HOW TO CATHETERIZE YOURSELF USING CLEAN TECHNIQUE (Male Patient)

HOW TO CATHETERIZE YOURSELF USING CLEAN TECHNIQUE (Male Patient)

GENERAL COMMENTS

The purpose of self-catheterization is to allow you to completely empty your bladder at regular intervals without the need for wearing a continuously draining catheter. Self-catheterization, by doing away with the continuously draining catheter, lowers the infection rate, prevents over-distension of the bladder, and frees you from having to wear a drainage bag.

Practice self-catheterizing in the position that you will be using the most - sitting, standing, in a wheelchair, or lying down. Empty your bladder of urine completely each time, and as often as directed by your doctor. Don’t miss a catheterization. It’s okay to be early, but never be late.

GOALS

As a rule the goal of self catheterization is to retrain your bladder to empty properly, if possible. More specific goals are to keep post-urination residual urine volumes (the amount you catheterize) under 3 1/2 ounces or 100 ccs. At the same time we would like to see your self urination amounts about double the catheterized amount.

Overdistension

Allowing the bladder to overdistend with too much urine can delay healing. As a rule, we do not like to see more than 500 ccs, 16 ounces or one pint of urine in the bladder at any time. If your volume (urinated plus catheterized) is consistently more than 16 ounces you must catheterize more often or reduce your fluid intake to some degree.

Timing of catheterization

You will need to catheterize yourself every [4] [6] [8] ____ hours or [as needed].

Try to urinate to empty your bladder as best possible, but do not strain. Then catheterize yourself immediately. At regular intervals you should measure the amount of urine that you urinated and then the amount that you obtained with the catheter.

At other times of the day, if you feel the urge to urinate, you may empty your bladder as completely as possible and NO catheterization is required. If you feel the urge to urinate but you cannot, you can always catheterize yourself.

TECHNIQUE

1. Gather the necessary equipment: towelettes (or a soapy washcloth and a wet washcloth for rinsing), a towel, a container for collecting the urine (if toilet is not available), water-soluble lubricating jelly, and a catheter (sizie is #16 French -- but catheter size may vary). You may use a coude‚ or elbow shaped catheter as instructed by your doctor or nurse. You may also have on hand an anesthetic lubricant such as 'lidocaine jelly'. Do not use petroleum jelly or Vaseline!

2. Wash your hands, then assume a comfortable position in bed or on the toilet. If you are in bed, place a towel under your hips to protect the bedding.

3. Wash the head of the penis with a towelette or soapy washcloth. Then rinse with a wet washcloth.

4. Apply lubricant to the insertion end of the catheter (lubricate about two inches of tubing). If you lubricate more than that, you may have trouble holding the catheter firmly as you insert the catheter. Use a WATER soluble lubricant such as KY Jelly or Lubafax (not Vaseline or petroleum jelly).

5. Use your nondominant hand to hold the shaft of the penis straight and upward (about a 45 degree angle from the stomach). This position makes catheter insertion easier.

6. Hold the catheter in your dominant hand and insert it into the urinary opening about eight to ten inches into the bladder. Lengths vary, but when the bladder is reached, urine will flow easily. The sphincter muscle is at the “door” to the bladder. Sometimes the “door” is closed (or tight) and the catheter cannot enter the bladder easily. Gently “knock” on the “door” with the catheter by using constant gentle pressure on the sphincter muscle. Take a deep breath or try changing the position you are holding the penis in order to get the muscle to relax. When it relaxes, the “door” will “open” and the catheter will slip into the bladder.

7. When urine starts to flow, let the penis return to its natural position. Hold the catheter in place until the bladder has been drained. When the urine flow begins to taper off, slowly withdraw the catheter. (As you do, you may note an increase in urine flow as urine pockets are drained.)

8. Remove the catheter. Wash it in warm, soapy water, and rinse it thoroughly. Then air-dry it and store it in a dry paper or cloth towel until you need it again. Store the catheter in a rolled up towel or facecloth, a toothbrush holder, or anywhere that is convenient. Have a catheter with you at all times. Keep one at school, at work, and one in the car, too. It is more important to catheterize on schedule than to worry about catheter cleanliness. A quick rinse with soap and water before use will do. At the end of two weeks, discard the catheter (time varies). However, if it becomes hard to clean before then, use a new one.

9. Look at the urine for changes. If you see any change in color or odor or if the urine appears cloudy, contact your nurse or doctor. Also call if you have:

* significant bleeding

* unusual or increased sediment in the urine

* back or abdominal discomfort

* fever of 101 degrees or greater

* trouble passing the catheter

* increased discomfort when passing the catheter

* leakage of urine in between catheterizations.

10. Catheterize periodically to maintain bladder volumes around 12 - 16 ounces (about a pint), which is the best volume for maintaining a healthy bladder and kidneys.

Catheterization outside the home

Self-catherization can be done in public bathrooms as well as bathrooms at other people's homes. The procedure is the same and the equipment must be carried with you. Usually a zip-loc bag or similar containing package works best. One bag should be made for each catheterization.

-Zip loc bag

-clean catheter

-washcloth or wipes (towelettes)

-small tube of K-Y jelly

Buying new catheters

Each catheter should last 2-4 weeks. They may be cleaned with soap and water and rinsed well. Discard any catheter that becomes faded, cracked or if pieces of rubber are falling off. You should buy 2-3 catheters at a time.

DATE____________________________

MEDICAL SUPPLIES PRESCRIPTION

Rx:

PATIENT NAME: ________________________________________________

DIAGNOSIS: __________________________________________________

ESTIMATED TIME OF NEED:___________________________ [ ] INDEFINITE

NOTE: __________________________________________________________

________________________________________________________________

[ ] Urethral Catheters Disp: # _________________ [ ] Q.S. 3 months

size/type___________________

[ ] K-Y Jelly Disp: # _________________ [ ] Q.S. 3 months

[ ] Box of towelettes Disp: # _________________ [ ] Q.S. 3 months

[ ] Tubing Disp: # _________________ [ ] Q.S. 3 months

[ ] 2% Xylocaine Jelly Disp: # _________________ [ ] Q.S. 3 months

[ ] Skin cleaner/prep Disp: # _________________ [ ] Q.S. 3 months

[ ] Saline for irrig Disp: Disp # ______________L [ ] Q.S. 3 months

[ ] Water for irrig Disp: Disp # ______________L [ ] Q.S. 3 months

[ ] Toomey Syringe Disp: # _________________ [ ] Q.S. 3 months

[ ] Urinal/Drain Bottle Disp: # _________________ [ ] Q.S. 3 months

[ ] Incontinence Pads Disp: # _________________ [ ] Q.S. 3 months

[ ] Leg Bags Disp: #_________________ [ ] Q.S. 3 months

[ ] ______________ Disp: # __________________ [ ] Q.S. 3 months

Additional:

PHYSICIAN_____________________________SIGNATURE ________________________