Continuous Bladder Irrigation

Continuous bladder irrigation (CBI) is a common medical procedure that flushes your bladder with a sterile liquid. It also removes urine from your body at the same time. Healthcare providers often use CBI in a hospital to prevent or remove blood clots in people who have blood in their pee (urine).

Your bladder is part of your urinary system. A balloon-like organ in your lower abdomen (belly), your bladder stores the urine your kidneys make when they filter waste out of your blood. Pee containing waste and extra fluid sits in your bladder until it exits your body through a tube called the urethra.

What is the purpose of continuous bladder irrigation?

You may need CBI after bladder surgery or prostate surgery to remove blood clots in your bladder. These operations can cause blood clots, pieces of tissue or other debris to circulate. Debris can prevent pee from flowing properly through your urinary system or a catheter (a tube for draining fluid).

Blocked pee can cause infection, swollen kidneys (hydronephrosis), kidney or bladder damage, and pain.

By flushing out blood clots, CBI allows pee to flow normally. Providers also use bladder irrigation to:

• Provide medication to your bladder
• Dissolve bladder stones
• Soothe an irritated, infected or inflamed bladder lining

Bladder irrigation can either be continuous or intermittent. You can have it after surgery for one to two hours. Intermittent bladder irrigation happens on occasion, either when needed or at set times.

What happens during continuous bladder irrigation?

First, you need to have a Foley catheter (tube) in your urethra and bladder. You may already have a catheter if you’ve had surgery or are in the hospital for another reason.

The end of the catheter stays outside your body, along your upper leg. A Foley catheter for continuous bladder irrigation has three ports (openings). Each has a different function:

• Drain pee and other liquid from your body.
• Inflate a balloon to keep your bladder open during catheter placement.
• Send solution into your bladder to flush it out.

A nurse or urologist (urinary system specialist) usually performs continuous bladder irrigation. To set it up, they’ll hang two bags on a pole. Both contain sterile saline (saltwater) and medication if needed.

They’ll clean the ports outside your body and connect two of the ports. 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 helps keep the catheter in place.

Throughout the bladder irrigation procedure (as often as every 15 minutes), a provider will:

• Check the color of the pee
• Control the drip and flow of the sterile solution, speeding it up or slowing it down as needed (using a faster flow rate for darker pee)
• Empty the drainage bag frequently
• Measure pee output (how much comes out compared to how much fluid went in)
• Monitor blood, clots or debris in the urine
• Replace a bag of sterile saline when it’s nearly empty

How long does continuous bladder irrigation last?

You’ll have continuous bladder irrigation until the urine looks clear or only slightly pink. The pee may start out bloody and have obvious debris. Over time, the pee should become clear. A provider disconnects the catheter from the bags and removes it from your body.

Is it a sterile procedure?

No. All equipment involved in CBI is sterile (free from living organisms, like germs). Healthcare providers use careful techniques to protect you from germs.

But there’s a minimal risk of infection. The equipment may come in contact with germs on your skin or in the air just before a provider inserts the catheter.

What are the potential benefits and risks of this treatment?

Continuous bladder irrigation serves an important purpose: protecting you from blood clots. 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 your urinary system
• Paraphimosis, when the foreskin on an uncircumcised penis gets stuck
• Bladder perforation or tear

How long will it take for me to feel better?

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

Is there anything I can do to make this treatment easier on me?

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.

When should I call my healthcare provider?

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

After constant 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