Intermittent Self-Catheterization

Intermittent self-catheterization (IC) is a safe procedure that can help bring your urinary symptoms under control. Many people self-catheterize and report that it has improved their quality of life. It will allow you to completely empty your bladder at regular intervals, protect your kidneys from infection and damage, lower the risk of distending (stretching) the bladder, and eliminate the need for wearing a continuously draining catheter. There are different kinds of catheters. Learn about them, discussing options with your provider.

Catheterization Procedures
The following procedures refer to catheters that are not pre-lubricated.

General Instructions:

1. Gather equipment needed:
• Mirror (for women to locate opening of urethra)
• Bath soap and clean towel
• Water soluble lubricant such as KY Jelly®
• New sterile catheter
2. Arrange your clothing so it is not in the way.
3. Attempt to urinate on your own. Even if you are able to urinate a large amount, there may still be some urine in the bladder that must be emptied to prevent infection. Proceed as instructed by your provider.
4. Wash your hands with regular bath soap and water. Wash the area of your urethral opening known as the perineal area (from front to back) with bath soap and water. Antiseptic wipes such as baby wipes may be used when away from home. Refrain from using these wipes for daily perineal care.
5. Open catheter packaging.
6. Open lubricant tube, and apply a generous amount of lubricant to the first few inches of the catheter. Lubricant can be purchased at most drugstores. The lubricant must be water soluble - DO NOT USE Petrolatum based products such as VASELINE®! Bacteria can "stick" to this type of lubricant and possibly cause a bladder infection.
7. Sit on toilet, or firm surface, and lean back.

Women:

1. Slightly spread legs apart for ease in inserting the catheter. Using the hand you will not be using to hold the catheter, spread your vaginal lips (labia) apart, both outer and inner parts.
2. Identify your clitoris, urinary opening, and vaginal opening using a mirror or by feeling the area.
Diagram 1: Female Anatomy

3. Pick up the lubricated catheter with the other hand. Hold it like a pencil about 2”-3” from its tip, and insert tip straight (or upward) into urinary opening, allowing the other end to hang down between your legs into a basin or toilet.
4. Gently thread the catheter 3”-4” into the bladder until you see urine flow into the basin or toilet. Then gently thread it another 1/2”-1” into bladder.
Note: If the catheter enters the vagina instead of the urinary opening, withdraw the catheter, wash it with soap and water, vigorously rinse the catheter lumen (tube) with tap water to remove vaginal mucus, dry it, and start again.
5. Hold catheter in place and allow urine to continue draining until it stops completely.
6. Gently remove the catheter from the bladder. Wipe yourself with tissue from front to back, and throw away the used catheter.

Men:

1. In a seated position, hold your penis horizontally from your body. Gently thread the catheter through the urethral opening 6” - 8” until you begin to see urine flow into a basin or toilet. Then, thread it an additional 1”-2” until a good, steady flow of urine is obtained. The only way to be sure that the catheter is in the bladder is to see urine flow.

Diagram 2: Male Self-Catheterization

 

2. If using a coudé (bent tip) catheter, maintain integrity of the solid strip as directed for correct position of the catheter. The “up” side of the coudé should always be facing the 12 o’clock position when threading the catheter into the bladder.
3. If the catheter is dropped onto a clean surface, wash it with soap and water to prevent germs from being introduced into your bladder.
4. Remove the catheter when urine flow ceases, and throw away the used catheter.

Some men manage a leaking bladder by using an external condom catheter that is worn on the penis. These catheters are sized to the circumference of the penis and ordered by your healthcare professional. Instructions on use and placement of condom catheters should be given by your provider’s nurse. Care of the penile shaft with any type of skin barrier is important should skin become irritated and begin to break down. Circumcised and uncircumcised designs are available.

If you meet resistance during the first two weeks of catheterization, don’t get discouraged. If you find it too painful to catheterize, call your health professional.

Catheters can be purchased at medical supply stores. Bring your prescription to the store with you. Also, check with your health insurance for coverage and reimbursement.