Catheters may be used as single use items known as intermittent catheters.
Disposable intermittent catheters are usually made from synthetic materials such as PVC or silicone and have a thin lubricating coating to make them smooth and comfortable when used. However, reusable metal intermittent catheters are available which some individuals prefer to use with a lubricating jelly. Whichever type of intermittent catheter is selected, it is the patient that will decide which one is the most comfortable and manageable. (See figure 8, Left)
Intermittent Urinary Catheters
What does intermittent catheterisation entail?
Intermittent catheterisation involves the temporary placement of a catheter into the bladder for just a few minutes in order to drain away the urine. It is the preferred method of catheterisation in patients with bladder dysfunction since the risk of developing a urinary tract infection is reduced compared with that of an indwelling catheter.
The intermittent catheterisation procedure is not new as it is believed to have been undertaken some 300BC years ago for short-term relief when voluntary urination was not an option or was proving to be difficult. Various tubing materials have been used for this procedure ranging from onion leaves to catheters made from silver, stainless steel, polyvinyl chloride (PVC) or silicone as developments occurred.
Today, intermittent catheters are more advanced with the development of different coatings that are added to the surface of the PVC or silicone tubing in order to ease insertion. The gentle passage of a coated catheter into the bladder, if undertaken correctly, is smoother and safer thereby reducing the risk of trauma along the way.
Intermittent catheterisation is sometimes referred to as Clean Intermittent Catheterisation (CIC). Studies have shown that undertaking a clinically clean procedure as opposed to a sterile procedure does not increase the risk of infection.
Additional benefits include self-care and independence as well as reducing the need for equipment such as drainage bags, especially as the intermittent catheter can be used to direct urine into the toilet. Also, there are fewer barriers to intimacy and sexual activities. Reduced urinary symptoms such as frequency, urgency and leakage in between the catheterisations are a further benefit. So, with these in mind it easy to understand why intermittent catheterisation is the preferred option.
Initially, your CIC procedure will be undertaken by a registered nurse or doctor. The nurse will teach and support you to undertake the procedure yourself as prescribed. This is usually between 1-4 times daily. Alternatively, a carer may be taught how to catheterise you intermittently if you are unable to do it yourself for whatever reason e.g. poor manual co-ordination.
I have been told I will need to catheterise following a urinary diversion operation (ie mitrofanoff procedure, bladder removal operation or bladder enlargment surgery)
Can this be done intermittently?
Yes. Intermittent catheters can be used to drain urine from the bladder following any of the above procedures which do not require a stoma bag to be fitted on to your abdomen in order to collect the urine. Instead, as the stoma is designed so as not to leak urine and the bladder or new pouch is unable to sufficiently contract to empty the bladder which is why intermittent catheterisation is necessary. The below image (Figure 9) shows an intermittent catheter inserted into the bladder via the abdominal stoma and channel made from the appendix following a Mitroffanoff diversion.
Intermittent catheterisation following a Surgical Mitrofanoff procedure