Basic Ostomy Skin Care

People with a stoma often worry that their skin may become irritated from the stool, urine, or pouching system. It is important to treat the skin gently, protect it from stool, urine, and chemicals, and use products correctly to decrease the chance for skin problems.

Caring for Yourself

How often should I change my pouching system?

How often you will need to change your pouching system depends on the type of stoma, the location of the stoma, and the kind of drainage from the stoma. There are three basic types of ostomies. Urostomies are for urine, colostomies are for drainage of the large bowel and ileostomies are for drainage of the small bowel. Using the right type of pouching system and putting it on the right way will also affect how long you can wear it. Wear time may be affected by other factors such as activity level, body shape, and perspiration. Many pouching systems are made to be worn for three to seven days. However, there are some pouching systems that are made to be changed every day. The type of pouching system you think is best for you is a personal decision. However, issues of reimbursement from Medicare or your private insurance company may influence this decision. Contact your WOC nurse or health care provider if you are changing your pouching system more often than expected or suddenly more frequently than your normal wear time.

When is a good time to change my pouching system?

Choose a day and time that is best for you. Try to pick a time when you won’t be disturbed and when your stoma is not putting out a lot of drainage. The best time to change the pouching system is

different for everyone. For most people, the stoma is less active before eating or drinking in the morning. Some people will do their care while they take their bath or shower. Other people may choose to do their care at the end of the day or at least two hours after a meal.

How do I get my old pouching system off?

Take your time when you remove your pouching system. You do not want to rip it off because this may hurt your skin. Try to remove it in the direction your hair grows. Loosen and lift the edge of the pouching system with one hand and push down on the skin near the skin barrier with the other hand. You may find it helpful to start at the top and work down to the bottom so you can see what you are doing, which would also allow the pouch to catch any drainage.

Some people use warm water to remove the pouching system and other people may use adhesive remover. If you use adhesive remover it is very important to wash off all the adhesive remover from your skin with soap and water and dry the skin completely before you put on your new pouching system. Sometimes your skin may look pinker, redder or darker right after you take off your pouching system. This should fade away in a few minutes.

How do I clean around my stoma?

To clean the skin around your stoma, all you really need to use is warm water and a washcloth, or good quality paper towels. The use of gauze or gloves is not necessary and can be expensive. It is not necessary to use soap to clean around your stoma. But if you prefer to use soap, use a very mild soap. Avoid using soaps and cleansers with oils, perfumes, or deodorants since these can sometimes cause skin problems or keep your skin barrier from sticking. Rinse the soap off the skin around your stoma very well because the residue may keep your skin barrier from sticking and may also cause skin irritation. If you are using paste, it may be easier to remove the paste before you wet the area. Some people may use adhesive remover. Do not worry if a little bit of paste is left on your skin.Always dry your skin well before putting on your new pouching system. Sometimes you may see a small amount of blood on your cloth. The stoma tissue contains small blood vessels and may bleed a small amount when cleaned. Any bleeding that does not stop should be reported to your health care provider. The stoma has no nerve endings, so you are not able to feel, if you are rubbing too hard. Therefore, use a gentle touch when cleaning around the stoma, do not scrub. Do not use alcohol or any other harsh chemicals to clean your skin or stoma. They may be irritating to your skin. Do not use moistened wipes, baby wipes or towelettes that contain lanolin or other oils, these can interfere with the skin barrier sticking and may irritate your skin.

Unless recommended, do not apply powders or creams to the skin around your stoma because they can keep your skin barrier from sticking.

What should I do with my soiled supplies after I change my pouching system?

Put your soiled pouching system into a plastic bag and throw it away in your household garbage. It is recommended to empty your pouch into the toilet first. For odor control with disposal when away from home, carry one to two plastic storage bags in a pocket or purse. If you used soft paper towels to wash your skin, you can throw them away with your pouching system in your household garbage. If you used washable items such as a washcloth to wash your skin, they may be washed with your household laundry. Some people who wear a two-piece pouching system choose to remove the pouch to empty it and then attach a clean one. They may decide to rinse out the soiled pouch and reuse it later. Some people use reusable (can be used over and over again) pouching systems. If you use this type of pouching system, follow the cleaning instructions from the manufacturer. If you use a clamp to close your pouch, remember to save it. Carry an extra clamp with you in case it breaks If you wear a urostomy pouch, the connector for use at bedtime should be saved and used again. The clamp and connector should be washed with soap and water. Wash your hands after taking care of your ostomy. You do not need to wear gloves.

Can I get my pouching system wet?

Yes. You can shower, bathe, swim or even get in a hot tub with your pouching system on. It is a good habit to empty the pouch before showering, bathing or other water activities. You can bathe or shower every day. On the day you plan to change your pouching system you can either leave it on or you can take the whole thing off to take your bath or shower.

Some people may choose to shower or bathe without their pouching system. Because the stoma has no muscle, urine or stool may drain from your stoma while showering or bathing. Water won’t hurt your stoma or go inside you. If the water pressure is strong do not let it hit your stoma directly. Only use a gentle spray of water on your stoma. Check your pouching system before and after water activities. If you are in the water for a long time the pouching system may start to loosen up from your skin. Some people may find it helpful to wait an hour or so after changing their pouching system before swimming. Pouching systems are waterproof. However, you may feel more secure if you wear an ostomy belt or put tape around the edges of your skin barrier when you are in the water. Some people will secure the edges of the skin barrier with waterproof tape. Other people prefer to use paper tape and then wipe the paper tape with a skin sealant to make it more waterproof. If you have sensitive or fragile skin, the use of paper tape may be gentler on your skin than a waterproof tape. If you do put tape around the skin barrier edges do not remove the tape after water activities. Removing the tape may cause the skin barrier to loosen. Some people wear tight ‘biking style’ shorts to keep their pouch close to the body and help keep it from ‘floating’. Gas filters do not work after they get wet. Therefore, it is best to protect the filter with waterproof tape before water activities. After bathing or swimming, you may use a towel or a hairdryer on the coolest setting to dry the tape and cloth packing of the pouching system to prevent skin irritation from wetness.

What are some ways to keep my skin from getting irritated?

The best skin protection is a well-fitted and comfortable pouching system. Your WOC nurse or health care provider will help you choose the system that works best for you. The opening of your skin barrier should be no more than 1/8 inch away from the edge of your stoma unless otherwise instructed by your WOC nurse or health care provider.

Measure your stoma once a week for the first 6 to 8 weeks after your ostomy surgery. Your stoma shrinks while it is healing and you need to keep measuring so you can make sure that the opening in the skin barrier is the right size for your stoma. Remeasure your stoma if any irritation develops between the stoma and skin barrier wafer. It is helpful to hold your skin smooth as you put your pouching system on to avoid wrinkles that may lead to leakage. Check your skin and the back of your skin barrier each time you change your pouching system. You can use a mirror to check your skin under the stoma. Look for any places where stool or urine may have leaked under the skin barrier and onto your skin. When you apply your next pouching system these areas may need some extra reinforcement with skin barrier strips, rings or paste. There are a variety of “paste” products available. Your WOC nurse or health care provider will advise you when this is recommended. When you have a stoma that drains urine or loose stool you may want to consider using an extended wear skin barrier because it will give your skin added protection. Ask your WOC nurse or health care provider for help with selecting an extended wear skin barrier.

I have sensitive skin. Will the skin barrier irritate my skin?

If your skin is sensitive, it is helpful to tell your WOC nurse, or health care provider. A skin patch test may be necessary to see if you have any reaction to the different skin barriers and tapes. For the most part, the ingredients in the skin barriers do not cause skin irritation. If you are having a “reaction” to the skin barrier or tape, most of the time you will see skin changes that match the shape of the product. Inform your WOC nurse or health care provider so they can determine the cause of the irritation and recommend another product if needed. Itching or burning under the skin barrier may indicate that you have leakage, a skin rash, or a skin infection. You need to remove your pouching system as soon as possible to check your skin for any irritation.

How can I prevent infection?

The stoma is your bowel. It is protected by mucus so stool or urine won’t hurt it. A stoma rarely becomes infected. The most important thing is to protect the skin around your stoma. A correct fitting pouching system is the best way to prevent an infection of your skin.

If there is a small leak under my skin barrier, is it okay to patch it with tape or paste?

Always change your pouching system at the first signs of leakage. Do not try to patch the pouching system with tape or paste. A leak under the skin barrier should not be fixed. Leaving a leaking pouch on can cause skin irritation.

How can I prevent leakage?

Always empty your pouch before it is half-full. Release gas before the pouch gets too full. If you have a lot of gas, you may want to consider using a pouch with a vent or filter. There are some medications that may be used to reduce gas. Check with your WOC nurse, health care provider or pharmacist to learn more about these medications.

I perspire a lot. How can I get the pouching system to stick better?

You can dust the skin with an ostomy skin barrier powder to help absorb perspiration. Then dab skin sealant on top of the powder so the pouching system will stick to the skin. There are additional ostomy adhesives available in sprays, wipes, skin cements and tapes.

What can I do to remove hair from around my stoma?

Some people shave with an electric razor while some dry shave with an ostomy skin barrier powder using a safety razor. Other people may use a safety razor and shave with mild soap and water. If a person decides to use shaving foam it is important to avoid foam that has moisturizers or perfumes that may irritate the skin or keep the pouching system from sticking to the skin. Always wash the skin well with water after shaving. Shaving or clipping excess hair around the stoma in the direction of hair growth may limit skin irritation.

Ostomy Care Products

Should I use a skin sealant?

A skin sealant, sometimes called barrier film, does not have to be used. The sealant puts a plastic like coating on the skin. It comes in the form of sprays, wipes, and gels. A skin sealant may help if you have skin that tears easily, have problems with leakage, or are using an ostomy skin barrier powder. Some people who have dry or oily skin find that their pouching system sticks better when they use a skin sealant. Most skin sealants contain alcohol and if the skin has an open area the sealant will cause a burning feeling when applied. Alcohol-free (non-sting) skin sealants are available.

A tip for use: Make sure the skin sealant dries completely before putting the pouching system on your skin.

Should I use adhesive remover?

Remember the basic rule that you do not want to use too many products on the skin. So if the pouching system can be gently removed with water then you do not need to use adhesive remover. Do use adhesive remover if you have skin that tears very easily. Sometimes people will use adhesive remover to prevent a build up of sticky residue on their skin. Adhesive remover often contains alcohol and feels oily. A tip for use: After using adhesive remover always wash well with water and a mild soap to remove the oily coating on the skin. Then rinse the skin well with water and dry completely.

Do I need to use a skin barrier paste?

Ostomy skin barrier paste is used as caulking to fill in gaps and creases. It will help even-out the skin surface around the stoma. This way the paste helps to make a better seal with the pouching system and prevent leakage.

You do not need to use paste if the skin around your stoma is smooth, you are getting a good fit with your pouching system, or you are not having any problems with leakage.Paste often contains alcohol and will cause a burning feeling if used on open skin. Tips for use: Apply the paste around the opening cut in the skin barrier, unless instructed otherwise. Use only a small bead of paste, like putting toothpaste on a brush. Let the paste sit for one minute (this gives the alcohol in the paste the chance to evaporate). Do not spread the paste. Do not use too much paste. When trying to remove paste from the skin let it dry a little first. Do not worry if a little bit of paste is left on your skin.

What are ostomy adhesives?

Ostomy adhesives like cements and sprays can have a latex or an acrylic base. They are used to increase the stickiness between the pouching system and the skin. Adhesives are NOT USED very often. When possible use latex-free products.

Tips for use: Only a light, even coating of an adhesive should be used. Give the adhesive time to dry completely before putting on the pouching system. It is important to follow the manufacturer’s directions. Many adhesives need to dry for three to five minutes. This helps to decrease the chance of chemicals hurting the skin.

When do I need to use skin barrier powder?

Ostomy skin barrier powder is used to dry a raw, weepy area on the skin. You only need to use powder if you are having a problem with your skin. Tips for use: Only a light dusting of an ostomy skin barrier powder should be used. Many people will dab or spray a skin sealant over the powder before putting their pouching system on to help it seal better.

What kind of skin barrier is best?

Some skin barrier wafers are called standard wear and others are extended wear. Your WOC nurse or health care provider will tell you what kind is right for you. In general, a standard wear barrier is used when the stool is semi-formed or formed. An extended wear barrier is usually used when a stoma drains urine or when a stoma drains stool that is loose or liquid. The extended wear barrier does not break down like a standard wear barrier, when it comes in contact with loose to liquid drainage.

You can order all your Ostomy products at the lowest cost online

Catheter-Related Urinary Tract Infection

Millions of people around the world use urinary catheters every day. The tubes running in and out of their bodies provide a safe way out for urine but leave people constantly open to the risk of infection.

A species of bacteria called Proteus mirabilis is particularly adept at building crusty scaffolds that eventually block the catheter tubes. We call these layers of bacteria biofilms and they are a serious problem; out of reach of the immune system and impenetrable to antibiotics, they thrive on medical devices.

An estimated 100 million catheters are fitted every year globally, a quarter of these in the US. They are by far the most commonly used medical devices that stay inside the body.

Up to half of people who use catheters long-term will at some point experience a blockage. This is bad news. When a catheter blocks, urine can no longer drain into the collection bag and so pushes back up from the bladder into the kidneys. There the bacterial infection builds where it can cause kidney failure, septicemia and death.

 

Many people who use catheters long-term do so at home, or in a care-home setting, where they don’t have access to clinical expertise. One of the advantages of our system is this visual clue, which can be spotted by anyone, regardless of their training.

The 2009 Centers for Disease Control and Prevention (CDC) guidelines for prevention of catheter-associated urinary tract infections (UTIs) recommends catheter use only for appropriate indications. Catheter use and duration should be minimized in all patients, especially those at higher risk for catheter-associated UTI (eg, women, elderly persons, and patients with impaired immunity). [3]

Catheters should be kept in place only for as long as needed. Indwelling catheters placed in patients undergoing surgery should be removed as soon as possible postoperatively. The use of urinary catheters for treatment of incontinence in patients and nursing home residents should be avoided.

The 2009 CDC guidelines recommend that clinicians avoid using systemic antimicrobials routinely to prevent catheter-associated UTI in patients requiring either short- or long-term catheterization. 

The 2009 Infectious Diseases Society of America (IDSA) guidelines for catheter-associated UTIs state that an indwelling catheter may be used at the patient’s request in exceptional cases and when other approaches to incontinence management have been ineffective. 

Long-term catheterization increases patient satisfaction but also increases mechanical complications. Contraindications include bleeding disorders, previous lower abdominal surgery or irradiation, and morbid obesity. Intermittent catheterization is an option, but most patients become bacteriuric within a few weeks; the incidence of bacteriuria is 1-3% per insertion.

According to the 2009 IDSA guidelines, if an indwelling catheter has been in place for more than 2 weeks at the onset of catheter-associated UTI and remains indicated, the catheter should be replaced to promote continued resolution of symptoms and to reduce the risk of subsequent catheter-associated infection.

Because infection rates are so high in people who use catheters, people are often given antibiotics to try to prevent infection. There are even catheters available that are impregnated with antibiotics. However, this is controversial given the increasing problem of antibiotic resistance: using antibiotics to prevent, rather than treat, infection can reduce their efficacy and contribute to resistance.

Below are the signs of infection:

  • cloudy urine
  • blood in the urine
  • strong urine odor
  • urine leakage around your catheter
  • pressure, pain, or discomfort in your lower back or stomach
  • chills
  • fever
  • unexplained fatigue
  • vomiting

Infections can be difficult to diagnose but if you experience any of the above symptoms, do not hesitate to contact your health care provider.

 

You can order all your catheter supplies here

Children and Catheters

Being the parent of a child with bladder emptying problems can be stressful. Aside from all the regular tasks of parenting, you also need to teach your child how to empty his/her bladder, probably with a catheter. You are also the person who has to make sure that your child is catheterized regularly, even when they are at daycare, school, or with friends or relatives.

Using a catheter to empty your child’s bladder

You will need to help your child catheterize until they are about five years old or until advised otherwise by your health care provider. If your child has spina bifida, they may not be able to empty their bladder naturally. Your doctor or nurse may prescribe the use of an intermittent catheter- a thin plastic tube that is inserted through the urethra and into the bladder.

Why emptying the bladder is so important

It’s important that you and your child both understand why bladder emptying is so important and develop a good bladder management routine.
The goals of good bladder management is to:

Prevent damage to the kidneys and prevent infections
Improve the child’s quality of life
Help the child become independent

 

If your child’s bladder is not emptied regularly, it may cause infections. Even small amounts of urine left in the bladder can cause infections.Getting started
Before starting any new bladder management routine, you should always consult your health care provider. Together with the doctor or nurse, you will decide what type of catheter best fits you and your child’s needs. They will also advise on how often you should catheterize. Typically, the bladder needs to be emptied 4–6 times a day – but this may depend on fluid intake and physical activities.

Helping your child learn

When your child starts to show an interest in self-catheterization – normally between the ages of three and five – you may consider to begin teaching them to empty their own bladder.

 

If you have a young child living with a catheter, click this link for an insightful story you can enjoy reading with them. Lifeline Medical Supply is dedicated to helping your or your loved ones live life to the fullest. You can order all your pediatric catheter supplies here.

Normal Life?

It’s possible to live a relatively normal life with a long-term urinary catheter, although it may take some getting used to at first.

Your doctor or a specialist nurse will give you detailed advice about looking after your catheter. You’ll be given a supply of catheter equipment when you leave hospital, and you’ll be told where you can get more supplies from. Catheter equipment is generally available on prescription from pharmacies.

You’ll also be shown how to empty and change your equipment.

Your regular activities

Having a urinary catheter shouldn’t stop you from doing most of your normal activities. You’ll be advised about when it’s safe for you to go to work, exercise, go swimming, go on holidays, and have sex.

If you have an intermittent catheter or a suprapubic catheter, you should be able to have sex as normal.

Indwelling catheters can be more problematic, but it’s still usually possible to have sex with them in place. For example, men can fold the catheter along the base of their penis and cover them both with a condom.

In some cases, you may be taught how to remove and replace the catheter so you can have sex more easily.

Intermittent catheters

Intermittent catheters are usually designed to be used once and then thrown away.

How to use them varies from person to person. You may be advised to use them at regular intervals spaced evenly throughout the day, or only when you feel you need the toilet.

 

Indwelling catheters

Indwelling catheters can either drain into a bag attached to your leg, which has a tap on the bottom so it can be emptied, or they can be emptied into the toilet or suitable receptacle directly using a valve.

You should empty the bag before it’s completely full (around half to three-quarters full). Valves should be used to drain urine at regular intervals throughout the day to prevent urine building up in the bladder. Leg bags and valves should be changed every seven days.

The bag can be attached to your right or left leg, depending on which side is most comfortable for you.

At night, you’ll need to attach a larger bag. Your night bag should either be attached to your leg bag or to the catheter valve. It should be placed on a stand next to your bed, near the floor, to collect urine as you sleep.

Depending on the type of night bag you have, it may need to be thrown away in the morning or it may be emptied, cleaned and reused for up to a week.

The catheter itself will need to be removed and replaced at least every three months. This is usually done by a doctor or nurse, although sometimes it may be possible to teach you or your carer to do it.

 

Preventing infections and other complications

Having a long-term urinary catheter increases your risk of developing urinary tract infections (UTIs), and can also lead to other problems, such as blockages.

To minimise these risks you should:

  • wash the skin in the area where the catheter enters your body with mild soap and water at least twice a day
  • wash your hands with warm water and soap before and after touching your catheter equipment
  • make sure you stay well hydrated – you should aim to drink enough fluids so that your urine stays pale
  • avoid constipation – staying hydrated can help with this, as can eating high-fibre foods, such as fruit and vegetables and wholegrain foods
  • avoid having kinks in the catheter and make sure any urine collection bags are kept below the level of your bladder at all times

Lifeline Medical Supply carries most major brands at the lowest cost to make life easier for those with urinary catheters so you can live your life! You can order your low cost catheter supplies here.

Enjoy Summer and Swim, Even If You Have an Ostomy

There is nothing better than getting in to cool water in the ocean, lake or pool to take a break from the summer heat. Don’t be limited due to your ostomy. Colostomy patients can do virtually everything that people without one can. In fact, a great number of patients can even do more than many people without a stoma. The only limitation, if there is any, is the limitation that the patient has set for him or herself. In other words, if you are a colostomy patient, try as much as is possible not to limit yourself to certain activities that had been part of your lifestyle before your surgical procedure.

Swimming is a great way for colostomy patients to keep fit and maintain good energy levels. To swim with a colostomy bag attached is fine as long as some securing ostomy product is used, or swimwear that fits firmly around the waist/abdomen is worn.

If you are worried about discretion, there are special small colostomy bags available which are very discrete and ideal for swimming. Therefore, there is no reason to think there’ll be “accidents” in the pool. The Coloplast Mio 1-Piece Closed Pouch has a “Full-circle filter for proven reduction of ballooning.” If the filter isn’t the issue, and it’s just about keeping the barrier waterproof, there are barrier strips you can use. Coloplast Brava® Elastic Barrier Strips, which come in a curved shape, Y shape or straight can be very helpful.

It is advisable not to stay in the water for more than forty five minutes. A prolonged stay in water is not the best for colostomy bag face-plates.Being in water for too long makes the edges of the faceplate (a waxy plate with adhesive) absorb water. If the plate is exposed to water long enough, the wax will start to soften and turn into a putty textured stuff. When this happens, the faceplate starts to loosen, and will come off eventually giving room for leakages or foul odor.

Having a colostomy bag on shouldn’t keep stoma patients from having a great time swimming nor having fun at the beach.

 

We carry a wide variety of Ostomy supplies and the lowest cost. Shop now.

What Are the Potential Complications of Urinary Catheters?

According to an article in BMC Urology, indwelling urinary catheters are the leading cause of healthcare-associated urinary tract infections (UTIs). Therefore, it’s important to routinely clean catheters to prevent infections. The symptoms of a UTI may include:

  • fever
  • chills
  • headache
  • cloudy urine (due to pus)
  • burning of the urethra or genital area
  • leaking of urine out of the catheter
  • blood in the urine
  • foul-smelling urine
  • low back pain and achiness

Other complications from using a urinary catheter include:

  • allergic reaction to the material used in the catheter, such as latex
  • bladder stones
  • blood in the urine
  • injury to the urethra
  • kidney damage (with long-term indwelling catheters)
  • infection of the urinary tract, kidney, or blood (septicemia)

How Do You Care for a Urinary Catheter?

Be sure to clean both the catheter and the area where the catheter enters the body with soap and water to reduce the risk of a UTI. You should also drink plenty of water to keep your urine clear or only slightly yellow. This will help prevent infection.

Empty the drainage bag used to collect the urine at least every eight hours and whenever the bag is full. Use a plastic squirt bottle containing a mixture of vinegar and water or bleach and water to clean the drainage bag.

Living With A Urinary Catheter

This site has one goal – to help those who must live with a urinary catheter. Whether you have a urethral or suprapubic catheter for just a few days or weeks, or must wear one long-term, I hope to pull together all the useful information, tips and suggestions that I can find to make your life a little easier. By the way, just to get this out of way up front – I am not a medical professional, doctor or nurse. I am a patient who is living with a catheter.

The main reason I put this site together is that I recently had to have a suprapubic catheter put in, but had a difficult time finding information to help me understand my new reality. There are a few forums out there, but the ones I could easily find were incredibly unresponsive and mostly inactive. I searched and read as much as I could find on the internet about how to best deal with all the logistics, lifestyle, and uncertainty. But what little I could find was either hyper-academic (hard to understand for regular, non-medical people like me), unhelpful, or just plain wrong.

So after six weeks, one urinary tract infection, two emergency room visits, and one catheter “up-sizing” procedure, I felt like I had pulled together a fair amount of useful information and experience that could be helpful to other folks. [UPDATE: Now it’s 4 years later:). I continue to update this site and engage with the community that’s built up around it. I’m doing my best to keep everything up to date. Thanks!]

My hope is that this site can help to ease the stress for those new to living with a catheter by providing easy-to-understand information that is also easy to find – basically the stuff that would have made my life easier (and less painful) had it been out there when I first came home with a tube sticking out of my abdomen and my “exobladder.”

My goal is to supplement my own experiences with excellent and valid medical information dealing the latest on things like urinary catheters, types of catheters (Duette, Foley, Intermittent, coudé or Texas/condom catheters), surgical techniques for things like urethral strictures (my particular issue), enlarged prostate procedures, UTIs etc.

I am obviously not going to know everything or have all the information, so I hope that folks who visit this site can help keep this information current, correct and comprehensive.

Cheers!

Ken

*Speaking of my not knowing everything, note this DISCLAIMER. I am NOT a doctor or nurse, or any kind of medical professional. All advice and opinions are mine.

 

Original article is posted from https://livingwithacatheter.com/

 

 

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Travel tips for those who use catheters

Travel tips for those who use catheters

You can safely manage your bladder with Clean Intermittent Catheterization (CIC) both at home and on your travels. Here we have gathered some advice so you can be prepared, and avoid the need for troubleshooting on your journey.

Packing for the trip

  • Bring extra catheters

    Always pack extra catheters. Your journey home can be delayed, or other contingencies may occur that cause the need for more catheters.

    Tip! Bring extra hand sanitizer. Wet wipes are also good to have.

  • Catheters in your carry-on bag

    Ensure that you pack extra catheters in your carry-on bag in case you lose the rest of your luggage. It’s a good idea to ask if your travel companion can bring catheters on your behalf in their luggage.

During your travel

  • Being discreet

    Bring a travel certificate (Medical Validation Certificate) from your catheter provider. This explains in different languages why you are carrying catheters in your luggage. There is also a section on the certificate that urges the customs service staff and TSA officials to show discretion.

  • Medication abroad

    If you take any medication, it is wise to pack this in your carry-on bag. Be aware that some medication requires certain certificates. Ask at your pharmacy or your doctor.

  • Empty the bladder on the flight or train

    You might fear long journeys, where you know you will need to empty your bladder at some point, and the space is limited in both the seat and in the bathroom.

    One solution is to use an indwelling catheter, on a temporary basis, but there are other solutions as well, if you can’t leave your seat. It is possible to attach a urinary bag to the catheter and use a blanket to cover your lap. There are good kit products on the market. The urine will be collected in a plastic bag, and can be taken away by your traveling companion.

When you are abroad

  • If you run out of catheters

    If you realize that you don’t have enough catheters during your trip, you can contact the local office of your catheter provider. In most cases they can help you out.

  • Clean water

    If you travel in countries with poor water quality, you can bring ready-to-use hydrophilic catheters.
    Don’t forget to wash your hands before CIC – and after!

    Tip! If the water quality at your destination is good enough to drink, you can use it for your catheter, but note that it should be cold water to reduce the risk of bacterial infection.

    Tip! If the tap water is not good, you can use bottled water.

Things to mark off your checklist

I have chosen the catheters with consideration given to my travel destination

I have packed enough catheters

I have divided the catheters between my carry-on bag and my other luggage

I have also brought hand sanitizer and wet wipes

I have a travel certificate for my catheters

Living with a urinary catheter

What is intermittent self catheterisation (ISC) and why is it used?

There are two main types of catheter:

  • intermittent catheter, where the catheter is temporarily inserted into the bladder and removed once the bladder is empty
  • indwelling catheter, where the catheter stays in place for many days or weeks

Intermittent catheterisation is a technique used to empty the bladder at regular intervals, varying from several times a day to once a week, depending on fluid intake, how quickly remaining (residual) urine increases in the bladder, and whether any urine is passed urethrally (the tube that leads from the bladder through which urine passes). Residual urine is the volume of urine left in the bladder immediately after someone has been to the toilet. Incomplete bladder emptying can lead to incontinence, urgency, frequency and recurrent infections. The catheter is temporarily inserted and removed once the bladder is empty. A person’s partner or a nurse may pass the catheter but many people master the technique themselves. Intermittent catheterisation is almost always done through the urethra (the tube through which urine passes). Occasionally it is done through the abdominal wall, called a Mitrofanoff (see ‘Using a Mitrofanoff for intermittent self catheterisation‘).

The catheter is removed after the flow of urine is stopped. Unlike the indwelling Foley catheter, intermittent catheters have no balloon on the tip so cannot stay in place unaided. Urine will flow out of the bladder and through the catheter, and can then be guided into the toilet. It should be painless but some people experience pain or discomfort at times.Studies suggest that clean intermittent catheterisation is the safest method of emptying the bladder because this method has the lowest potential for urological complications (Weld and Dmochowski 2000; Wyndael 2010). The consultant we interviewed is convinced that the intermittent catheter is the best type. He called it ‘the gold standard’ because the bladder can be emptied completely, thus reducing the risk of infection, which is common when people use an indwelling catheter.

Some catheters are ‘self-lubricated’- after it is soaked in water for a short time it becomes slippery enough to insert. With others, a lubricating jelly is used to ease insertion. Most catheters nowadays are ‘single use’, but some people still use the same catheter more than once, storing it in a clean place when not in use. Based on current research it is not possible to state that one type of catheter used for intermittent self catheterisation (ISC) or one technique or strategy is better than another (Moore, Fader and Getliffe 2007).

Peter was diagnosed with multiple sclerosis in 1993. From about 2003 he had problems withincontinence so started intermittent self catheterisation.

Carol used intermittent catheterisation on several different occasions because of problems brought on by bladder endometriosis.

References:
Moore K, Fader M, Getliffe K. (2007) Long-term bladder management by intermittent catheterisation in adults and children. Cochrane database systematic review  October 17; 4: CD006008

Weld K. &Dmochowski R. (2000) Effect of bladder management on urological complications in spinal cord injured patients. The Journal of Urology163, 768-772

Wyndael J. et al. (2012) Clean intermittent catheterization and urinary tract infection: review and guide for future research. BJUI110; E910-E917

Read more: http://www.healthtalk.org/peoples-experiences/long-term-conditions/living-urinary-catheter/what-intermittent-self-catheterisation-isc-and-why-it-used#ixzz4ilXuq0Jd
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