Urination through catheterisation
Catheterisation is mostly applied in people with spinal cord injury with a flaccid bladder. A local medical sedation can sometimes enable catheterisation in patients with a spastic bladder. In order to live as independently as possible, it is important to learn self-catheterisation – this is also feasible for tetraplegics with a low level of spinal cord injury.
How often do I have to catheterise?
At the beginning, self-catheterisation is required every 3 – 4 hours – also at night. The intervals between catheterisations are determined by the fullness of the bladder. To avoid the risk of bladder distension, the maximum filling should not exceed 500 ml of urine. By observing and adjusting one’s drinking habits, the frequency of catheterisation can be adapted individually – this generally enables a longer break at night.
Catheterisation must be carried out under clean conditions. Careful personal hygiene is therefore of the utmost importance. If the catheterisation does not take place at home, but in a public toilet for example, it is important to comply with the hygiene standards. The bladder emptying might require other material than it does at home.
The right product
There are a variety of catheters (with or without surface coating), separate lubricants and urine pouches available on the market that can be purchased from numerous suppliers. Accessories such as pant holders for bladder emptying while sitting in a wheelchair or cathing mirrors for women make catheterisation easier. There are numerous alternatives in the event of material problems. The material needed can be obtained from companies specialised in incontinence articles or from medical stores.
It is important to bear in mind that insurance companies do not pay for all products available on the market.
Do I have to stick to the products presented to me once or can I try other products at home?
There are lots of different products available. Please consult your urologist before making any changes with regard to procedures or products.
Should catheterisation at home be as complex as it is in hospital?
No. The risk of cystitis is reduced with catheterisation at home. It is important to disinfect your hands before and after the catheterisation and to disinfect the urethra.
What if I go on a trip?
Self-catheterisation is also possible when you are on a trip. The risk of infection won’t increase if you stick to the hygiene requirements, just as you do at home. If self-catheterisation is not possible, e.g. during a flight, there is also the possibility to use a permanent catheter as a temporary measure.
Before you go on holiday, consider how much material you will require. Unfortunately, the material is not available in all countries.
What should I do if I notice blood at the tip of the catheter, in the urine bag or coming out of the urethra?
The bleeding is probably caused by mucous membrane injuries. These might happen when inserting the catheter tip or they might be caused by an increased suction that occurs if the catheter is not clamped when removing it. Speak to your GP or urologist if the bleeding is continuous or heavy.
What if I cannot get the catheter to go into my bladder?
Men are particularly likely to be affected by a contraction of the sphincter muscle. Try to cough or to breathe in and out deeply. This helps to relax the sphincter muscle.
Do not pull back the catheter, wait a few minutes, and then try again to insert it – without force. If you do not succeed, stop trying and try again later. If you continue to have difficulties, please contact your urologist.