What is intermittent self-catheterisation and when is it used?
Catheters come in two main types and they are used depending on your specific needs at any given time:
- intermittent catheters – this type of catheter is inserted temporarily into the bladder and it is emptied at set intervals or when it is full; this catheter is used on patient who require short-term catheterization, generally during hospital stays;
- indwelling catheters – this type of catheter is employed when patients require long term catheterisation; typically, these catheters are designed work for extended periods of time, multiple days or even weeks without additional assistance;
Let’s have a look at what intermittent self-catheterisation is all about and who needs it:
Intermittent catheterisation, as the name implies, is a catheterisation procedure which allows urine releases at set intervals or when the bladder is full. The emptying procedure may vary from several times a day to once a week, depending on various factors, such as fluid intake, the quantity of the residual urine, the urine buildup over time, whether urine passes through the urethra normally or whether the ureters (the tubes which direct urine from the kidneys to the bladder) work properly.
Residual urine refers to the volume of urine which is normally left in the bladder after a person goes to the toilet. In some cases, incomplete bladder emptying can cause incontinence or frequent and recurrent urinary tract infections. To avoid these situations, the catheter should be temporarily inserted and removed every time the bladder is empty. Generally, intermittent catheters are inserted by qualified medical professionals, like nurses, but some patients may want to insert the catheter themselves.
Intermittent catheterisation is almost always done through the urethra. In special cases, the catheterisation is done through the abdominal wall – this procedure is known as the Mitrofanoff catheterisation.
Intermittent self-catheterisation – the specifics
Intermittent catheters, unlike Foley catheters, do not have a balloon to hold them in place during the catheterisation procedure, so they cannot stay in place unaided. Intermittent catheters are removed and reinserted every time the bladder is emptied, or the flow of the urine is stopped. Urine flows out of the bladder, into the catheter and will be guided into the toiled; the procedure is painless and the discomfort should be minimal.
Multiple studies (Weld and Dmochowski 2000 and Wyndael 2010) done in hospital environments have shown that intermittent self-catheterisation is the safest way of emptying the bladder for patients. It also has the lowest risk of urological complications when compared to other catheterisation options. Many urologists and experts consider the intermittent catheter as the “gold standard” in the industry because the bladder can be emptied completely, thus reducing the risk of other urinary tract infections, which are common when using indwelling catheters, for instance.
Certain intermittent catheter models are self-lubricated, that is, when soaked into water they become slippery, thus allowing an easier insertion. Lubricating jelly (also water based) is also used in some catheters. Similar to other catheters, intermittent catheters are also single-use and sterile, so washing them is not recommended. Recent research doesn’t guarantee or suggest a specific type of intermittent catheter or any specific insertion technique. In other words, there is no strategy better than another.