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Clean intermittent self catheterization
 
SubjectContents
Definition 
Alternative Names How to perform CISC (women); CISC; How to perform CISC (men)
Information SHORT TERM (INTERMITTENT) CATHETERS: Some people may require catheterization for a short period of time or on an occasional basis. Intermittent short-term catheterization may be necessary for people with neurological disorders, women after certain gynecological surgeries, and anyone who is unable to properly empty their bladder. The goal of intermittent catheterization is to prevent urinary tract infections while still completely emptying the bladder. Most people are able to learn to perform this procedure, which is often called clean intermittent self catheterization (CISC). To perform CISC, the person performing the catheterization must learn the basic location of the important urological landmarks. Additionally, the person who will be performing the CISC must have the physical ability to reach the urethra and must be able to manipulate the equipment. People who are unable to visualize the urethra, may be taught how to feel for the proper location of the urethral meatus. Catheters that are used for CISC are slightly different than the catheters used for indwelling (long-term) catheterization. CISC catheters are straight plastic tubes without the side balloon inflation port and balloon that are used to keep the indwelling catheters in place. The CISC catheters are more rigid than an indwelling catheter, making insertion a little easier. The CISC catheters may be a clear plastic, or a softer red rubber material. These catheters also come in a variety of sizes. Although all catheters are intended to be disposable, one use products, some CISC catheters can be re-used. Most insurance plans will not cover the cost of these catheters. Therefore, your urology nurse may recommend use of the red rubber catheters, which can be re-used. HOW TO PERFORM CISC (MEN): 1. Assemble all equipment: catheter, lubricant, drainage receptacle. 2. Wash your hands and clean the penis and urethral opening. 3. Lubricate the catheter. 4. Hold the penis on the sides, perpendicular to the body. 5. Begin to gently insert and advance the catheter. 6. You will meet resistance when you reach the level of the prostate. Try to relax by deep breathing, and continue to advance the catheter. 7. Once the urine flow starts, continue to advance the catheter another 1 inch and hold in place until the urine flow stops and the bladder is empty. 8. Withdraw the catheter in small increments to make sure the entire bladder empties. 9. Wash the catheter with soap and water. Rinse the catheter completely and dry the outside of the catheter. Store the catheter in a clean, dry, secure location. Some people keep their clean catheters in a zip lock bag, or a Tupperware container. 10. Record the amount of urine obtained, if instructed by your health care provider. HOW TO PERFORM CISC (WOMEN): 1. Assemble all equipment: catheter, lubricant, drainage receptacle. 2. Wash your hands and clean the vulva and urethral opening. Wipe from front to back to prevent contaminating the area with fecal contents. 3. Lubricate the catheter. 4. Locate the urethral opening (meatus). The meatus is located below the clitoris and above the vagina . 5. Spread the labia with the second and fourth finger, while using the middle finger to feel for the meatus. 6. Begin to gently insert the catheter into the meatus, in a upward direction toward the umbilicus. 7. Once the catheter has been inserted about 2 to 3 inches past the meatus, urine will begin to flow. 8. Once the urine flow starts, continue to advance the catheter another 1 inch and hold in place until the urine flow stops and the bladder is empty. 9. Withdraw the catheter in small increments to make sure the entire bladder empties. 10. Wash the catheter with soap and water. Rinse the catheter completely and dry the outside of the catheter. Store the catheter in a clean, dry, secure location. Some people keep their clean catheters in a zip lock bag, or a Tupperware container. 11. Record the amount of urine obtained, if instructed by your health care provider. Some women may perform CISC standing up with one foot on the toilet. This position is also recommended when there is a question about the cleanliness of the toilet, such as in public facilities. A CISC catheter may be re-used for 2 to 4 weeks. It may be helpful to soak the catheters in a white vinegar solution once a week to control odor and remove thick mucus deposits. Other cleaning or sterilization techniques may be recommended by your health care provider if infection occurs frequently.
  

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