What is Clean Intermittent Catheterization?
Intermittent catheterization is the temporary placement of a catheter to help empty urine from the bladder. It may be necessary for anyone who is not able to properly urinate to empty the bladder. The catheter will be placed through the urethra. Clean intermittent catheterization (CIC) is a technique used to place the catheter that should prevent infection without the need for gloves, disinfectant or absolute sterility. You can perform this in any clean washroom with counter space within reach. You may also see this referred to as self-catheterization or CIC.
Supplies you will need:
- Clean, dry towel
- Soapy washcloth, unscented diaper wipes or disposable towelettes
- Water soluble lubricant, like KY Jelly. Do not get mineral oil or petroleum jelly (like Vaseline)
- Clear plastic or soft rubber catheter, size 12, 14 or 16 French
- Catheter storage container
- Urine collection container (optional)
How do you perform CIC?
- Assemble all the supplies listed above; have them close at hand
- Try to urinate straining, if possible
- Wash hands well with soap and warm water; nails should be clean and short
- Get into a comfortable position; standing, propped up in bed, sitting in front of a toilet or sitting on a toilet are all ok.
- Wash the penis head with soap and warm water and then rinse and dry. You may also use a damp towelette instead. If you are not circumcised, pull back the foreskin to properly clean the head of the penis.
- Lubricate about 8cm (3in) of the catheter tip with the lubricant.
- Use your non-dominant hand (right –hand for left handed men) to hold behind the penis head and straighten it by pulling gently and slightly upwards. The straighter the penis is, the easier the catheter is it insert.
- With your dominant hand, slowly insert the catheter into you urethra until the urine begins to flow.
- Breathe slowly and relax your muscles
- You may feel slight resistance at the sphincter and prostate.
- Keep advancing the catheter another 3 cm ( 1 inch) to make sure the tip is well into the bladder
- Drain the urine into the toilet or into a container. Gentle straining may help. Pay attention to the amount of urine obtained.
- After the urine stops flowing, slowly pull the catheter out. Urine flow may be irregular.
- If desired, wipe the penis opening and replace the foreskin (if uncircumcised)
- Clean and store your catheter.
- Wash hands well again.
When to catheterize?
- Your healthcare provider will instruct you on how often you need to catheterize.
- Frequency of emptying depends on type and amount of fluid you consumed, and your individual bladder storage capacity.
- Usually the feeling of needing to urinate will alert you when to catheterize.
- Men who use only a catheter to empty urine will need to do so about 4-6 times per day
- If you are getting more than 600 ml (20 ounces) of urine when you catheterize, you will need to catheterize more often
- If you get less than 200ml (7 ounces) at a time, and are voiding without a catheter as well you can catheterize less often
- Record your catheterization times and volumes to help your healthcare provider customize your schedule
- When in doubt, let it out. You will learn to recognize a full bladder reliably soon enough.
- Keep 2-3 spare catheters on hand at all times
- You can clean and reuse the same catheter for about a week as long as it does not become rough, cracked or damaged.
- Immediately wash your catheter after use with warm soapy water inside and out and air dry. Adding a small amount of vinegar to the water will help with cleaning. (1:4 vinegar to water ratio)
- Store in a dry paper towel or clean plastic bag
Contact your healthcare provider if you encounter any of the following:
- Pain or resistance. This may mean not enough lubricant or (occasionally) scar formation in the urine passageway.
- Large amounts of blood on the catheter or urine. This may mean injury to the bladder, prostate or urethra. Continuous, heavy or frequent bleeding should cause concern.
- Fever over 38.5C (101F), chills, sweating, cloudy urine, foul urine odor or painful urination should be reported as this could indicate you have an infection.
- If you cannot successfully insert the catheter after several attempts, go immediately to a hospital emergency room.