Intermittent Catheters

Intermittent catheters are hollow tubes used to drain urine from the bladder. They are inserted at intervals throughout the day, or when you feel the need to go to the toilet. Once the urine has drained out, the catheter is removed. This is called intermittent self-catheterisation (ISC). Most catheters for ISC are used once and then thrown away. Some are designed to be cleaned and reused.

There are three main types:

• Plain catheters are made of plastic and have to be used with a special lubricant before insertion.
• Coated catheters have a hydrophilic coating. The catheter is soaked in water for a short while before use. The water makes the coating become slippery so it is easy to insert.
• Pre-lubricated catheters are plain catheters which come packed with lubricant so they are ready to use.

• How do I self-catheterise?

Many people find it easy to self-catheterise after a time, although it is generally a bit awkward to start with and needs lots of practice before you become an expert. Before use, all catheters should be stored in a dry area, lying flat and straight.

If the packaging is damaged, do not use the catheter. You should be taught how to insert the catheter by a health professional - this can be done in a hospital, clinic or at home.

You have to ensure that your vulva area (between your legs) or the area around the tip of the penis, if you are a man, is clean. It may be that a daily shower or bath is sufficient but when you go out it is useful to keep a small pack of baby wipes in your handbag or pocket to enable you to ensure the area is clean. It is very important to wash your hands before touching or inserting the catheter - again you may choose to use a fresh baby wipe if there is no wash hand basin in the toilet. Once you have washed your hands, do not touch anything else except your catheter.

Most catheters have a sticky back patch which allows you to open it and stick it on the wall, making it easier to access when you are ready to insert it into the urethra. For women there are several ways to catheterise yourself - you can learn to insert the catheter while sitting on the toilet or in your wheelchair, when standing or by putting one foot up on to the toilet seat to enable you to locate your urethra more easily. You can experiment and decide which way feels most comfortable.

When you are ready take the catheter by the drainage end from the packaging and gently push the other end into your urethra. If you are a woman and find it hard to locate your urethra, try using a mirror to see where your urine comes out. Once you have done this several times you will probably not need a mirror. You can do it over the bath if it's easier. When the catheter has reached the bladder, urine will drain from it. Make sure all the urine has drained from your bladder before removing it.

To remove the catheter, gently twist it and pull down. Don't worry if it doesn't come out first time. Try again, continuing to pull gently.

"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."

Catheters that are designed to be used more than once should be cleaned after each use with soap and water, dried with a clean tissue and kept in a sealed plastic bag or container.

• If I self-catheterise, will I be more likely to get an infection?

It is important to wash your hands when possible before inserting your catheter to help reduce the risk of infection. If this isn't possible, there are catheters available that require minimal handling, helping to cut the risk of infection.

You might also benefit from drinking cranberry juice. Cranberry juice helps to line the bladder making it harder for any infection to thrive. But note that people with diabetes, as well as people taking Warfarin (blood thinning medication), should consult their doctor before drinking cranberry juice. Anyone who has Interstitial Cystitis or related bladder diseases should also avoid cranberry juice.

• How can I use ISC safely when away from home?

If it is likely that good toilet facilities won't always be available when you are away, you might like to try a different type of catheter - e.g. one that is self-lubricating, or one that needs minimal handling (see above). There is also an intermittent catheter with its own drainage bag attached, making it ideal for use when no toilets are available.

• I have poor eyesight and find it difficult to handle a catheter. What can I do?

You need to have good control of your hands because it can be a fiddle and you should have reasonable eyesight so you can see what you are doing. But, there are special devices available to help you if you find it hard to handle a catheter. There are also catheters available that have a mirror attached to them so you can see what you're doing more easily, without having to hold a mirror in your other hand.

• Where can I find out more about the different catheters available?

Incontact has a factsheet which contains contact details for manufacturers of catheters for intermittent use. Call 0870 770 3246 for more information.

Promocon can give information and advice about the range of products available. Call them on 0161 834 2001.

" I have been using ISC for 11 years now and I can't believe how it has helped me to get my life back. Without it I would be wet all the time and not be able to travel abroad and lead an active and full life."

"I look at my catheters as my little friends that go everywhere with me."

Contact your continence advisor/urology nurse before using intermittent catheters. If you need the number of your local continence advisor, please call Incontact on 0870 770 3246.

Incontact, SATRA Innovation Park, Rockingham Road, Kettering, Northants, NN16 9JH

Tel: 0870 770 3246

Website: www.incontact.org

Email: info@incontact.org