Intermittent Self-Catheterisation (ISC) for beginners

Incontact member Sue Kent gives her thoughts

What is ISC?

ISC stands for "intermittent self-catheterisation". My first continence nurse told me that the catheter looks like a mini drainpipe...and this is the job that it is designed to do. It drains away unwanted urine that will otherwise sit in your bladder and might then become infected.

So you've been told you have to start ISC....

Do you use catheters to drain your bladder? Does your bladder retain urine? As you start this new activity, it is natural to feel a little hesitant, if not scared - I know: I've been there. Try to see it as a challenge.

I started using catheters when I was 36 and at first I did feel weird about it, believing I was the only person who had to do this. However this is not the case - you are not alone. I have MS and, through the MS society, I found a friend who was able to give me a lot of support. Using catheters can improve the quality of your life. I can go out for an hour or so now without needing to 'go', which is a big bonus. They have helped to fend off infections. I recommend drinking lots of fluids and two glasses of cranberry juice daily.

Although I have had plenty of advice from my various continence nurses, I never found much information to read for myself. So I decided to write this. I hope it helps you face and cope with ISC.

Procedure and Hygiene Products

You should ask your continence advisor, nurse or doctor to teach you in person how to insert the catheter. It is not a good idea to try on your own before a trained expert has shown you what to do.

Always follow the instructions that come with your catheter. Different brands have different ways of lubricating the catheter - it is important to do this correctly so the catheter can be inserted and taken out with minimum discomfort.

Undress from the waist down and carefully wash "down below", paying particular attention to the front area. Thoroughly wash your hands and dry them on a clean towel. Do not touch anything, now, but your catheter.

Take the catheter holding it at the "drainage" end and use the other end to feel for your urethra opening (see finding your urethra below). You will eventually find that it will feed in gently here. Make sure that the drainage end is over a large bowl or the toilet. Once it reaches the bladder the urine will flow freely and needs to be drained off. To release the catheter, I cough several times and give it a gentle twist. Carefully draw it out this way. This comes with practice - don't panic if it doesn't release first time, several strong coughs should loosen it up.

When I first began, I found it useful to make a brief checklist of the above procedure on a piece of paper. This acted as a reference whilst I learned.

Finding your urethra

Initially, before I even started thinking about doing anything with the catheter, I spent time locating my urethra. I put the mirror at the bottom of the bath and just peed over it. I was then able to watch where the urine flowed from. This gave me clues as to where to aim for when inserting the catheter! Practice makes perfect, and eventually many people become familiar just feeling their way.

When I first began with the catheter, I set it up in the following way. I protected the floor by laying down a large folded towel. I put a chair near the sink, and below it I put a large bowl. On the edge of the chair I put a small mirror. Then I got my catheter and carefully stuck it (by its sticky pad) to the back of the chair and within easy reach. I was then ready to begin.

Handy Hints (things that helped me)

• Begin this procedure in a relaxed situation, perhaps put on some calming music, and take precautions to avoid any interruptions.
• Initially it might be helpful to try this when you are alone in the house. At the very least put a sign on the door saying "I'm busy - Go away!"
• Give yourself rewards. I bought a box of chocolates and, regardless of how things went, ate one after each attempt!
• A friend told me to think of it as steps on a ladder - you are taking steps up to be able to control your own symptoms.

Good luck. I promise you that with time you will get the hang of ISC... and feel very proud of yourself once you have. The best advice and encouragement may well come from your continence nurse specialist, but I hope that this article will help you too. My apologies that this is written from a female perspective, but perhaps there is a man out there who could write from a male point of view to keep things balanced.

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