A patient who needs to empty his/her bladder from time to time in a special manner is often taught to perform self-catheterization. Although it may seem a bit unusual and complicated at first, using a urinary catheter to relieve yourself can be done safely and easily to manage various urinary problems.
What is Urinary Catheterization?
Urinary catheterization is a procedure performed to drain and collect urine from storage in the urinary bladder using a thin, flexible tube. This tube, called a catheter, is usually inserted into the urethra, a short tube that drains urine from the bladder to the outside. The catheter is guided into the urinary bladder and it allows urine to drain into a bag, a special container or into the toilet.
Urinary catheterization is usually done on a short-term basis for patients who are undergoing surgery or for a person who has a condition where there is a temporary inability to empty the bladder. This procedure is often done in a medical facility by trained medical personnel.
Sometimes intermittent or repeated urinary catheterization may be required for a long time, and indications for this include:
- removing urine from the bladder of a person who cannot control urination due to nerve damage, a condition known as neuropathic bladder (for example, in spinal cord injury)
- treating loss of bladder control or urinary incontinence that does not respond to other medical treatments ( for example, in diabetic neuropathy)
- reducing the risk of kidney infection in people who have functional obstructions which prevent adequate urination (for example, sphincter dysfunction)
Patients who suffer from these conditions need to empty their bladders intermittently using a catheter and they are therefore trained to perform self-catheterization at home.
Self-Catheterization at Home
Patients who are highly motivated to perform self-catheterization can be trained to perform the procedure at home. Those who are too young or too weak to do it may be assisted by a caregiver or a parent, but generally, disability is not a contraindication because patients in wheelchairs have been known to master the technique in spite of paraplegia, old age, spinal deformity, mental handicap, or blindness.
A doctor will first assess the patient by taking a complete medical history, physical examination, and laboratory examinations as necessary. The doctor will also give a prescription for the right catheter suitable for the patient, of which there different types and sizes. These catheters may be bought at medical supply stores or from numerous online retailers, and may also be available at a reduced cost (or for free) through Medicare or Medicaid. The patient is often advised to empty their bladders with the catheter three to six times a day.
An incontinence adviser may teach the patient how to insert the urinary catheter through the urethra. This procedure varies for males and females, and may be a little uncomfortable at first. However, with practice, it becomes a relatively quick routine that has the potential to change lives.
To establish your individual routine, a patient may be advised to regularly record the time they catheterize, the amount of urine drained, and if he was wet, dry or damp. This is important to establish an acceptable routine until it is no longer required to measure your urine.
General Guidelines for Self-Catheterization
Self-catheterization can be easy and safe as long as proper precautions are observed, such as the following:
- Remember to empty the bladder every 3 to 8 hours. It is advisable to keep urine volumes in the bladder not more than 400 milliliters (ml) at any time.
- Avoid skipping a catheterization for any reason to prevent urinary tract infection. Prolonged accumulation of urine in the bladder encourages the growth of bacteria.
- Urine output and frequency of catheterization is directly related to fluid intake. Normal fluid intake consists of 6-8 glasses per day, at 8-oz/glass. An increase in fluid intake may mean more frequent catheterization.
- Catheterize just before going to bed and upon waking up in the morning. You may need to empty your bladder in the middle of the night if you go to bed early or if the amount of urine collected in the morning is more than 400 ml.
- Empty the bladder completely but do not compress the bladder to hasten emptying. Increased pressure on your bladder may cause backflow of urine to the kidneys.
- Always wash your hands before and after catheterization.
- Keep some catheters available in various places for convenience, such as the car glove compartment, in the bathroom, in a bag, etc.
- Keep the catheter clean for repeated use by washing with soap, rinsing it inside out, and storing it dry in a clean plastic bag.
- If the catheter could not be washed immediately, just wipe it off instead before use, remembering that it is always more important to empty the bladder.
- Discard used catheters when they turn brittle, lose flexibility, and become discolored.
Risks of Self-Catheterization
The most common complication from urinary catheterization is acquiring a urinary tract infection or UTI. Symptoms include:
- pain during urination
- increased frequency of urination
- passing urine that is cloudy and foul-smelling
- fever (temperature of 38C /100.4F or above)
- back pain or flank pain
- blood in urine
Contact your doctor as soon as possible if you have symptoms of a UTI.
Other infrequent, but possible complications of self-catheterization include:
- urethral bleeding and pain – due to rough insertion of the catheter, leading to injury
- urethral stricture – narrowing of the urethra due to formation of scar tissue
- bladder injury – due to incorrect insertion of the catheter
- bladder stones – these may develop after years of catheterization
Contact your doctor if you notice any bleeding, pain, abdominal distension, leaking of urine between catheterizations and difficulty in inserting the catheter.
- Tidy, C. Intermittent Self-catheterisation. http://www.patient.co.uk/doctor/Intermittent-Self-Catheterizations.htm
- NHS Choices. Urinary catheterization. http://www.nhs.uk/Conditions/Urinary-catheterization/Pages/Introduction.aspx
- U-M Health System. Intermittent Self Catheterization (Females). http://www.med.umich.edu/1libr/urology/postcare/femaleself-cath.htm