For any woman, the thought of performing intermittent self-catheterisation for the first time can seem very daunting. If you also have mobility issues, it’s even more common to feel apprehensive. When coming to terms with your new condition, it’s natural for any change to your daily routine to induce some anxiety — making the idea of self-catheterising seem intimidating.
However, this process can easily become a routine activity if learnt and practiced correctly. We’ve put together the following steps to guide you through the process, to help you easily incorporate it into your lifestyle.
ISC is a well-established procedure1 that allows for safe, effective and complete emptying of urine from the bladder. As it is a clean technique, it is very important to have good hygiene standards throughout the procedure. Begin by making sure you have all the equipment you will need. Your equipment list will include: a catheter, disposable wipes or unperfumed soap and water, a mirror, a towel (kept for this purpose only) and a container for urine (if your urine is not going to be drained directly into the toilet).
Wash your hands thoroughly with soap and water, ensuring you wash your thumbs too, and then dry with a towel. Once you have collected everything you are going to need, take off or loosen your clothing as necessary and sit down on the toilet. Most people find it easiest to catheterise this way.
In order to prevent pushing bacteria into the urethra and bladder when you use the catheter, you must first clean the area around the urethra properly. Spread the labia (or lips of your vagina) apart and wash the opening to the urethra. Wash from front to back to avoid transferring any bacteria that may cause an infection. Use each wipe only once.
Women that have poor eyesight can use a touch technique to identify vaginal areas and the position and feel of the urethra. Those that have reduced manual dexterity and mobility can aid ISC by using catheter handling aids, labial separators, and mirrors that are attached to a leg strap.
Inserting the catheter
Always ensure your catheter is prepared for use according to the manufacturer’s instructions. Place the unopened catheter packet (clear side facing downwards) on a flat, clean surface. Next, remove the catheter from the pouch. You will notice the first five centimetres is lubricant free, making it easy for you to hold. Slowly peel back the paper side of the packet and remove this completely without touching the catheter, which should remain in the clear packet.
Without touching the catheter (but maintaining hold of it through the packet), pick it up and hold it like a pen in your dominant hand. Peel back the clear packet to reveal the tip of the catheter. Next, find a comfortable position and, using the index finger and middle finger of your non-dominant hand, gently part the labia and lift gently upwards to show the urethral opening. A freestanding magnifying mirror may be helpful to use here.
To make insertion of the catheter as easy as possible, it’s important that you relax2. Start by holding the catheter in your dominant hand and gently insert the catheter tip into the urethral opening and continue to insert the catheter into the bladder slowly until urine starts to flow. You may find it helpful to bend the funnel end of the catheter before the flow starts as this will avoid any urine spillage. For some women, for example, those with a prolapse, it may be necessary to slightly angle the catheter to ease insertion. Once urine is slowing down, move the catheter forward very slightly to ensure that all the urine is drained from the bladder. Make sure you direct the flow of urine into the toilet or a container. When you feel the flow has come to a stop, have a cough and press gently over your bladder as more urine may flow out by doing this. If you find the catheter is stuck, don’t worry: however, do not force the catheter. Remove it and try again later.
You may feel some pain when you first begin catheterising, but this does stop3. However, pain can also be a sign of infection. If the pain persists or if there is blood on the catheter when you take it out, seek medical advice.
Removing the catheter
When the flow has stopped, move a little and straighten yourself up to make sure that the bladder is completely empty. Slowly withdraw the catheter to ensure you drain any remaining urine at the base of your bladder. Place a finger over the end of the funnel to prevent urine leaking from the catheter on removal. The used catheter is then placed back into the packaging, and this can be disposed of as part of your normal household rubbish – do not flush the catheter or the packaging down the toilet. Wash your hands, and then you have successfully completed the process!
For more information on intermittent catheterisation, just pop across to our Learn section. Alternatively, if you want to get in touch, we can put you through to one of our Bard nurses for a chat.
1 "PROCEDURE FOR URINARY CATHETERISATION." 2012. Accessed: 14th May 2016< http://www.wirralct.nhs.uk/attachments/article/19/NPC02ProcedureForUrinaryCatheterisation.pdf >
2 “Clean intermittent catheterization and selfcatheterization British Journal of Nursing” 2008. Accessed: 14th July 2016 <https://www.researchgate.net/publication/23411619_Clean_intermittent_catheterization_and_self-catheterization>
3 Accessed: 14th July 2016 http://www.waisman.wisc.edu/~rowley/sb-kids/publications