What is a clean intermittent self-catheterization?

Each time you urinate you’re 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 clean intermittent self-catheterization. This painless procedure helps you empty your bladder of urine. It can be performed at home.

Clean intermittent self-catheterization is recommended when you have a condition that affects your ability to empty your bladder properly. “Clean” refers to the fact that the procedure requires clean techniques, such as washing your hands and skin before insertion to prevent infection.

Some people who may require clean intermittent self-catheterization include:

  • women who have had gynecologic surgeries
  • people with nervous system disorders
  • people who can’t empty their bladders

If you can’t fully empty your bladder, you’re at greater risk of urinary tract infections, which can ultimately damage your kidneys. The use of clean intermittent self-catheterization can help prevent a urinary tract infection.

While many types of catheters are intended to stay in for days or weeks, a catheter used for clean intermittent self-catheterization is used several times a day to empty the bladder. The catheter is attached to a plastic bag that can be used to measure the amount of urine. The process of clean intermittent self-catheterization for women is different from the process for men.

For women

You must first wash your hands and the area around your urinary opening to prevent infection. You also must be able to identify the urinary meatus (opening where urine flows). You need to lubricate the tip of the catheter and insert it into the urinary meatus.

When the catheter is properly inserted, urine will flow into the catheter’s bag. Allow all urine to drain. When the urine stops flowing, slowly and gently remove the catheter. Measure and record the amount of urine in the bag and then empty the bag.

Clean the catheter and urine collection device with mild soap and hot water immediately after use. Rinse the materials and air dry. Store the materials in a clean, dry container.

For men

First wash your hands and cleanse the area around the top of your penis to reduce bacteria and risk for infection. Lubricate the first several inches of the catheter tip. Insert the catheter into the urinary opening of your penis until 8 or 9 inches of the catheter have been inserted. You may feel some resistance after inserting 6 inches of the catheter. This not uncommon, as this is the location of the urinary sphincter muscles. Take a few deep breaths and increase the pressure while continuing to insert the catheter.

Make sure the urine has stopped flowing, and you’ve completely emptied your bladder. Then slowly remove the catheter. Measure and record the amount of urine in the bag, and then empty the bag.

Clean the catheter and urine collection device with mild soap and hot water immediately after use. Rinse the materials and air dry. Store the materials in a clean, dry container.

General info

As mentioned, each time you’re finished using the catheter, always wash it with soap and hot water, let air dry, and then store in a clean, dry container. You should replace your catheter every two to four weeks, according to the National Institutes of Health (NIH). If your catheter becomes hardened, discolored, brittle, or too soft for insertion, discard it.

Your doctor will likely recommend how often you should perform clean intermittent self-catheterization. A typical schedule is every six hours and just before you go to bed. If you’re urinating more than 400 mL at a time with clean intermittent self-catheterization, you may need to increase the frequency to prevent infection, according to the NIH.

Your doctor will likely ask you to keep a record of your daily liquid intake and output while you’re performing clean intermittent self-catheterization. Intake includes anything you drink, such as water, juice, soda, tea, alcoholic beverages, and coffee. Be sure to drink between 2,000 mL and 2,500 mL (or 8.5 to 10.5 cups) of fluid, preferably water, per day.

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 your recorded output doesn’t match up with your intake, notify your doctor.

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

Always notify your doctor if you experience pain during catheterization. Also report any abdominal or lower back pain or burning sensations. These can be symptoms of a urinary tract infection.