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How many times a day should I self catheterize?
2022\04\07Depending on the reason you've been prescribed to use intermittent catheters, you may only need to catheterize once a day or multipe times a day.For example, some users with urine retention, may need to catheterize 5-6 times a day as the primary method of draining urine from the bladder.
Your healthcare professional will provide you with guidance on how many times you should be catheterizing throughout the day for your specific condition. Work with your doctor to help you define a cathing routine that works with your health and lifestyle needs.
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Is it common to have to use an intermittent catheter?
2022\04\07As an intermittent catheter user, one thing you definitely shouldn’t feel is “alone”. There are numerous conditions that affect draining the bladder which may require the use of an intermittent catheter at different stages in life, from young men or women with multiple sclerosis to older people with urine retention or prostate challenges. There are more people using intermittent catheters than you would imagine and finding ways to ensure they continue to live the lives they want to live.
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Why do I need to use an intermittent catheter?
2022\04\07For many people, learning to self-catheterize is a small part of what they are currently dealing with. There are many reasons people start cathing;some only for a short time, some people for life. Sometimes it's due to a physical problem.Sometimes it's because of a problem related to brain signals, known as "neurogenic bladder". There is a long list of reasons why your healthcare professional may prescribe the use of an intermittent catheter, including:
Multiple sclerosis
Spinal cord injury
Stroke
Diabetes
Pregnancy
Urine retention
Prostate tumor
Spina bifida
Bladder exstrophy
Benign prostatic hyperplasia
There are several others, but intermittent catheters are recommended to help take back control from urinary incontinence. Fundamentally, each of these conditions may mean there is something affecting how the bladder sphincter or detrusor muscle (the bladder wall) function. Meaning your body may need a little help to drain urine.
After speaking with your doctor, a self-catherization routine that best meets your needs and approach to cathing should be determined. This routine should include knowing on average, how many times a day you’ll need to self-cath and what products are right for you.
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The history and development of Intermittent Catheters
2022\03\28The use of a catheter to empty the bladder intermittently has been around for a long time.
Ancient texts from China report the use of onion stalks, while Hindus, Egyptians, Romans and Greeks described the use of tubes made from wood and precious metals.1 American Founding Father Benjamin Franklin created a flexible silver coil catheter in 1752 when his brother suffered from bladder stones.2 Mass-produced catheters became available in the mid nineteenth century thanks to Charles Goodyear, who was looking for applications for his newly developed vulcanized rubber.3
For much of the twentieth century, although intermittent catheterisation was known, it was not recognised as a method that patients could perform themselves in community settings. Urologists advocated only laborious sterile catheterisation because of the perceived risk of bacterial infection. But this changed in the early 1970's when it was demonstrated that catheters could safely be used to drain the bladder intermittently in conditions that were simply clean rather than totally sterile, without causing infections.1, 4 Since then, millions of people all over the world have been able to independently manage bladder dysfunctions associated with many conditions using “clean intermittent catheterisation”.
When clean intermittent catheterisation was introduced it was performed using a water-based lubricant and plain, plastic or rubber catheters that were washed and used many times. 2 Later, catheters intended for single use were developed and these are now the norm in the UK. These single-use catheters are usually either packaged pre-coated in a lubricating gel, or have a hydrophilic coating that becomes slippery when soaked in water for a short period. Some hydrophilic catheters are packaged with their own reservoir of water. With some patients catheterising up to five times per day, the cost implications are significant. Costs to the NHS in England for intermittent catheters rose from around £13.5 million per annum in 1999 to £88 million in 2013 and >£120 million in 2017, the bulk of this cost being for single-use catheters. 5,6
There is little research evidence to suggest that single-use is superior to multi-use of catheters, or indeed to recommend any particular approach to intermittent catheterisation or catheter design over any other. The evidence that does exist suggests that no method is more likely than any other to cause urinary tract infections or any other problems. Some evidence suggests that some users find it difficult to carry a lot of single-use catheters with them and that disposing of them and their packaging can be difficult, especially in public places, and that some prefer multi-use catheters. 7,8 In many countries around the world, the re-use of catheters is commonplace. 8, 9 10, 11, 12 Furthermore, the environmental challenge to reduce the amount of plastic and other non-biodegradable materials being thrown away makes this research to provide robust evidence for single or multi-use of catheters very timely.
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Clean intermittent catheterisation
2022\03\28Clean intermittent catheterisation is a way of emptying the bladder of urine if weeing is difficult or impossible. It involves passing a catheter (thin, plastic tube) through the urethra into the bladder.
Good hygiene is extremely important in clean intermittent catheterisation as it reduces the risk of developing a bladder infection, which is unpleasant and can sometimes lead to more widespread infection.
How does the urinary system work?
The urinary system consists of the kidneys, the bladder, the ureters and the urethra. The kidneys filter the blood to remove waste products and form urine. The urine flows from the kidneys, down through the ureters to the bladder. From here it passes through another tube called the urethra to the outside when urinating (weeing).
Why might my child need clean intermittent catheterisation?
Children who have spinal problems, such as spina bifida or a spinal cord injury, may find it more convenient to use clean intermittent catheterisation. It is also suggested if a child has trouble emptying their bladder completely – leaving a small amount of urine behind in the bladder can increase the risk of infection. Children who are wet (incontinent) can also benefit from clean intermittent catheterisation as it will increase the amount of time they can stay dry during the day.
Equipment
You will need:
catheters
disposable wipes
water-based lubricant (if required)
container for collecting urine (if not using a toilet)
Catheters are usually supplied by a home care company so remember to re-order new supplies in plenty of time. If you have any problems getting hold of supplies, please tell us.
Most catheters are disposable ‘single use’ catheters. Please do not re-use single use catheters as it can increase the risk of infection. Used catheters can be disposed of in your household rubbish.
If you are going abroad on holiday, it can be helpful to carry a letter from your child’s consultant explaining why you are carrying catheters. Remember to keep a few days’ supply in your hand luggage just in case your suitcases go astray.
Instructions
1. Collect all the equipment needed.
2. Wash your hands with soap and water.
3. Get your child into a comfortable position.
Sitting on the toilet.
Lying on their back.
Sitting in their wheelchair.
Girls – clean the outside area first, then part their labia to clean thoroughly from front to back.
Boys – clean the tip of the penis using an inwards circular motion towards the urethra, gently pulling back their foreskin to clean underneath.
6. Open the catheter packaging – avoid touching the end of the catheter.
7. Add a small amount of lubricant to the outside surface of the catheter (unless it is a lubricated type).
8. Gently insert the tip of the catheter into the urethra.
9. Use gentle pressure to pass the catheter through the sphincter (ring of muscle) at the neck of the bladder.
10. Continue to insert the catheter into the bladder until urine starts to flow.
11. Hold the other end of the catheter over the container or toilet.
12. Keep the catheter in place until the flow of urine stops.
13. Slowly remove the catheter, pausing if urine starts to flow again.
14. Dispose of the catheter as instructed.
15. Wash your hands again with soap and water.
Trouble shooting
Cloudy or smelly urine:
This may be a sign of infection.
Take a sample of urine using the catheter and take it to your family doctor (GP) for testing.
A course of antibiotics may be needed.
Drinking plenty of fluids will also help.
This usually improves in time.
If pain continues, talk to your clinical nurse specialist.
This may be a sign of infection.
Take a sample of urine using the catheter and take to your family doctor (GP) for testing.
A course of antibiotics may be needed.
Drinking plenty of fluids will also help.
It may also be a sign of bladder irritation.
If it does not improve in a few days, talk to your clinical nurse specialist.