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Clean Intermittent Catheterisation (CIC): What You Need To Do

[fa icon="calendar"] Jun 15, 2021 10:05:00 AM / by Calvin Leong

CGM _CIC

 

Clean intermittent catheterisation (CIC) is a procedure to remove urine from the bladder by placing a small, flexible tube (catheter) into the bladder though the urethra. The urethra is a tube in the body that carries urine from the bladder out of the body.

CIC may be done when:

  • You cannot completely empty your bladder on your own. This may be due to a blockage in the bladder or urethra.
  • Your bladder leaks urine. This may happen when the muscles or nerves near the bladder are not working normally, so the bladder overflows.
  • Your healthcare provider will show you how to perform CIC and will help you to become comfortable performing this procedure at home. Your healthcare provider will also help you to get the home care supplies that are needed for this procedure.

 

Supplies needed:

  • Germ-free (sterile), water-based lubricant.

  • A container for urine collection. You may also use the toilet to dispose of urine from the catheter.

  • A catheter. Your health care provider will determine the best size for you.

  • Clean gloves.

  • Soap and water.

  • Towel.

 

How to perform this procedure:

Most people need CIC at least four times per day to adequately empty the bladder. Your healthcare provider will tell you how often you should perform CIC.

 

To perform CIC, follow these steps:

  1. Wash your hands with soap and water. If soap and water are not available, use hand sanitiser.

  2. For males, clean your penis with soap and water. Dry the tip of your penis completely.

  3. For females, it may be helpful to use a handheld mirror to look at the opening of your urethra.

  4. Lying down with your head raised on pillows and your knees pointing to the ceiling. You may wish to place a waterproof mat or pad under you.

  5. Prepare the supplies that you will use during the procedure. Open the catheter package and lubricant.

  6. Get in a comfortable position. Possible positions include:
  • Sitting on a toilet, a chair, or the edge of a bed.

 

  • Standing near a toilet. Females can also stand next to a toilet with one foot on the toilet rim.

 

7. If you are using a urine collection container, position it between your legs.

8. Urinate, if you are able.

9. Put on gloves.

10. Apply lubricant to about 2 inches (5 cm) of the tip of the catheter.

11. Set the catheter down on a clean, dry surface within reach.

 

For males:

  • Gently stretch your penis out from your body. Pull back any skin that covers the end of your penis (foreskin). Clean the end of your penis with medicated sterile swabs as told by your health care provider.
  • Hold your penis upward at a 45–60 degree angle. This helps to straighten the urethra.
  • Slowly insert the lubricated catheter straight into your urethra until urine flows freely. This is usually about 6–8 inches (15–20 cm).

 

For females:

  • Gently spread the folds of skin around your vagina (labia) with your non-dominant hand. For example, if you are right-handed, use your left hand to do this. With the other hand, clean the urethral opening with a washcloth and warm, soapy water, wiping from front to back. Dry the area completely with a towel.
  • While keeping your labia spread apart, slowly insert the lubricated catheter straight into your urethra until urine flows freely. This is usually 2–3 inches (5–8 cm).

 

12. When urine starts to flow freely, insert the catheter 1 inch (3 cm) more. Allow urine to drain into the toilet or the urine collection container.

13. When urine stops flowing, slowly remove the catheter.

14. Note the colour, amount, and odour of the urine.

15. Measure your urine and note the amount, if told by your healthcare provider.

16. Discard the urine in the toilet.

17. Clean your penis using soap and water.

18. Move the foreskin back in place, if applicable.

19. If you are using a single-use catheter, discard the catheter and supplies.

10. Wash your hands with soap and water.

 

If you are using a reusable catheter, follow package instructions about how to clean the catheter after each use.

thinking woman with question mark on gray wall background

How often should I perform this procedure?

Do CIC to empty your bladder every 4–6 hours or as often as told by your healthcare provider.

If you have symptoms of too much urine in your bladder (over-distension) and you are not able to urinate, perform CIC. Symptoms of over-distension may include:

  • Restlessness.

  • Sweating or chills.

  • Headache.

  • Flushed or pale skin.

  • Bloated lower abdomen.

 

What are the risks?

Generally, this is a safe procedure, however problems may occur, including:

  • Infection.

  • Injury to the urethra.

  • Irritation of the urethra.

 

Follow these instructions at home

General instructions

  • Drink enough fluid to keep your urine pale yellow.

  • Dispose of a multiple use catheter when it becomes dry, brittle, or cloudy. This usually happens after you use the catheter for one week.

  • Avoid caffeine. Caffeine may make you need to urinate more frequently and more urgently.

  • When traveling, bring extra supplies with you in case of delays. Keep supplies with you in a place that you can access easily. If traveling by plane make sure that the lubricant in your carry-on bag is less than 100 mL. Use a single-use catheter. It may be difficult to clean a reusable catheter in a small bathroom.
  • Take over-the-counter and prescription medicines only as told by your health care provider.

  • Keep all follow-up visits as told by your healthcare provider. This is important.

Safety - Text on Puzzle on the Place of Missing Pieces. Scarlett Background. Close-up. 3d Illustration.

Contact a healthcare provider if you have:

  •  difficulty performing CIC.

  •  urine leaking during CIC.

  • dark or cloudy urine.

  • blood in your urine or in your catheter.

  • a change in the smell of your urine or discharge.

  • a burning feeling while you urinate.

  • feel nauseous or you vomit.

  • have pain in your abdomen, your back, or your sides below your ribs.

  • have swelling or redness around the opening of your urethra.

  • develop a rash or sores on your skin.

    Get help right away if you have:

  • a fever.

  • symptoms that do not go away after three days.

  • symptoms that suddenly get worse.

  • severe pain.

  • a decrease in the amount of urine that drains from your bladder.

 

Summary

Clean intermittent catheterisation (CIC) is a procedure to remove urine from the bladder by placing a small, flexible tube (catheter) into the bladder though the urethra.

Your healthcare provider will show you how to perform CIC and will help you to become comfortable performing this procedure at home.

Most people need CIC at least four times per day to adequately empty the bladder.

 

This information is not intended to replace advice given to you by your healthcare provider. Make sure you discuss any questions you have with your healthcare provider.

References:

Bennett E.: Intermittent self-catheterization and the female patient. Nurs Stand 2002; 17: pp. 37-42.

Fasugba O., Koerner J., Mitchell B.G., Gardner A.: Systematic review and meta-analysis of the effectiveness of antiseptic agents for meatal cleaning in the prevention of catheter-associated urinary tract infections. J Hosp Infect 2017; 95: pp. 233-242.

Kozier B., Erb G., Berman A., Snyder S.: Fundamentals of nursing: concepts, process, and practice.2000.Prentice HallNew Jersey

Long B., Koyfman A.: The emergency department diagnosis and treatment of UTI. Emerg Med Clin North Am 2018; 36: pp. 685-710.

Serlin D.C., Heidelbaugh J.J., Stoffel J.T.: Urinary retention in adults: evaluation and management. Am Fam Phys 2018; 98: pp. 496-503.

 

For more information on intermittent catheters, visit:

Actreen Lite Cath Nelaton

Actreen Lite Cath Tiemann (Bended Tip)

 

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Topics: Wellness

Calvin Leong

Written by Calvin Leong

Calvin Leong holds a Master in Medical Education from the University of Dundee, United Kingdom. He is certified in Clinical Wound Care by the ASEAN Wound Care Association. Calvin has 20 years of clinical and lecturing experience focusing on Mentoring in Healthcare, Traumatology and Medical Sciences. Calvin is HRDC certified trainer. He is also a Life Member of The Malaysian Association for the Study of Pain (MASP) and the Malaysian Society of Wound Care Professionals (MSWCP).

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