Intermittent Self Catheterization for Males CEAC 0371 January 2016
Intermittent Self Catheterization This involves inserting a catheter (small tube) into your bladder at regular intervals to help empty your bladder. Remove the catheter when the flow of urine stops. This is a procedure that can be done by oneself or by a family member. It is important to avoid introducing germs and infection into your bladder - follow your nurse s instructions. Your nursing staff show you how to do intermittent catheterization and supervise you while you practice. You have help for as long as you need it. Terminology Bladder - where the urine is stored in the body Bladder Spasm - muscle contractions of the bladder that may be uncomfortable Catheter - a plastic tube used to drain urine from the bladder Void - to pass urine Over distended - describes the condition of the bladder when there is more than a normal amount of urine in it. Those who have difficulty voiding could experience low back or abdominal pain or pressure, chills, restlessness, or feeling sweaty Perineum - the part of the body between the scrotum and the rectum Urethra - opening where the urine drains from the body 1
Insertion of the Catheter Before you begin, make sure you have everything you need: soap and water for hand washing plastic catheter (the size and type recommended by your doctor or nurse) clean washcloth and soap lubricant that dissolves in water such as Ky Jelly not Vaseline toilet paper container for urine (measuring cup, plastic toilet container, or bedpan). mirror plastic bag. When you are being discharged from hospital you may obtain a small amount of catheters and lubricant from the hospital before you go home. If you need more supplies you must purchase your own. Some local medical supply stores sell catheters for self catheterization. Ask your Home Care nurse for more information. Some health insurance plans cover the cost of supplies. 1. Gather the equipment you need and place it on a clean surface close at hand. Make sure you can reach all equipment. 2. Go to the bathroom and pass urine if you are able. Be sure to measure the urine if your doctor has instructed you to do this. 3. Wash your hands with soap and water. Dry well. 4. Lubricate 6 inches (15 cm) at tip of catheter. Place catheter on clean surface within reach. 5. Position yourself either sitting or lying on a bed propped in a semi-sitting position. 6. Hold your penis with one hand and wash it well with soap and water using a circular motion. 7. Move from the tip of your penis to the base. 8. If you are not circumcised pull the foreskin back and wash well with soap and water. 9. Hold your penis upright at a 60 to 75 angle to your body. 2
10. Slowly put the catheter in your urethra until urine begins to flow. This is about 8 to 10 inches (20 to 25 cm). Sometimes the catheter is hard to push just before it goes into the bladder. This is normal. Use gentle but firm pressure on the catheter until it passes this point and the urine begins to flow. 11. When the urine flows, push the catheter in about 1 inch (2 cm) more. 12. Relax and let all the urine drain from your bladder. 13. Push down gently on your abdomen to help empty your bladder. 14. Remove the catheter slowly when the urine stops and set it aside. 15. Measure the urine and write down the time of catheterization and amount of urine. 16. Wash your hands well. Equipment Care 1. Discard catheter after each use. 2. Wash all other equipment with dish soap, rinse with clear water, and allow to air dry. Catheter Use Follow the manufacturer s directions when caring for the catheter. Some risks with the cleansing, reusing and/or resterilizing a catheter designed for single use include, but are not limited to: increased risk of infection increased risk of cracking, breaking, or structural failure of the catheter. It is unknown what other changes in the catheter material could occur with resterilization. For single use catheters, use a new sterile packaged catheter for each catheterization. Should you decide to reuse your catheter knowing these risks, it is recommended that you do the following: 1. Wash the catheter well. 2. Place the catheter on a clean surface, free from dust and other germs. 3. Discard the catheter within 24 hours of its first use. 3
Prevent Infection 1. Do not let your bladder become over distended (too full). Bladder distention is one of the main causes of urinary tract infections. Your bladder is becoming over distended if you experience any of the following: feeling restless sweating chills headaches looking flushed or pale cold fingers, toes, arms, or legs the lower part of your abdomen looks bloated. 2. Drink plenty of fluids 6 to 8 glasses (1 glass = 8 oz or 250 ml) every day. Avoid caffeine, as it makes you feel like you need to void more quickly and more often. 3. Keep your equipment and supplies clean and store them properly. 4. Keep your groin area clean and dry. How Often I Need to Catheterize Your doctor discusses with you how often you need to self catheterize. Specific instructions are given to you before discharge from the hospital. Most people need to catheterize every 4 to 6 hours when they are awake. If you are experiencing any signs of an over distended bladder then it is important that you catheterize as soon as possible. Some people are able to void a small amount before catheterizing, and need to catheterize only to remove the urine left in their bladder after voiding. Use the chart at the back of this booklet to record your self catheterizations. *Always consult your doctor before you stop self catheterization* 4
Problems You May Encounter I cannot put the catheter in my urethra. Wait a few moments. Try to relax. Relocate the urethra. Relubricate the catheter and try again. Apply gentle pressure. Men can try changing the angle of the penis. It hurts while inserting a catheter. There may be some slight discomfort when inserting the catheter, but if it continues to get worse, call your doctor. I see blood in the urine. A small amount of blood in your urine is not unusual. Try to increase the amount of fluids you are drinking. If it continues, talk to your doctor. Bladder spasms. You may have the odd bladder spasm. If they continue, talk to your doctor. Some people take medication prescribed by their doctor to help reduce bladder spasms. I measure more than 2 cups (500 ml) of urine. This means that you should catheterize yourself every 4 to 6 hours when a person is awake. I am unable to remove the catheter. Wait 5 to 10 minutes. Try to relax and try again. If still unsuccessful, call your doctor or go to the Emergency Department. Call your doctor if you have any of the following symptoms of a bladder infection: pain in lower back or lower abdomen cloudy, foul smelling urine chills or fever (temperature higher than 38.5 C or 100 F) lack of appetite and/or energy sand-like material (sediment) in your urine red or swollen urinary opening nausea or vomiting. You may need to increase the amount of fluid you drink as well as the number of times you catheterize, if you experience any of these symptoms. 5
Acknowledgements: St. Joseph s Hospital Foundation, Hamilton, Ontario Video Preview Female Intermittent Self-Catheterization Saskatoon City Hospital, Saskatoon, Saskatchewan Intermittent Catheterization Patient Teaching Booklet Mosby s Patient Teaching Guide Diagrams hand drawn by Medical Media, Regina Qu Appelle Health Region Self Catheterization. (n.d.). Retrieved June 22, 2006, from Malecare@: http://malecare.com/urinary-catheter-110.htm 6
Table Date Time Fluids I Drank Amount I Voided on My Own Amount I Catheterized 7
CEAC 0371 January 2016