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What is Clean Intermittent Self Catheterization (CISC)?

For individuals who are unable to pass urine in the normal way, Clean Intermittent self-catheterization is a safe and effective method of completely emptying the urinary bladder.

Each time you need to empty your bladder, you have to put a small tube called a catheter through the urinary passage (urethra) into the bladder using clean technique.

Why do I need intermittent Catheterization?

Intermittent self catheterization is usually advised to people who are not able to empty their bladders completely. Performed correctly, intermittent catheterization is a simple way of solving a serious problem. The exact reason why you need intermittent catheterization will be explained to you in detail by your physician.

Intermittent catheterization is usually advised to:
  • Keep the bladder empty and prevent infection
  • Keep bladder and kidneys healthy by preventing over distention
  • Keep you dry
When to catheterize or how frequently?

This depends on how much fluid you drink and how much urine you make. Most people need to catheterize every 4-6 hours when they are awake.

You may need to adjust the times you catheterize and the amount of fluid you drink. A general guideline is that each time you catheterize, the amount of urine in the bladder should not be more than 400-500mls.

Avoid over distension of the urinary bladder. Thus pick times during the day that will drain the right amount of urine (400-500 ml) and avoid over distension of the bladder.

The signs of over distension of bladder are:

  • Feeling of fullness
  • Feeling restless
  • Sweating
  • Chills
  • Headache
  • Looking flushed or pale
  • Cold fingers, toes, arms or legs
  • The lower part of the belly looks bloated

If you have any of these feelings, you need to catheterize as soon as you can.

How do I adjust the timing between intermittent catheterization? When can I stop doing intermittent catheterization?

Whenever you can, try to void before you catheterize. The urine left in your bladder after you void is called residual urine. If you have 200ml or less when you catheterize after you void, you can increase the time between catheterizations. Remember the total amount of urine which you void plus the residual urine should be between 400-500ml.

You can maintain a record to help adjust your catheterization times. Example:

Date

Time

Fluids I drank

Amount I voided on my own

Amount came with catheterization

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


As voiding improves, the amount of residual urine will decrease. If the amount of residual urine stays close to 50ml, you may be able to stop doing intermittent catheterization. Do not stop catheterizing without consulting your doctor.

How much fluid should I take? Are there any specific dietary restrictions?

If there are no restrictions on fluid intake (due to cardiac or kidney conditions) then you should drink between 2-3 liters of fluids (8-10 glasses) in a day.

You do not need to follow a special diet unless advised by your doctor Eat foods high in fibre to prevent constipation. High fibre foods include whole grain products, bran, fruits and vegetables, salads.
Avoid Caffeine- Caffeine makes you feel the need to void more often and right away. Caffeine is in coffee, tea, colas. Drink fluids at regular interval

What do I need?

  • Catheter -- #14 French or the size specified by your physician.
  • A clean, dry container to carry the catheter. This could be a zip-lock style bag or toiletry bag
  • Water soluble lubricant (Xylocaine jelly 2% or K-Y Gel)
  • Do not use mineral oil or petroleum lubricant
  • Soap and water

    You can purchase the catheter and lubricant from a medical store

Can I reuse the Catheter?

Yes, the catheter can be reused for limited period provided it is cleaned after every use and used with a clean technique. Catheters should be thrown away when they begin to lose their flexibility, or become brittle or discolored. This happens in about a week.

How to clean the catheter?

  • Always wash hands before and after procedure.
  • Wash catheter after use with soap and rub the catheter for 10 seconds, then rinse well
  • Run tap water through the catheter. Place the catheter on a clean cloth or paper towel to air dry.
  • When the catheter is dry, put it in a clean dry container for the next use.
  • Catheters should be thrown away when they begin to lose their flexibility, or become brittle or discolored. This happens in about a week.
  • An option to cleaning your catheter is to soak it in a solution of 1 part vinegar to 3 parts tap water once every 3 days (for 20 minutes) to keep urine crystals from forming inside the catheter.

Step by Step Procedure for Clean Intermittent Self Catheterization

Remember

  • Catheterize regularly, every 3 to 8 hours to keep urine volumes low.
  • Do not skip a catheterization for any reason.
  • Always wash your hands before and after the procedure.
  • Fluid intake is directly related to urine output and the frequency of catheterization. Normal intake is six to eight 8-ounce glasses per day. 
  • If the catheter is accidentally dropped and cannot be washed properly, it may be wiped off to remove any possible grit and then used to catheterize.
  • It is more important to empty your bladder.
  • You are more likely to get an infection from a full bladder than an unwashed catheter.
  • Check for any unusual odor and/or cloudy hazy urine. Be aware of any changes that need to be reported to your physician.

Call your physician if you have any of the following:

  • Fever
  • Nausea
  • Pain in the back
  • Cloudy urine
  • Urine with a foul odor
  • Blood in urine
  • Sudden pain or bleeding when inserting the catheter
  • Inability to keep urine volume within recommended amount
  • Inability to urinate of presence of abdominal distention
  • Absence of urine for 6 to 8 hours
  • People with spinal cord injuries should call their doctor if they have a severe pounding headache (this may indicate unresolved autonomic dysreflexia) and immediately catheterize themselves to empty their bladder

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