Catheterization
Catheterization

Clean intermittent self-catheterization

Definition:

Intermittent catheterization involves the placement of a temporary catheter (tube) to remove urine from the body. This is usually done by placing the catheter through the urethra to empty the bladder.



Alternative Names:
Self-catheterization; CISC; CIC; Intermittent catheterization

Information:

INTERMITTENT CATHETERS:
Some people may require catheterization for a short period of time or on an occasional basis. Intermittent (short-term) catheterization may be necessary for people with neurological disorders, women who have undergone certain gynecological surgeries, and anyone who is unable to properly empty the bladder.

The goal of intermittent catheterization is to prevent urinary tract infections and/or to completely empty the bladder. Most people are able to learn how to perform this procedure.

To perform clean intermittent self-catheterization (CISC), the person must learn the basic location of the important urological landmarks.

Additionally, the person must have the physical ability to reach the urethra and must be able to manipulate the equipment. People who are unable to visualize the urethra may be taught how to feel for the proper location of the urethral meatus (opening).

Catheters that are used for CISC are slightly different from the catheters used for indwelling (long-term) catheterization. An indwelling catheter is held in place by a balloon; CISC catheters do not have this balloon or the side balloon inflation.

CISC catheters may be made of a clear plastic or a softer rubber material. These catheters also come in a variety of sizes.

Although some catheters are intended to be disposable, some CISC catheters can be reused.


HOW TO PERFORM CISC (MEN):
1. Assemble all equipment: catheter, lubricant, drainage receptacle.

2. Wash your hands thoroughly with soap and water and clean the penis and urethral opening.

3. Lubricate the catheter.

4. Hold the penis on the sides, perpendicular to the body.

5. Begin to gently insert and advance the catheter.

6. You will meet resistance when you reach the level of the prostate. Try to relax by deep breathing, and continue to advance the catheter.

7. Once the urine flow starts, continue to advance the catheter another 1 inch and hold it in place until the urine flow stops and the bladder is empty.

8. Withdraw the catheter in small increments to make sure the entire bladder empties.

9. Wash the catheter with soap and water. If the catheter is disposable, discard it right away. If it is reusable, rinse the catheter completely and dry the outside. Store the catheter in a clean, dry, secure location.

10. Record the amount of urine obtained, as instructed by your health care provider.

HOW TO PERFORM CISC (WOMEN):
1. Assemble all equipment: catheter, lubricant, drainage receptacle.

2. Wash your hands thoroughly with soap and water and clean the vulva and urethral opening.

3. Lubricate the catheter.

4. Locate the urethral opening (meatus). The opening is located below the clitoris and above the vagina.

5. Spread the labia (vaginal lips) with the second and fourth finger, while using the middle finger to feel for the opening.

6. Begin to gently insert the catheter into the opening, guiding it upward as if toward the belly button.

7. Once the catheter has been inserted about 2 to 3 inches past the opening, urine will begin to flow.

8. Once the urine flow starts, continue to advance the catheter another 1 inch and hold it in place until the urine flow stops and the bladder is empty.

9. Withdraw the catheter in small increments to make sure the entire bladder empties.

10. Wash the catheter with soap and water. If the catheter is disposable, discard it right away. If it is reusable, rinse the catheter completely and dry the outside. Store the catheter in a clean, dry, secure location.

11. Record the amount of urine obtained, as instructed by your health care provider.

Some women may perform CISC standing up with one foot on the toilet. This position is also recommended when there is a question about the cleanliness of the toilet, such as in public facilities.

A CISC catheter may be reused for 2 to 4 weeks. It may be helpful to soak the catheter in a white vinegar solution once a week to control odor and remove thick mucus deposits. Other cleaning or sterilization techniques may be recommended by your health care provider if infection occurs frequently.


Review Date: 10/28/2002
Reviewed By: David R. Knowles M.D., Department of Urology, New York-Presbyterian Hospital Columbia Campus, New York, NY. Review provided by VeriMed Healthcare Network.
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