The solution for many people suffering from bladder dysfunction, meaning urination becomes impossible or problematic, is intermittent catheterization . And because it is a fairly simple procedure, most people can do it themselves, with complete safety, using self-lubricating catheters .
At first, many people feel anxious or find it a little difficult, but by following the instructions of the doctor and nursing staff and of course, with daily practice, self-catheterization very soon gives millions of people back full control of their bladder, making them completely independent but at the same time reducing the risk of infections to a minimum .
Thus, intermittent self-catheterization is something that even very young children perform daily without any help from their parents.
B Braun's Actreen range of disposable intermittent catheters are ready to use and have been specifically designed for self-use even with reduced dexterity. Pre-lubricated with a unique hydrophilic lubricant, they provide comfort, flexibility and high levels of hygiene, without dripping.
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What is intermittent catheterization?
With intermittent catheterization, a sterile catheter is inserted and gently guided into the bladder through the urethra to drain the urine into the toilet or into a container or bag. When the flow stops, it is a good idea to move the catheter a little because there may be more urine. Once the bladder is empty, the catheter is removed and of course, this process is repeated several times a day, usually four to six times.
Intermittent catheterization began to be applied in the early 1960s with the sterile technique , that is, in conditions of complete sterilization and only by medical and nursing personnel.
In the 1970s, mainly in the United States, the clean technique developed and became preferred, involving the use of gloves and the reuse of the same catheter for multiple catheterizations. Between uses, the catheter is soaked in antiseptic or washed with soap and water.
Due to the simplicity of Clean Intermittent Catheterization ( CIC ), patients were able to undertake the procedure themselves, and thus Intermittent Self-Catheterization ( ISC ) was created. The patient self-catheters with bare hands after first washing them with soap and water.
In 1990, Europe established the aseptic technique that includes disposable catheters where the user does not touch them since
- are packaged in such a way that the packaging can be used to hold the catheter during insertion
- are in a protective casing and are ready for use (e.g. pre-lubricated, hydrophilic, self-lubricating )
All that is required is cleaning your hands and genital area with plain soap.
Who benefits from the use of intermittent catheters?
Several health problems can cause urinary retention, incontinence, and other serious bladder problems that can lead to further kidney damage. Below are the most common cases where intermittent catheterization is common.
- Bladder surgery
- Central nervous system tumors (astrocytoma)
- Benign prostatic hyperplasia
- Multiple sclerosis (MS)
- Neurogenic bladder dysfunction (neurogenic bladder) caused by cerebral palsy, Parkinson's disease, spina bifida, myelodysplastic syndromes, or spinal cord injuries
- Cerebral
- Peripheral neuropathy (e.g.from diabetes mellitus)
- Urinary incontinence
- Urinary retention
- Urethral stricture
- Fistulas
- Cauda equina syndrome
- Constipation
What are the advantages of disposable catheters?
For many years, doctors and patients have preferred disposable catheters for intermittent catheterization and self-catheterization , mainly because it mimics the normal function of the bladder. Regular and timely catheterization prevents bladder distention, while the absence of a permanent catheter helps reduce potential infections and allows the patient to have a normal and active lifestyle .
All the latest research concludes that the reuse of catheters is associated with a higher risk of urinary tract infection ( Krassioukov et al 2018 ). In contrast, hydrophilic disposable catheters significantly reduce the occurrence of urinary tract infections ( DeFoor et al 2018 ) and are associated with better patient health outcomes.
Intermittent catheterization dramatically reduces the likelihood of complications such as:
- urinary tract infection
- leakage
- blockage
- bladder spasms
especially when using self-lubricating disposable catheters .
Possible problems of intermittent self-catheterization
The main concern is the proper management of fluid intake. The general rule is that the bladder should not be filled with more than 500ml and for this reason catheterization is recommended every 4 to 6 hours. Of course, this schedule should be adjusted according to fluid intake, that is, when you know that you have consumed 500ml of fluids. It is worth noting that drinks containing caffeine or alcohol increase the amount of urine produced by the body.
Of course, your urologist is the one who will determine all the parameters after a urodynamic study and determine the appropriate catheterization schedule .
As already mentioned, self-catheterization may initially seem time-consuming or you may encounter minor difficulties during the application, but it very quickly turns into an extremely easy process. Of course, the necessary ability to use the hands functionally must be present. However, the existence of urethral strictures and obesity often make it difficult to perform intermittent self-catheterization correctly.
Finally, there is always the risk of infections but it is significantly lower than with an indwelling Foley catheter .