advance the catheter approximately one to two centimeters further to ensure it is fully positioned.
Allow the urine to drain completely into the toilet or collection container. To ensure the bladder is fully empty, you may slowly rotate the catheter slightly or gently apply pressure to the lower abdomen. Wait until the flow stops and no more urine is draining through the tube before proceeding to the removal step.
Hygiene and Managing Common Issues
When the bladder is empty, gently and slowly withdraw the catheter, pausing if urine begins to flow again. Once the catheter is fully removed, focus on cleanliness and disposal. Single-use, disposable catheters should be discarded immediately. If using a reusable catheter, clean it immediately with soap and warm water, rinse thoroughly, and allow it to air-dry on a clean towel.
Maintaining a rigorous schedule and sterile technique is the best defense against common complications, particularly urinary tract infections (UTIs). Signs of a UTI include cloudy or foul-smelling urine, a burning sensation during urination, or lower abdominal discomfort. If these symptoms occur, contact your healthcare provider promptly for evaluation.
Difficulty inserting the catheter can sometimes be caused by a bladder spasm or tension; if this happens, take a moment to relax and try again without forcing the tube. If the catheter is mistakenly inserted into the vagina, remove and discard it, then use a new, sterile catheter for the procedure. Tracking your fluid intake and the volume of urine drained offers a practical way to monitor bladder health and the effectiveness of your routine.