Intermittent urethral catheterisation

Some children have problems with how their bladder works. Their bladder may not empty properly and so clean intermittent catheterisation (CIC) can help with this.

Your doctor or nurse will explain why we have recommended this for your child. It may be because they:

• were born with a condition that affects their nerves, such as spina bifida
• have a problem with their bladder, such as posterior urethral valves
• have had an injury

How does the bladder work?

The kidneys make wee by filtering waste products from the blood. The wee runs down 2 small tubes (called the ureters) into the bladder where it is stored.

When wee is in the bladder, the bladder walls relax and muscles at the bottom of the bladder close to hold the wee in.

When the bladder is full and needs to be emptied, a message is sent along the nerves from the bladder to the brain. This is what makes you feel like you need to go to the toilet.

The brain then sends a message to the muscles at the bottom of the bladder telling them to relax and open to let the wee out.

At the same time the brain sends a message to the muscles further up the bladder, telling them to tighten and squeeze, to push the wee down.

If the bladder muscles do not work effectively they might not completely empty the bladder of wee. This can cause problems such as infections, or your child wetting themselves.

If wee is left in the bladder for a long time, it can cause damage to the bladder walls and kidneys.

How does intermittent catheterisation work?

Clean intermittent catheterisation (CIC) is used to empty wee from the bladder at various times during the day. It is a simple and easy procedure but we understand that you may feel anxious about this.

The catheter is placed into the urethra and up into the bladder. This lets the wee drain out. The catheter completely empties the bladder which reduces the risks of infections and kidney damage.

It may also help to keep your child from wetting themselves.

This needs to be done at regular times throughout the day. Your specialist nurse or doctor will advise you on this.

How do I do catheterisation?

It is very important to wash you hands well before starting.

You use a new, clean catheter each time. If you drop the catheter or it touches surfaces or clothing it is important to bin it, and use a new one.

If your child is young, you will need you to do their CIC for them. Most older children and teenagers can learn to do CIC themselves.

CIC can be done both laying down or sat on a toilet.

1. Collect the equipment, including catheter, wipes, lubrication
2. Wash your hands thoroughly
3. Clean the genital area using wipes, making sure you have wiped the urethral opening. With girls you must wipe downwards, towards the bottom
4. Wash your hands thoroughly again
5. Remove catheter from packet
6. Lubricate it if it is not already coated
7. Insert the catheter until some wee comes out. Push it up a little further then hold onto the catheter until it stops wee stops coming out
8. Slowly remove the catheter. If any more wee comes out, stop, and let it continue to drain until the bladder is completely empty
9. Dispose the catheter in a bin and wash hands thoroughly again

Catheter details

Catheter:

Size:

Manufacturer:

You can get  more catheters from your GP or home delivery service.

Your specialist nurse will discuss these options with you.

It will then be your responsibility to make sure you have enough supplies, and to activate your order every month. Please re-order when you have at least 2 weeks supply left.

If you have any questions or concerns, please contact the urology and continence team on 0114 226 0502.

Specialist Nurse:

Mobile:

Weekends and evenings call Ward 1 on 0114 271 7398.

Frequently asked questions

What if the catheter does not drain any wee?

Make sure the catheter is all the way into the bladder. Try to push the catheter in a little more.

If your child is a girl you may have put the catheter in the vagina, rather than the urethra.

The catheter can get blocked by a mucus plug. Slowly pull out the catheter, and get a new one.

The catheter will not go in or come out?

This may be due to muscle spasms. Try to get your child to relax and try again after 5 minutes.

Putting your child in a warm bath may help them to relax.

Contact a medical professional if this problem continues.

What about school or nursery?

For young children, the urology nurses or your local children’s community nurses can teach school or nursery staff how to do this for your child.

If your child is older, support your them to do their own catheters.

What do we do when travelling abroad?

Order your child’s catheter delivery in advance so they arrive in good time.

It is helpful to have a letter from your GP or specialist nurse to let people  know you will be carrying medical equipment (catheters).

Carry some catheters in your hand luggage in case your suitcase is lost.

Encourage your child to drink lots of fluids whilst in hot countries.

Can catheterisation be affected by the bowel?

It is important that your child has a regular soft poo, preferably everyday. When the bowels are empty, it makes it easier for the bladder to empty.

If your child is constipated they may wet themselves between catheterisation.

What if I see blood in my child’s wee or on the catheter?

This will usually only be a few specks and it is likely that the catheter has scratched the lining of the urethra. This is normal and will stop by itself.

If the bleeding continues or becomes very heavy call your specialist nurse, the hospital, or GP for advice.

What if my child gets an infection?

Signs of an infection include:

• cloudy or smelly wee
• it stings when they do a wee
• pain or difficulty when passing the catheter
• tummy pains
• you have to catheterise more often
• wetting themselves in between catheterising
• high temperature

Take a sample of wee to your GP and wait for the results before starting on antibiotics.

What might have caused an infection?

Things that can cause an infection include:

• not drinking enough (6 to 8 drinks a day)
• not catheterising enough (needs to be done at least every 4 hours)
• not thoroughly hand washing or catheterisation process was not clean enough
• lots of bubble baths (soap is drying changing the bacteria around the urethra)