Intermittent catheterization means removing urine from the bladder by placing a tube into the bladder. This is done when a child is unable to empty his bladder on his own, when a child's bladder leaks urine, or when very high pressures have developed in the bladder.
When performing catheterization, it is important to prevent urinary tract infections. Extra urine in the bladder can grow germs. Chronic infections and high bladder pressures can over time damage the kidney.
Intermittent catheterization is not a difficult procedure. You cannot hurt the bladder if you follow directions. Almost anyone can learn the technique, even a 5 or 6 year old child.
Show All- Bladder:
- A muscular sac which holds urine until it is emptied from the body.
- Bladder overdistention:
- A bladder filled beyond normal capacity.
- Catheter:
- A tube used for emptying urine from the bladder.
- Foreskin:
- A fold of skin covering the tip of the penis.
- Lubricant:
- A water soluble, jelly-like substance used to prevent irritation. (Do not use a petroleum-based product, such as Vaseline. Use a product such as K-Y Jelly which will not damage the catheter).
- Urethra:
- The tube that carries urine from the bladder to the outside.
- Void:
- To urinate; to empty the bladder.
Urine (the body's liquid waste) is made in the kidneys through a blood filtering process. Urine passes kidneys, down through the ureters and into the bladder. The bladder is an elastic muscle which acts as a storage tank. As the bladder fills, its walls relax to hold more urine and the sphincter muscle remains tight to prevent leakage of urine.
Assemble after washing hands
- Lubricant (K-Y Jelly or Lubafax)
- Paper towel
- Catheter (size ______)
- Diaper (for infants)
- Plastic cup (if a specimen is needed)
- Betadine wipes or swabs
- Soap and water (a mild soap, such as liquid ivory or dial)
(May vary according to your doctor's preference)
- Wash hands well with soap and water.
- Place catheter on paper towel or leave in Ziploc bag if self sterilized. If disposable, open pack and leave catheter in pack. Roll the tip and the first 1-2 inches in lubricant and place nearby.
- For babies, take off old diaper and place on new one.
- Cleanse the penis. Hold both sides of the penis, with nondominant hand. Holding it away from the body, pull back on the foreskin (if necessary). Wash the tip of penis well with Betadine wipes or swabs, or antiseptic if directed so by physician. Continue to hold foreskin back.
- Locate urinary opening at the tip of penis. Insert catheter gently. You may meet resistance about 3/4 of the way in (a tightened muscle). If this occurs, hold firm, steady pressure against the muscle. You may need to hold this pressure for up to a minute or more for the muscle to relax. Do not force the catheter. You should feel a "release" and then find that the catheter slips in easily. If you can't get the muscle to relax, try changing the angle of the penis. If this doesn't help, try again in 30 minutes.
- Let urine drain into diaper for infant or a cup if a specimen is needed. Sometimes, your health care provider will want you to measure the amount of urine that comes out of the bladder with the catheterization.
- When urine stops flowing, slowly remove catheter, allowing all urine to drain.
- Rinse antiseptic off.
- Note appearance and amount of urine. If something unusual happens, report to your doctor.
- You should do this _______ time(s) a day.
- To self sterilize catheters, follow instructions given by your doctor or nurse.
In Infants:
Look out for cloudy or dark urine, blood in urine, vomiting, chills or fever, crankiness, drowsiness, swelling or redness around urethral opening, change in smell of urine, painful urination, or an unusual discharge from urethra or around catheter.
In Older Children:
Look out for cloudy or dark urine, blood in urine, nausea or vomiting, chills or fever, flank pain, lethargy, frequency of urination, urgency (a need to quickly get to the bathroom), swelling or redness around urethral opening, change in smell of urine, painful urination, an unusual discharge from urethra or around catheter, or noticeable decrease in the amount of urine.
- It is important that your baby is taking ______ounces of formula at feeding times
- Offer baby pacifier, comforting toy, or turn on musical mobile to distract them
- Hold and comfort baby afterwards
- It is very important that you catheterize your child on time, every time, and that you do not skip it (evenly space catheter times from morning to night)
- Drink a lot of liquids to improve the flow of urine through the kidneys
It was first used in 1970 as a home non-sterile self technique. Its effectiveness and safety have since been proven. It is used worldwide. Thousands of people use the technique to manage bladder function.
Leaking Urine
- The catheter may not be inserted far enough
- The catheter may be blocked
- The bladder may be having a contraction
No Urine During Catheterization
The catheter may not be inserted far enough (especially in boys). You may not be drinking adequate fluids. The catheter may be blocked. Urine may already have leaked out.
Blood in the Catheter
It usually indicates a mild bladder or urethral irritation. It will usually clear by itself. If blood persists or is associated with difficulty in passing the catheter, contact your doctor. You should never have to force a catheter into the bladder.
For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.
