The solution for many people who suffer from bladder dysfunction, ie urination becomes impossible or problematic, is intermittent catheterization. And because it is a fairly simple procedure, most people can do it on their own, with complete safety, using self-lubricating catheters.
At first many people feel anxious or find it a little difficult but following the instructions of the doctor and the nursing staff and of course, with daily practice, very soon self-catheterization gives millions of people back full control of their bladder, making them completely independent while reducing the risk of infection to a minimum.
So, intermittent self-catheterization is something that even very young children do every day without any help from their parents.
Actreen, B Braun's series of disposable intermittent catheters is ready to use and is specifically designed for application by patients themselves even when they have reduced dexterity. Pre-coated with mild lubricant provide comfort, flexibility and high levels of hygiene without dripping.
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What is intermittent catheterization?
With the intermittent catheterization method, a sterile catheter is inserted and gently pushed into the bladder through the urethra to drain urine into the toilet or into a container or bag. When the flow stops, it is good 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 procedure is repeated several times a day, usually four to six.
Intermittent catheterization began to be applied in the early 1960s with the sterile technique, ie in conditions of complete sterilization and only by medical and nursing staff.
In 1970, mainly in the United States, the clean technique was developed and preferred, including the use of gloves and the reuse of the same catheter for multiple catheterizations. Between uses, the catheter is impregnated with 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 achieved. The patient self-catheterizes with bare hands after they are first washed with soap and water.
In 1990, Europe introduced the aseptic technique of disposable catheters where the user doesn’t touch them after
- are packed in such a way that the packaging can be used to hold the catheter in place during insertion
- are inside a protective barrier and are ready for use (eg degreased, hydrophilic, self-lubricating)
All that is required is to clean the hands and genital area with soap.
Who benefits from the use of intermittent catheters
Many health problems can cause urinary retention, incontinence and other serious bladder problems that can lead to further kidney damage. Below are the most popular cases where intermittent catheterization is common.
- Bladder surgery
- Tumors of the central nervous system (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
- Peripheral neuropathy (eg from diabetes)
- Urinary incontinence
- Urine retention
- Urethral stenosis
- Horseradish syndrome
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 swelling of the bladder while the absence of a permanent catheter helps reduce possible infections but also allows the patient to have a normal and active lifestyle.
All recent research concludes that catheter reuse is associated with a higher risk of urinary tract infection (Krassioukov et al 2018). In contrast, disposable hydrophilic catheters significantly reduce the incidence of urinary tract infections (DeFoor et al 2018) and are associated with better patient health status.
Intermittent catheterization dramatically reduces the likelihood of complications such as
- ITC (urinary tract infection )
- bladder spasms
especially when disposable self-lubricating catheters are used.
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 more than 500ml and therefore catheterization is recommended every 4 to 6 hours. Of course, this schedule should be adjusted according to fluid intake, ie when you know 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, it is your urologist who will determine all the parameters after a urodynamic study and determine the appropriate catheterization schedule.
As already mentioned, self-catheterization may seem time consuming at first or you may experience small difficulties during the application but it quickly turns into an extremely easy process. Of course, there must be the necessary ability to use the hands functionally. However, the presence of urethral strictures and obesity often make it difficult to perform intermittent self-catheterization.
Finally, there is always the risk of infections but it is significantly lower than a permanent Foley catheter.