What Is the Meaning of Self-Catheterization?
As the name suggests, self-catheterization is a process that involves the drainage of urine through a catheter and is done by the patient himself. Normally, the urinary tract consists of immune cells that protect it from various diseases. However, the problem arises when these immune cells fail to function, making the urinary system vulnerable to infections. Most medical conditions that affect the urinary system interfere with urine flow. As a result, the patient experiences difficulty passing urine. In such a situation, a tube known as a catheter is inserted into the urinary bladder through the urethra. The urine flows through the catheter into the toilet or a container. After the bladder is empty, the patient slowly removes the catheter. These steps need to be repeated throughout the day until the patient starts urinating normally.
What Are the Different Types of Urinary Catheterization?
Urinary catheterization is done to facilitate the passage of urine after surgery or when the urine flow has become restricted. The different types of urinary catheterization are listed in the table below:
Why Do Patients Require Self-Catheterization?
Certain medical conditions interfere with the normal functioning of the urinary system and restrict urine flow. As a result, it becomes difficult for the patient to empty the bladder. The following conditions require self-catheterization:
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Cystectomy - Cystectomy is a procedure in which the urinary bladder is removed surgically. It is impossible for the patient to pass urine without the bladder. So, a catheter is inserted and left in place after the surgery to facilitate urine drainage.
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Benign Prostate Hyperplasia - It is a condition in which the prostate gland becomes enlarged. As the gland is located close to the neck of the urinary bladder, it restricts urine flow. As a result, the patient needs to insert a catheter to drain the urine.
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Astrocytoma - Astrocytoma is a central nervous system tumor, including the brain and spinal cord. A network of nerves connects the bladder to the brain and spinal cord. This communication gets disturbed when the tumor develops in the brain and spinal cord. As a result, the urine remains in the bladder, and the patient does not get the sensation of passing urine. Therefore, the patient requires self-catheterization to empty the bladder.
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Neurogenic Bladder -The nerves that carry the message between the bladder and the brain are damaged in a neurogenic bladder. In such a situation, self-catheterization is required to drain the urine.
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Stroke - Stroke is a condition in which the blood supply to the brain is blocked. When the brain does not receive sufficient blood, it fails to send signals that a person needs to urinate. As a result, a catheter drains urine from the body.
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Urinary Retention - There are several causes of urinary retention, including urethral strictures, bladder infection, and ureteropelvic junction obstruction. Patients suffering from these conditions are unable to pass urine and require self-catheterization.
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Severe Constipation - Constipation is a condition in which the stools remain within the rectum, and bowel movement becomes difficult. Hard stools exert pressure on the bladder and restrict urine flow. As a result, the urine is drained from the body by a catheter.
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Urinary Retention - There are several causes of urinary retention, including urethral strictures, bladder infection, and ureteropelvic junction obstruction. Patients suffering from these conditions are unable to pass urine and require self-catheterization.
How Should the Patient Prepare for Self-Catheterization?
Use the catheter only after consulting the doctor to know the right one. The catheters are available in different shapes and sizes, but usually, they are six inches long. Catheters are easily available at medical stores. The patient will also require small plastic bags and gels like K-Y jelly or Surgilube. Do not use petroleum jelly for lubrication. After the patient has purchased the correct catheter, he must follow the given steps:
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Go to the bathroom and urinate the traditional way.
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The patient must wash his hands thoroughly with soap and water for 20 seconds. If hand sanitizer is used, cover them with it and rub them until they become dry.
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Next, the patient must clean his penis with soap and water and dry it with a towel.
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Remove the packaging of the catheter and keep it on a clean surface.
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If the catheter is not pre-lubricated, apply a lubricant over the tip of the catheter.
How Does the Patient Perform Self-Catheterization?
The steps of performing self-catheterization are similar for males and females. Sometimes, females might need a mirror to check the urethral opening. The steps of self-catheterization are listed below:
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Sit or squat over the toilet. Females might prefer to stand near the toilet.
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Insert the lubricated end of the catheter into the urethra by applying a small pressure.
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Hold the opposite end of the catheter near the toilet.
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Slowly insert the catheter until it reaches the bladder.
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As the catheter reaches the bladder, the urine starts flowing out.
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Insert the catheter a few more inches (usually 2 inches).
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Make sure the catheter remains in place until the urine flows out.
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When the urine stops, remove the catheter slowly.
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Wash the tip of the penis with soap and water, and pat it dry.
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After the procedure is complete, the patient must wash their hands with soap and water to prevent infection.
How to Clean the Catheter?
There are a variety of catheters available in the market. Some can be reused, while some need to be discarded after one use. If the patient plans to reuse the catheter, it must be cleaned daily. Ensure that the catheter does not touch the bathroom surface, as there are chances of infection. The steps for cleaning a catheter are listed below:
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Wash hands with a soap solution and water.
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Rinse the catheter with a vinegar solution (one-part vinegar and four parts water). The other way to clean the catheter is to soak it in a hydrogen peroxide solution for 30 minutes.
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Rinse the catheter with cold water.
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Hang the catheter near the towel and let it dry.
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After the catheter becomes dry, store it in a new plastic bag.
What Are the Complications of Self-Catheterization?
Though self-catheterization is a simple procedure, the patient might have some complications. For example, if the procedure is not performed correctly, the following complications arise:
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Bladder Spasm - Bladder spasm is a condition in which the muscles of the urinary bladder contract without any warning. As a result, the urine leaks out without any warning. Some people only experience urine leakage, while some might present with pain and a burning sensation while urinating.
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Kidney Infection - Kidney infection is additionally referred to as pyelonephritis. It is a urinary tract infection that spreads from the urethra to the kidneys. The inflammation of the kidneys that occurs due to bacterial infection is known as pyelonephritis. It is commonly seen in women and can cause permanent damage to the kidneys if not treated at the right time. The bacteria named Escherichia coli (E.coli) is the main culprit behind the infection in the majority of the cases.
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Urethral Strictures - The urethra is a tube that connects the bladder to the outside world. Urethral stricture or narrowing of the urethra might occur if the catheter is forcefully inserted. When the urethra becomes narrow, the urine cannot flow out of the body. As a result, the danger of urinary tract infections increases.
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Urinary Tract Infections - The risk of urinary tract infections increases with self-catheterization. The bacteria can easily enter the urethra through the catheter and cause infection. Therefore, it is recommended to clean the catheter after every use. Also, discard the catheter after it becomes dry and brittle.
When Must the Patient Consult the Doctor?
If the patient finds the self-catheterization procedure difficult, he can immediately report it to the doctor. For example, if the following problems arise, inform the doctor immediately:
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Bladder spasm.
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Urinary incontinence.
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Hematuria (blood in the urine).
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Difficulty in using the catheter.
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Dysuria (painful urination).
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Skin rash.
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Urinary tract infections.
Conclusion:
The patients prefer self-catheterization or clean intermittent catheterization because it can be done at home. Also, the patient does not have to visit the hospital for the procedure. A catheter is a tube-like structure that needs to be inserted into the urinary bladder. It helps to drain the urine into the toilet or the container. The process of self-catheterization is simple and does not require any special equipment. The patient needs to purchase a catheter and a disposable bag easily available at all the medical stores. However, the procedure should be done after proper training to avoid complications. If the problem is severe, surgical intervention might be required. Consult the doctor to know more about the self-catheterization procedure.
