What is intermittent catheterisation?

Intermittent catheterisation is the repeated drainage of the bladder through a thin disposable catheter

It´s a simple method of draining the bladder gently and without causing damaging pressure. Intermittent catheterisation is generally required four to six times a day depending on the liquid intake.

Intermittent catheterisation (IC) can be performed for the patient by health staff, a carer or relative. It can also be performed by the user themselves and then it is called intermittent self catheterisation (ISC).

What does intermittent catheterisation mean?

“Intermittent” means “occurring occasionally or at regular intervals”. During intermittent catheterisation (IC), the bladder is emptied at certain times by using a single-use catheter. This is a small tube which is inserted up the urethra into the bladder and allows the urine to flow out. The catheter will be slowly removed once the bladder is completely emptied. With this form of treatment the bladder can be emptied without pressure and without leaving residual urine, which reduces the risk of inflammation of the bladder and protects the kidney function.

What is important to consider for intermittent catheterisation?

Using a disposable catheter for bladder drainage must be an aseptic process, that means*:

• using sterile materials (catheter)
• washing the genital area and disinfecting the entrance to the urethra
• using a sterile lubricant or a sterile saline solution for hydrophilic coatings
• performing an aseptic non-touch insertion of the catheter

How is intermittent catheterisation performed?

The use of a single-use catheter for the bladder should be an aseptic process, particularly in the case of pre-existing paralysis of the bladder. Aseptic means sterile materials should be used, the entrance to the urethra should be disinfected, a sterile lubricant or a sterile saline solution for hydrophilic coatings should be used and it requires an aseptic non-touch insertion of the catheter. A distinction is made between (intermittent) catheterisation assisted by others, such as parents, relatives or nursing services, and self-administered catheterisation, which the user does by him or herself. Please note: a catheter should only be used once.

How frequently is intermittent catheterisation required?

This depends on the daily liquid intake as this determines the daily quantity of urine excreted. When using intermittent catheterisation, the bladder is normally drained 4-6 times a day.

At the beginning, the catheterisation can be done by following a schedule. After some experience the user will get to know when the bladder needs to be emptied.

The information provided here is no substitute for consulting a physician and carefully reading the instructions for use.

What are the advantages of intermittent self-catheterisation (ISC)?

Intermittent self-catheterisation is a gentle technique which may help improve the quality of life for many people with a voiding disorder. It is a gentle and safe method to empty the bladder, that

• gives you back control over bladder emptying
• empties the bladder completely
• protects the function of the kidney and bladder
• reduces the risk of urinary tract infections and secondary complications/diseases
• improves the chances of regaining continence
• improves your personal comfort
• does not interfere with your sex life
• increases your personal independence
• supports an active lifestyle

Above all, intermittent self-catheterisation is not associated with irreversible changes. If the situation alters, the procedure can be stopped at any time without causing damage. ISC is usually the preferred catheterisation technique, if possible, as it offers more freedom and comfort than catheterisation performed by another person.

What are the requirements for intermittent self-catheterisation (ISC)?

The intermittent self-catheterisation method is not equally suited for every patient. Certain conditions in relation to both bladder function and the situation of the affected person as a whole must be met. The most essential of these conditions are to be both self-motivated and to have a good understanding of how the technique should be performed. It is important to comprehend the fundamentals of the technique and how to perform it safely.

Your hand function can be limited but must still be effective to an extent that you are able to access the urethra independently and perform the procedure (with or without aids). If this is not possible in a sitting position, then you must be able to move independently into a position that permits you to apply the catheterisation.

You have to make sure that the location where you want to perform ISC offers sufficient space to move and to lay out the required materials. If you suffer from bladder spasticity, there is a need to suppress it for ISC.

If anatomical changes or injuries to the urethra occur, ISC may no longer be suitable. Your bladder capacity should be 400–500 ml.

(*) EAUN Guidelines „Catheterisation urethral intermittent in adults”, 2013