Self-Catheterization (Clean Intermittent Catheterization)
Overview
What is self-catheterization?
Self-catheterization is a way to empty your bladder when you have difficulty urinating. As the name suggests, you perform the procedure yourself.
Self-catheterization, also called clean intermittent catheterization (CIC) or intermittent self -catheterization (ISC), involves inserting a thin, hollow tube called a catheter into the bladder through the urethra (the tube from which the urine exits your body). Urine drains out of the catheter into a toilet or container. When your bladder is empty, you slip out (remove) the catheter. You repeat these steps at regular intervals (intermittently) several times a day.
What are the types of urinary catheterization?
There are several ways to use a catheter to empty the bladder:
- Indwelling: A sterile tube called a Foley catheter stays in the bladder. The tube is inserted through the urethra, or in some cases directly into the bladder from the lower abdomen (supra-pubic catheter). The catheter attaches to a drainage bag that collects urine throughout the day and night. A balloon in the tip of the catheter keeps the catheter from slipping out of the bladder. Depending on your mobility and situation, the drainage bag may attach to a bed, your leg, or clothes.
- Condom: Males can slip a condom-like device over the penis. The device has a tube that drains urine into a bag.
- Self (clean intermittent): You or a caregiver insert a catheter into the bladder at regular intervals throughout the day. Urine drains through the catheter into a toilet, collection bag or container.
Who might need self-catheterization?
Certain health problems can make it difficult to empty your bladder. Bladder control issues that could require a catheter are more likely if you have:
- Bladder surgery.
- Central nervous system tumors (astrocytoma).
- Enlarged prostate (benign prostatic hyperplasia).
- Multiple sclerosis (MS).
- Neurogenic bladder caused by cerebral palsy, Parkinson’s disease, spina bifida or spinal cord injuries.
- Stroke.
- Urinary incontinence, urinary retention or urethral strictures, and urinary fistulas.
- Severe constipation.
Procedure Details
How should I prepare for self-catheterization?
Your healthcare provider will show you how to perform self-catheterization. The process gets easier with practice. Before performing self-catheterization, you should:
- Try to urinate the regular way.
- Wash your hands with soap and water.
- Wash your genitals with soap and water or an antiseptic towelette. This step lowers infection risk.
- Remove the catheter from its package being careful to keep it very clean.
- Apply a water-based lubricant on the tip and top two inches of the insertion end of the catheter if needed. Some catheters come pre-lubricated.
How do I perform self-catheterization?
Regardless of gender, the steps for performing self-catheterization are generally the same. Females may find it helpful at first to use a mirror to find the urethral opening where urine comes out. To perform self-catheterization:
- Sit on the toilet (females may prefer to stand or squat over the toilet).
- Use firm, gentle pressure to insert the lubricated end of the catheter into the urethra.
- Hold the other end of the catheter over the toilet bowl or container.
- Slowly slide the catheter until it reaches the bladder and urine starts to flow out of the tube.
- Continue inserting the catheter another inch or two.
- Hold the catheter in place until the bladder empties.
- Slowly and gently slide out the catheter.
What should I do after finishing self-catheterization?
Cleanup is an important step to preventing infection. Always wash your hands when you finish in the bathroom. The catheters are all single-use, please dispose of it in the trash.
How often do I need to perform self-catheterization?
Your healthcare provider can help determine how many times a day you need to empty your bladder. Most people complete the process four to six times a day or every four to six hours.
Risks / Benefits
What are the potential risks or complications of self-catheterization?
Inserting a catheter can raise the risk of introducing infection-causing bacteria into the body, but having an indwelling Foley catheter presents even a higher risk. So if possible, CIC is a better option than an indwelling Foley. With any type of catheter, you have a higher chance of having a:
- Bladder infection, perforation or spasms.
- Kidney infection.
- Urethral scarring and strictures.
- Urinary tract infection (UTI).
When to Call the Doctor
When should I call the doctor?
You should call your healthcare provider if you experience:
- Bladder spasms (sudden painful cramps and unexpected leaking of urine).
- Blood in urine (hematuria).
- Difficulty inserting the catheter.
- Unusually small amounts of urine when emptying your bladder.
- Painful urination (dysuria).
- Signs of urinary tract infection (fever, pelvic pain, urinary leakage).
- Skin rash or sores at the site of insertion.
A note from Cleveland Clinic
Some people need self-catheterization for a short time. Depending on the cause of the bladder problem, medications or surgery may correct the problem. If you have a chronic problem or a condition that is expected to get worse over time, you may always need to use a catheter to urinate. Everyone’s situation is different. Talk to your healthcare provider about what you can expect.
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