Intermittent Self Catheterisation

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1 Urology Intermittent Self Catheterisation (ISC) patientinformation Rotherham Hospital Your health, your choice, our passion

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3 What is Intermittent Self Catheterisation (ISC)? Intermittent Self Catheterisation is passing a small tube, called a catheter, into the bladder, to allow the urine to flow out of the bladder. The catheter, which is soaked in normal cold tap water for 30 seconds to activate the special coating, is easy to use, and does not cause any damage to your bladder or urethra, even if this is performed over a long period of time. Why do I have to perform ISC? The reasons why your bladder cannot empty properly and you may have to perform ISC are: l The result of an operation on the prostate/pelvis/bladder. l Bladder muscles that are too loose. l Communication problems between the valve and the brain. l Nerve damage caused by spinal injury or disease. l A muscle valve that is too tight. One thing is for sure, urine must not be left in the bladder; if it remains there for too long, it can become stale and cause infection. Normal bladder function The bladder is where the urine is stored. To stop the urine continually leaking from the bladder, the bladder muscles relax and the muscle valve is closed. 3

4 Before urine is passed, a signal is sent to your brain, your brain then sends a message to the muscle valve to open, and the bladder s muscles contract. This is when you pass urine, until your bladder is completely empty. Normally, you pass urine between 4 6 times a day, or whenever the bladder contains about mls. 4 Figure 1 Testis Male Anatomy Figure 2 Clitoris Urethra opening Vagina Prostate Bladder Penis Urethra Female Anatomy What are the advantages of ISC? l It can improve your quality of life by giving you the confidence to take part in normal activities. l If you have experienced episodes of incontinence in the past, performing ISC can help to reduce this problem. l It reduces the risk of bladder and kidney infections caused by urine staying inside you for too long. l You have control over your bladder, which results in improved lifestyle. l It is a convenient way to ensure complete and regular bladder emptying. There is no need for other appliances e.g. pads, drainage bags. The male anatomy In men, the urethra is 10 18cm long and shaped like the letter S (see figure 1). When inserting the catheter, you should straighten out the S by lifting your penis up towards your stomach. The female anatomy A woman s urethra is straight and is approximately 4cm long. It runs from the bladder, to an opening between the vagina and clitoris (see figure 2).

5 Preparing your catheter for use l Try to pass urine normally. l Wash your hands with soap and water. l Open the packet carefully, pulling the tabs slightly apart. l Fill the packet 3/4 full with cold tap water. l Remove the adhesive tag from the back of the packet, and fix to a convenient surface. l Leave the catheter to soak for at least 30 seconds, as this is when the coating is activated. l The catheter will now be ready for use. Figure 3 Catheter Bowel Bladder Lift Penis Urethra Male Anatomy Figure 4 Bowel Uterus Bladder Anus Vagina Urethra Female Anatomy How to use your catheter Step 1 for men Gently pull your foreskin back if you have one. Wash the end of your penis with soap and water. Hold your penis up towards your stomach. In this position, your urethra is extended and becomes U-shaped, making it easier to guide the catheter into your bladder. Do not squeeze your penis too hard as this can block the opening of your urethra. (See figure 3). Step 1 for women Spread the labia apart and wash around the urethral orifice. Wash yourself with a downwards movement towards the rectum (not away from it, because this can transfer any bacteria and cause infection). You can choose between several different positions and it is important during the learning phase to find one that suits you best. (See figure 4). 5

6 You can: l Squat against a wall. l Sit on the floor with your back against a wall/chair, with your knees bent up. l Sit on the edge of the bath, one leg resting on the side of the bath, the other leg in the bath. l Sit on the toilet, either facing the correct way, or back to front. l Rest one leg up on the toilet seat, with the other leg remaining on the floor. Step 2 Remove the catheter from the bag. Gently insert the catheter into the urethra until it reaches the bladder and urine starts to flow. If you bend the catheter before the flow starts, this will avoid spillage. Step 3 When the flow stops, move the catheter down a little to make sure that the bladder is completely empty, and then slowly remove the catheter. Step 4 Dispose of the catheter properly, by placing it in a plastic bag, and putting it in your household rubbish. Remember NOT to flush it down the toilet. Step 5 Finish by washing your hands. 6

7 What should I do if I can t insert the catheter? If the catheter is difficult to insert, this is usually because you are not relaxed. If you cough a couple of times this helps the muscles relax. If you have tried and failed, don t worry or panic, and don t try again immediately. Have a warm bath and try to relax before attempting to insert the catheter again. If you still cannot insert the catheter, please seek medical advice. What should I do if I can t remove the catheter? Again, try to stay calm and don t panic. Try to relax for 5 10 minutes before trying again, or try the same relaxation methods as above. If you cannot remove the catheter, please seek medical advice. Which catheter should I use? During your first appointment, the clinical nurse specialist will help you find the right one for you. How often should I catheterise myself? This can vary according to: l Your particular type of bladder problem. l Medication you may be taking. l The amount of fluid you drink. Some people may need to perform Intermittent Self Catheterisation once a day, whilst others may need to repeat it 3 or 4 times. This is something you can discuss with the clinical nurse specialist. 7

8 Where do I get the catheters from? The clinical nurse specialist will give you a small supply of catheters at your first visit. A letter will be sent to your GP stating the size and type of catheter you are using. You will need to make an appointment to see your GP to arrange a prescription for a further supply. For your own peace of mind, try to keep at least a week s supply in advance when arranging your next prescription. What happens when I travel abroad? Catheters are not available in all countries, and even if they are, you don t want to be thinking about where to get them from. Pack as many catheters as you will need for the duration of the holiday or business trip. To avoid any problems with customs, ask your GP for a written statement saying the catheters are necessary for medical reasons, and are for your personal use. If you are worried about the quality of the water in some countries, it is best to be on the safe side, and use bottled water. General Advice If a few specks of blood appear when removing the catheter, don t worry. This sometimes happens, and should clear up in a few days. If the bleeding continues, or can be seen everytime you pass urine, you should contact your GP. 8

9 If you experience any of the following: l Shivering l High temperature l Fever l Cloudy and/or smelly urine you should drink extra fluids and contact your GP immediately. You may have a urine infection. You will need to drink plenty of fluids, at least 6-8 cups per day, whilst you are catheterising yourself. Try to reduce your intake of tea and coffee, as these can irritate your bladder, and increase the amount of water your drink. A glass of cranberry juice can help prevent urine infections. When you first begin ISC, it is useful to keep a diary of the volume of urine that you pass, when you catheterise yourself. It is important that you avoid becoming constipated. Eat a well balanced diet with plenty of fruit and vegetables. If you do become constipated, consult your GP, as this may interfere when you are performing ISC. Who do I contact if I have any questions? If you need to contact the Urology Department, please telephone or contact the Urology Nurses on (an answer machine may be in use at busy times). 9

10 Patients Notes Department of Urology Rotherham General Hospital. Name of Nurse Name of catheter I use Order code Size Catheterise every Additional information 10 hours Useful contact numbers NHS Direct Telephone Patient Services Telephone Health Info Telephone Stop Smoking Service Telephone A&E Telephone For GP out of hours, contact your surgery Useful websites If you require this document in another language, large print, braille or audio version, please contact Patient Information on Produced by the Department of Urology Nurses Revised August 2007, September 2011 Revision due September Version: 3.0 The Rotherham NHS Foundation Trust All rights reserved.

11 How to find us Hospital site plan Woodlands P Two Way traffic One Way traffic Public Parking Leapfrog Day Nursery Child Development Centre Oakwood Hall Greenoaks P Oakwood Hall Annexe P Oldfield Centre Moorgate Wing OAKWOOD HALL DRIVE Day Surgery Centre Maternity Entrance Rotherham Hospital Main Entrance Accident & Emergency P PAY AND DISPLAY P PAY AND DISPLAY P PAY AND DISPLAY One Way Bus stop BAKER STREET MOORGATE One way Bus stop ROAD A618 Bus stop Security Centre TO WOODSIDE Rotherham main routes To Leeds Parkgate To Doncaster 35 Thorpe Hesley B6089 A633 M1 North 34 South 34 To Sheffield Kimberworth Park A629 Kimberworth A6109 A631 A630 A630 Woodside Brinsworth A A630 TOWN Clifton CENTRE A618 A631 East Dene Rotherham Hospital Moorgate A6123 Whiston Herringthorpe A631 M1 Wickersley Bramley 32 A631 To A1, M62 & Hull M18 1 To Sheffield Treeton A618 M1 To Nottingham and the South

12 LS /11 V3 WFO How to contact us Urology Department Telephone am to 5.00pm Urology partial booking appointments Telephone Urology Ward Telephone hour service Urology Nurses Telephone Switchboard Telephone Rotherham Hospital Moorgate Road Oakwood Rotherham S60 2UD Telephone Sustainable Forests / Low chlorine

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