Continuous Bladder Irrigation

What is continuous bladder irrigation?

Continuous bladder irrigation (CBI) is a medical procedure that flushes your bladder with a sterile liquid. It also removes urine (pee) from your body at the same time. Healthcare providers often use it to prevent or remove blood clots after surgery on the urinary system. The procedure takes place in a hospital over several days.

Your urinary system is responsible for filtering waste out of your blood. It creates urine (pee) to get waste and extra fluid out of your body. The bladder is part of the urinary system. It’s a balloon-like organ in the lower abdomen (belly). Your bladder stores urine until it exits your body through a tube called the urethra.

What is the purpose of continuous bladder irrigation?

Healthcare providers often use CBI to prevent or remove blood clots in the bladder after urinary surgery. Examples include bladder surgery or prostate surgery such as transurethral resection of the prostate (TURP).

An operation on your urinary system can cause blood clots, pieces of tissue or other debris to circulate. Clots and other debris can prevent pee from flowing properly through your system.

After urinary surgery, many people have to pee through a catheter (a tube used as a drain). Clots can prevent urine from flowering properly through the catheter as well.

Blocked urine can cause infection, kidney damage and pain.

CBI can help prevent blood clots and flush them out so urine can flow normally. Healthcare providers also use continuous bladder irrigation to:

• Administer medication to the bladder.
• Dissolve bladder stones.
• Soothe an irritated, infected or inflamed bladder lining.

Is continuous bladder irrigation a sterile procedure?

All equipment involved in CBI is sterile (free from living organisms, such as germs). Healthcare providers use careful techniques to keep the procedure sterile and protect you from germs.

However, there is a minimal risk of infection. The equipment may come in contact with germs on skin or in the air just before insertion.

What are the two types of bladder irrigation?

Bladder irrigation can either be continuous or intermittent. Continuous bladder irrigation occurs over a few days. Intermittent bladder irrigation happens on occasion, either when needed or at set times.

What happens before continuous bladder irrigation?

Before continuous bladder irrigation, you must have a catheter placed in the bladder. You may already have one if you’ve had surgery or are in the hospital for another reason.

A catheter is a thin tube. It’s inserted into the area where you pee. It travels up the urethra and into your bladder.

The end of the catheter lies outside your body, along your upper leg. It has three ports (openings), each with a different function:

• Drain urine and other liquid from your body.
• Inflate a balloon to keep your bladder open as the catheter is placed.
• Send solution into your bladder to flush it out.

What happens during continuous bladder irrigation?

Continuous bladder irrigation is usually performed by a nurse or urologist, a specialist in the urinary system. The healthcare provider hangs two bags on a pole. Both contain sterile saline (saltwater) and medication if needed.

The healthcare provider cleans the ports on the outside of the catheter and connects two of them. One attaches to a bag on the pole. The other connects to an empty bag at your side that collects fluid as it comes out of your body. The third port isn’t actively used but helps keep the catheter in place.

Throughout the process, a healthcare provider will:

• Check the color of the urine.
• Control the drip and flow of the sterile solution, speeding it up or slowing it down as needed.
• Empty the drainage bag frequently.
• Measure urine output (how much comes out).
• Monitor blood, clots or debris in the urine.
• Replace a bag of sterile saline when it’s empty.

In the beginning, the urine may be bloody and have obvious debris. Over time, the urine should become pink and then clear.

You may experience some discomfort with the catheter in place. You may feel like your bladder is full or like you constantly have to pee. Be careful not to pull on the catheter, let your nurse know if you feel pain or see fluid leaking from the catheter.

What happens after continuous bladder irrigation?

The healthcare provider will end continuous bladder irrigation once you have clear or only slightly pink urine for a day or two. The catheter is disconnected from the bags and removed from your body.

What are the risks or complications of this procedure?

CBI is generally very safe, but there are some rare complications:

• Catheter blockage, which requires a healthcare provider to flush the tube or replace it.
• Urinary tract infection if bacteria get into the urinary system.
• Paraphimosis, when the foreskin on an uncircumcised penis gets stuck.
• Bladder perforation or tear.

What’s the recovery time after continuous bladder irrigation?

You won’t need recovery time from the bladder irrigation procedure. But you will need to recover from the initial surgical procedure. Your healthcare team will give you specific instructions.

When should I see my healthcare provider?

Your healthcare provider will give you detailed reasons to seek medical attention after your surgical procedure.

After bladder irrigation, tell a healthcare provider if you experience any of the following when going to the bathroom:

• Blood.
• Burning sensation.
• Inability to pee.
• Pain.

A note from Cleveland Clinic

Continuous bladder irrigation (CBI) is a medical procedure that flushes the bladder with sterile liquid. The process takes several days and removes blood clots and other debris after surgery in the urinary system.