I. What is intermittent catheterization?
Intermittent catheterization is a method of emptying the bladder by inserting a catheter to drain the urine from the bladder at certain intervals or according to the sensation of the bladder.
II. What is the need for intermittent catheterization?
Intermittent catheterization is one of the main ways of bladder function training for patients with neurogenic bladder. By intermittently inserting a catheter to empty the bladder, the bladder expands and contracts regularly as normal. This method of voiding allows for the best bladder training while avoiding the many complications associated with long-term indwelling urinary catheters and cystostomies, and is a highly recommended method for patients with neurogenic bladder at home and abroad.
C. What is the difference between intermittent catheterization and indwelling catheterization?
Intermittent catheterization does not require patients to have a urinary catheter in their body for a long time, which greatly reduces the occurrence of complications such as urinary tract infections, stones, polyps, ulcers, etc. Moreover, there is no urinary catheter in the patient’s body during two catheterizations, which makes it convenient for the patient to move around or carry out other treatments.
Intermittent catheterization has certain comorbidities, such as urethral injury and urinary tract infection, but it is safer and more reliable compared with indwelling urinary catheter and cystostomy.
IV. Can intermittent catheterization cause more infections? Is it harmful to the body?
A large number of studies and clinical data show that intermittent catheterization has a much lower incidence of urinary tract infections than indwelling catheterization and cystostomy, and intermittent catheterization will not lead to more infections.
As long as the indications and contraindications for intermittent catheterization are strict and the standardized catheterization techniques and operation points are mastered, intermittent catheterization is a safe, simple, practical and effective method of bladder emptying.
V. Is intermittent catheterization suitable for all spinal cord injury patients?
No, only patients with spinal cord injury who meet the indications for intermittent catheterization are suitable for intermittent catheterization.
VI. Indications for intermittent catheterization.
1. adequate bladder capacity: 300-500 ml.
2. low-pressure storage: forced urinary muscle pressure less than 40 cmH2O (safe bladder capacity).
3.Adequate urethral resistance: to prevent leakage and to achieve abstinence.
VII. Contraindications to intermittent catheterization.
1, severe urethral deformity, stricture, urethritis, urethral abscess, bladder neck obstruction, prostatic hyperplasia
2, vesicoureteral reflux, hydronephrosis.
3, severe spasm of the pelvic floor muscles or external urethral sphincter.
4, severe vegetative hyperreflexia.
5.Severe urinary incontinence, the patient can not cooperate, etc.
If urethral stricture, bladder neck obstruction, prostatic hyperplasia, spasm of pelvic floor muscles or external urethral sphincter make catheterization difficult or even dangerous, intermittent catheterization can be performed after surgical treatment.
VIII. What are the methods of intermittent catheterization?
1.According to the different sterilization methods: sterile intermittent catheterization and clean intermittent catheterization.
2.According to the different operators of catheterization are divided into: intermittent catheterization of self and intermittent catheterization of others.
9. Key points of intermittent catheterization.
1.Prepare catheterization supplies (disposable catheterization kit, urine pad, etc.).
2.Patients lying on their backs, legs flexed and separated, reasonable exposure, urine pads under the buttocks, pay attention to warmth.
3.Carefully disinfect (clean catheterization only requires cleaning) the perineal skin and urethral orifice.
4.Checking the validity of the catheterization package for damage, opening the package, washing the operator’s hands and wearing sterile gloves (clean catheterization operators wash their hands).
5. Select the appropriate size catheter and fully lubricate the catheter.
6. Expose the external urethral orifice with one hand and insert the catheter slowly and gently from the external urethral orifice with the other hand. In women, the urethral catheter is inserted 4-6 cm into the urethra, and then 1-2 cm after seeing urine, fix the catheter and drain the urine. In male patients, the urethral catheter is inserted 20-22 cm into the urethra, and then 1-2 cm after seeing urine, the catheter is fixed and urine is drained.
7, observe the urine flow and urine color, slowly remove the urethra after the urine flow stops with gentle pressure on the lower abdomen, clip the urethra before it comes out of the urethra and remove all the urethra.
8.Wash hands and record urine volume.
9.Tidy up the catheterization supplies and finish the catheterization.