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.
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
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