Continuous Bladder Irrigation - Types and Complications

Introduction

A urinary bladder is nothing but a pouch or a bag-like structure present in the lower abdominal region. It lies immediately below the tubes that transport the urine from the kidneys. When viewed through a cystoscope, the bladder looks like a balloon. It consists of muscles that contract and relax with the passage of urine. As a result, the urine gets transported from the bladder to a tube known as the urethra. Hence, the main function of the urinary bladder is to transport urine from the kidneys to the outside body.

What Is a Continuous Bladder Irrigation Procedure?

As the name suggests, continuous bladder irrigation is a therapeutic procedure used to flush out the irritants from the urinary bladder using a sterile liquid. Doctors use this procedure frequently to remove the blood clots formed in the urinary system after the surgery. It also helps the patient remove urine from the body simultaneously. It is a simple procedure wherein a sterile solution enters the bladder through a thin tube. Finally, the fluid is removed and collected in a bag. This procedure gets completed in several days in the hospital. The urinary system works to filter the waste from the blood. It creates urine to expel toxins from the body. The bladder is a balloon-like structure present in the lower abdominal region. It stores the urine until it exits through the urethra.

Why Is Continuous Bladder Irrigation Done?

Sometimes, doctors use continuous bladder irrigation procedures to remove the blood clots formed after the urinary surgery. The surgeries that might cause blood clot formation in the urinary bladder include bladder surgery and prostate surgery, including the transurethral resection of the prostate. Sometimes, blood clots, tissue pieces, and other debris might circulate and accumulate in the urinary bladder. This debris and clots obstruct the urine flow. Mostly, patients use a catheter to urinate after urinary surgery. The blood clots might obstruct the urine flow through the catheter also. Urine blockage can result in kidney infections, pain, and kidney damage. Therefore, a continuous bladder irrigation procedure is used to

• Administer medications into the urinary bladder.

• Dissolve the stones present in the urinary bladder.

• Soothe an irritated and inflamed lining of the bladder.

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What Are the Different Types of Bladder Irrigation Procedures?

Bladder irrigation procedures can be categorized into two types, continuous and intermittent. As the name suggests, continuous bladder irrigation is done over a few days. In contrast, intermittent bladder irrigation is done occasionally or when the need arises. The patient must not be worried about the procedure as all the equipment used is sterile and protects him from germs. Though the risk of infections is minimal, the instruments must be used carefully before, as the germs in the air might come in contact with the skin before the instruments for irrigation are inserted.

What Happens Before the Continuous Bladder Irrigation Procedure?

Continuous bladder irrigation is a simple procedure, so the patient does not have to undergo any surgical trauma. The doctor will place a tube known as the catheter into the patient’s urinary bladder. If the patient has undergone any urologic surgery, he might already have the catheter in place. In simple terms, the catheter is nothing but a thin tube inserted into the urethra to drain the urine. Therefore, one end of the catheter lies in the body, whereas the other end lies outside the body on the leg. The catheter comprises three openings or ports which have the following functions:

• Expel urine and other liquids from the body.

• Inflate the balloon attached to the catheter so that it remains open when inserted into the bladder.

• Carry the solution into the urinary bladder to flush out the debris.

What Happens During the Continuous Bladder Irrigation Procedure?

A urologist usually performs the continuous bladder irrigation procedure. The doctor hangs two bags containing the sterile solution or salt water on the poles. These bags might contain the medications if required. Next, a sterile catheter is taken and cleaned. One end of the catheter is attached to the bag, and the other end is attached to any empty bag outside the body. This empathy bag collects the fluid flushed out during the bladder irrigation procedure. The third opening of the catheter is infrequently used, but it helps keep the catheter in place. During the procedure, the doctor will:

1. Check the urine color.

2. Control the speed of the saline solution meaning the doctor will alter the speed as per the requirement.

3. Empty the drainage bag after it is one-third to one-half full.

4. Measure the output of urine.

5. Evaluate the debris and blood clots in the urine.

6. Replace the bag of saline when it becomes empty.

In the initial stages, the urine might have blood and few debris. However, the urine becomes pink and clear after a few days. The patient must remain careful and avoid pulling the catheter. He must inform the doctor if he feels pain or notices the fluid leaking from the catheter.

What Happens After the Continuous Bladder Irrigation Procedure?

The doctor will end the procedure as soon as the debris and blood clots get cleared from the urinary bladder. The patient will have clear or pink-colored urine for one or two days after the procedure. Finally, the doctor will remove the catheter and other bags from the patient’s body after the procedure is complete.

What Are Some of the Complications of the Procedure?

The patient hardly presents with any risks or complications after the procedure. However, the following complications might arise:

• The catheter might get blocked, so the doctor must repeatedly replace it.

• The risk of bacterial entry and urinary tract infections is high.

• Males might suffer from paraphimosis (a condition wherein the foreskin gets stuck behind the penis).

• Tear or bladder perforation.

When Should the Patient Consult the Doctor After the Procedure?

After the continuous bladder irrigation procedure, the patient must consult the doctor regarding the following:

1. Blood in the urine (hematuria).

2. Burning sensation while passing urine.

3. Inability to pass urine.

4. Pain.

Conclusion

Continuous bladder irrigation is a commonly used procedure because it helps remove blood clots and debris from the bladder by a simple irrigation method. Though the procedure is safe and does not pose any major risk, the patient must remain careful before and after the procedure. Consult a doctor to know more about the bladder irrigation procedure.