About Catheterization
Intermittent catheters are used in persons with spinal cord injuries (quadrapelegics & paraplegics) and for those persons with urinary retention (incomplete bladder emptying). During urination, the bladder contracts, and the pelvic floor muscles relax to allow urine to pass through the urethra. Normally, after the bladder empties, there is a small amount of urine (less than 3 ounces) left in the bladder. What is left is known as the Post-Void Residual Volume. If you cannot urinate or completely empty your bladder, a large residual volume will build up. A large build-up of urine in the bladder is unhealthy. This condition can cause bladder infections, urinary incontinence, and permanent damage to the bladder and kidneys.
You will finish emptying the urine from your bladder by inserting a slim tube known as a catheter down the urethra and into the bladder after you urinate. This catheter will drain the remaining urine, and then it is removed. Removing the catheter is safer than leaving it in. By inserting the catheter several times during the day you lessen the episodes of over distension (when the bladder becomes overfilled) of the bladder. This type of catheterization is usually done by the person or by a family member using sterile or clean catheters.
A routine bladder emptying schedule is done usually 3 to 4 times per day. Long-term use of intermittent catheterization is preferable to leaving a catheter in the bladder (indwelling urethral catheterization) because of the low chance of infection and other problems. Problems that can happen from doing this type of catheterization are swelling of the urethra, stricture, false passage, kidney damage, and epididymitis.
The non-sterile clean approach is called clean intermittent catheterization (CIC.) This has a low risk of infection and if an infection occurs it is usually managed without causing damage to your kidneys. Older persons and those with impaired immune systems (e.g. persons with AIDS or those receiving chemotherapy) are at risk for developing urinary infections. The sterile approach may be better. It is not known if elderly persons should also perform the catheterization using sterile catheters.
Anyone can insert these catheters because it is a safe and a simple procedure to learn. Older persons, family members, and/or caregivers who have the physical and mental abilities and who are motivated can be taught to perform CIC. Considerations for CIC are age, the physical ability of the person to perform catheterization, willingness, and the self-discipline.
CIC is also known as ICP (Intermittent Catheterization Program), or I & O (In and Out) catheterization. As described above, you insert a catheter into the bladder and empty it completely every four to six hours. The goal is to cath frequently enough to keep urine volumes in the bladder lower than 500 ml. This method requires that you closely monitor your fluid intake, usually around 2 liters per day, otherwise you might be cathing too frequently to make this practical.
ICP and CIC is the preferred method for patients who have enough hand function (usually C7 and below, or C6 for motor incomplete injuries) to perform it independently and who can remember to cath on schedule. It is the closest thing to the normal bladder function, where the bladder fills continuously for a period of time and then empties all at once. This method reduces the risk of bladder infection (or urinary infections) because there isn’t enough time for any bacteria left in the bladder to reproduce enough to cause symptoms.
ICP is not usually a good method for someone who is unable to perform it independently. Having someone else cath you increases your risk for infections and also reduces your independence, since you need someone with you to perform the ICP.
Indwelling catheters remain in the bladder for days or even weeks by means of an inflated balloon. Intermittent urinary catheters are inserted into the bladder to void the bladder of urine and then removed as soon as the bladder is empty.
Male urinary catheters are typically 12 to 16 inches long and come in French sizes 10Fr-24Fr. Female urinary catheters are typically 6 inches long and come in French sizes 8Fr-24Fr. Pediatric urinary catheters are typically 10” long, and come in French sizes 5Fr-10Fr.
Intermittent catheters require lubrication for insertion and use. Some catheters, such as the O'Neil range, have hydrophilic coating and do not require manual lubrication. Additionally, there are antibacterial catheters and combination hydrophilic antibacterial catheters. Antibacterial catheters have nitrofurizone to reduce pathogenic urinary bacteria associated with urinary tract infections (UTI's). Hydrophilic coated catheters have a special gel polymer coating on the surface of the catheter to reduce friction during catheter insertion, use and withdrawal.
Let American Australian Medical Inc. provide you with an O'Neil intermittent catheter to suit your individual catheterization needs.
