What do I need to know about intermittent catheterisation?

We aim to demonstrate that this method of bladder emptying gives you back the control of your bladder

We would like to give you the security and confidence to start by sharing with you essential information, helpful recommendations and important tips to help you safely and competently self-catheterise, and by answering some of the most commonly asked questions.

What is important to know about applying intermittent self-catheterisation (ISC)?

The main worries of patients who are learning to catheterise themselves are injuring the urethra and causing inflammation of the bladder.

There is no need to worry. When you carefully follow the instructions, use the right type of catheter, and keep to some basic rules, self-catheterisation will be unproblematic and can be carried out over a long period of time without causing any damage to your urethra or bladder.

Is it difficult to learn the application technique?

It may seem strange at first to empty your bladder with a urinary catheter. Fear of the unknown is common and it is normal to feel scared of things we don’t understand or are not familiar with.

You can relax. Almost everyone can perform intermittent self-catheterisation, even children and people with limited mobility and manual dexterity. With the right training, it is easy to learn to safely catheterise yourself.

When you start catheterising yourself, try to be relaxed and patient. The handling can be at first a little tricky and difficult until you find the right grip and your best practice. Your ISC teacher will help you. They are specialised healthcare professionals, who individually teach you the right technique, so that you find the best way and position for you to accomplish safe and pain-free ISC.

If appropriate, they also may introduce you to various aids, which can make catheterisation substantially easier, such as aids to remove and put on trousers or catheterisation aids for limited hand function.

Besides detailed training they also help you to put aside your fears and uncertainties and respond to your individual needs and questions. You will see, with some practice self-catheterisation will become natural to you.

Take part in a professional training session, it is essential for your comfort as well as for a low complication rate and your long-term satisfaction with the procedure.

Are there complications to expect?

Potential complications can be injury to the urethra, bleeding from the urethra, inflammation of the urethra and urinary tract infections that are caused by introducing bacteria during catheterisation. With the right and appro priate catheterisation technique this risk can be reduced.

Should I tell the people close to me?

It might be helpful to share and feel able to talk about it with someone close like your family, partner or friend. It can be useful when you need assistance or understanding in a special situation. Otherwise, using this form of catheterisation is very discreet. Nobody will notice.

Specially packaged bladder catheters can be carried discreetly, even several at a time, in a small washbag, etc. Single-use catheters with integrated collection bags are available to facilitate catheterisation in the workplace or on holiday. The important thing is to remember to take enough urinary catheters with you.

Basic rules for intermittent self-catheterisation (ISC)**:

• The ISC should be carried out under aseptic conditions.*
• Wash your hands and meatus (urethral opening) with water and soap and/or disinfect them with a disinfectant agent before catheterisation.*
• Use a new sterile single-use catheter for every catheterisation.
• Never touch the part of the catheter that is inserted into the urethra and bladder and avoid letting it touch other surfaces. When in doubt, discard the catheter and start over the process with a new one.
• Never exceed your normal bladder capacity. It varies from person to person and will be identified in your training. The bladder should not contain more than 350–500 ml. If you don’t catheterise often enough and the bladder is overstretched, the risk of urinary tract infection and urine leakage increases. In the long term you can seriously damage your kidneys.
• Make sure you have chosen the right diameter for your urinary catheter. A catheter with a diameter that is too large can harm the urethra, a catheter with a diameter that is too small will take too long for the urine to leave the bladder. It also increases the risk of injury. For adults, catheters of size 12–14 Charrière (3 Charrière = 1 mm) are usually the most appropriate.
• Never force the bladder catheter. If you have difficulties inserting or are unable to catheterise, you should see a urologist or the nearest hospital for appropriate evaluation.

* Recommendations of the European Associaton of Urology Nurses (EAUN) Guidelines 2013.
** The information provided here is no substitute for consulting a physician and carefully reading the instructions for use.