Clean Intermittent Self-Catheterization

Written by Rachel Nall | Published on August 7, 2012
Medically Reviewed by George Krucik, MD

What Is a Clean Intermittent Self-Catheterization?

Each time you use the restroom, you are exercising your bladder muscles. However, some people’s bladder muscles don’t work as well as others. When this is the case, your doctor may recommend intermittent clean self-catheterization.

This painless procedure helps to empty your bladder of urine and can be performed at home.

What Conditions Require This Treatment?

Clean intermittent self-catheterization (CISC) is recommended when you have a condition that affects your ability to excrete properly. The “clean” portion of CISC refers to the fact that the procedure is not sterile, but instead requires clean techniques, such as washing your hands and skin to prevent infection.

Some people who may require CISC include:

  • women with previous gynecological surgeries
  • those with nervous system disorders
  • those who cannot empty their bladders

If you cannot fully empty your bladder, you are at greater risk for urinary tract infections, which can ultimately damage your kidneys. By using CISC, you are able to prevent infection.

How Is the Procedure Performed?

While many catheter types are intended to stay in for days or weeks, a CISC catheter is inserted, urine is released, and the catheter is removed. This process is different for women and men.

Women

The procedure is performed by first washing your hands, any materials used during CISC, and the area around your vaginal opening to prevent infection. Women must be able to identify the urinary meatus (opening where urine flows).

The tip of the catheter is then lubricated and inserted into the vagina. When the catheter is properly inserted, urine will flow into the catheter’s bag for measuring.

Slow removal of the catheter ensures less mess and allows you to fully empty the bladder.

Men

Men performing CISC must first wash their hands and cleanse the area around the top of the penis to reduce bacteria and risk for infection.

The first several inches of the catheter tip must be lubricated. The catheter must be inserted into the urinary opening and advanced between 8 and 9 inches. Meeting some resistance after advancing the catheter 6 inches is not uncommon, as these are the urinary sphincter muscles. Take a few deep breaths and increase the pressure while further inserting the catheter.

Keep it in place until the bag stops draining and remove slowly.

General

Always wash the catheter with soap and water. Store in a clean, dry container if you will be reusing the catheter.

Your physician will likely recommend how often you should perform CISC. A typical schedule is to perform this procedure every six hours and just before you go to bed. If you are voiding more than 400 mL at a time with CISC, you may need to increase the frequency, according to the National Institutes of Health (NIH).

How Is the Procedure Monitored?

Your physician will likely ask you to keep a record of your daily liquid intake and output while you are performing CISC. Intake includes anything you drink, such as water, juice, soda, tea, and/or coffee. Drinking between 2,000 and 2,500 mL of fluid per day can ensure you are filling your bladder enough.

If your kidneys are working properly, you should flush out the same amount of fluid as you take in over the course of the day. If you record your output and it doesn’t match up with your intake, notify your physician.

What Are the Test’s Side Effects?

Catheterization can involve some discomfort as the catheter is inserted into the bladder. This technique can take some practice to become more comfortable with the process. At first, you may require assistance from a medical provider or loved one.

Always notify your physician if CISC becomes painful. If you experience symptoms such as a burning sensation when catheterizing or pain in your abdomen or lower back, report them to your doctor. These can be signs of a urinary tract infection.

You should also replace your CISC catheter every two to four weeks, according to the National Institutes of Health (NIH). If your catheter becomes hardened or too soft for insertion, discard it.

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