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Questions about Catheters?
Catheter Overview- A urinary catheter is any tube system placed in the body to drain and collect urine from the bladder.
- Urinary catheters are used to drain the bladder. Your health care provider may recommend a catheter for short-term or long-term use because you have or had: Urinary incontinence (leakage of urine or the inability to control when you urinate), Urinary retention (being unable to empty the bladder when you need to), Surgery that made a catheter necessary, such as prostate or gynecological surgery, Other medical conditions such as multiple sclerosis, spinal cord injury, or dementia.
- Catheters come in many sizes, materials (latex, silicone, rubber), and types (Funnel End, Straight, Coude tip).
- In general, the smallest possible catheter will be used. Some people may need larger catheters to control urine leakage around the catheter or if the urine is thick and bloody or contains large amounts of sediment.
Types of Catheters- There are three main types of catheters: Intermittent (short-term) catheter, Condom catheter, Indwelling catheter

INTERMITTENT (SHORT-TERM) CATHETERS
- Some people only need to use a catheter on occasion. Short-term, or intermittent, catheters are removed after the flow of urine has stopped.
- Short-term (intermittent) catheterization may be necessary for: Anyone who is unable to properly empty the bladder, People with nervous system (neurological) disorders, Women who have had certain gynecological surgeries.
- The goal of intermittent catheterization is to: Completely empty the bladder, Prevent further bladder or kidney damage, Prevent urinary tract infections.

INDWELLING URETHRAL CATHETERS
- An indwelling urinary catheter is one that is left in place in the bladder. Indwelling catheters may be needed for only a short time, or for a long time. These catheters attach to a drainage bag to collect urine. A newer type of catheter has a valve that can be opened to allow urine to flow out, when needed.
- An indwelling catheter may be inserted into the bladder in two ways: Most often, the catheter is inserted through the urethra, which is the tube that brings urine from the bladder to the outside of the body. Sometimes, the doctor will insert a tube, called a suprapubic catheter, into your bladder from a small hole in your belly. This is done as an outpatient surgery or office procedure.
- An indwelling catheter has a small balloon inflated on the end of it. This prevents the catheter from sliding out of the body. When it's necessary to remove the catheter, the balloon is deflated.

CONDOM (EXTERNAL) CATHETERS
- Condom catheters are most frequently used in elderly men.There is no tube placed inside the penis. Instead, a condom-like device is placed over the penis. A tube leads from this device to a drainage bag. The condom catheter must be changed every day.
Catheter Sizing- The French catheter scale or "French units" (Fr) is commonly used to measure the outside diameter of needles, catheters and other cylindrical medical instruments.

1 Fr is equivalent to 0.33 mm = .013" = 1/77" of diameter. Thus, the size in French units is roughly equal to the circumference of the catheter in millimeters.

Sizing ranges include: Pediatric (usually 8FR and smaller), 10FR, 12FR, 14FR, 16FR, 18FR, and larger
How to perform Clean Intermittent Self-Catheterization (CISC)- To perform clean intermittent self-catheterization (CISC), the person must learn the basic location of the important parts of the urinary system. The person must also be physically able to reach the urethra, and to move the equipment as necessary. People who are unable to see the urethra may be taught how to feel for the proper location of the urethral opening.
- CISC catheters may be made of a clear plastic or a softer rubber material. These catheters also come in a variety of sizes.

HOW TO PERFORM CISC (MEN):
1. Assemble all equipment: catheter, lubricant, drainage receptacle (container).
2. Wash your hands thoroughly with soap and water and clean the penis and opening of the urethra.
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. Hold it in place until the urine flow stops and the bladder is empty.
8. Remove the catheter in small steps to make sure the entire bladder empties.
9. Wash the catheter with soap and water. If the catheter is disposable, discard it right away. If it is reusable, rinse the catheter completely and dry the outside. Store the catheter in a clean, dry, secure location.
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 thoroughly with soap and water and clean the vulva and opening of the urethra.
3. Lubricate the catheter.
4. Locate the urethral opening. The opening is located below the clitoris and above the vagina.
5. Spread the lips of the vagina (labia) with the second and fourth finger, while using the middle finger to feel for the opening.
6. Begin to gently insert the catheter into the opening. Guide it upward as if toward the belly button.
7. Once the catheter has been inserted about 2 - 3 inches past the opening, urine will begin to flow.
8. Once the urine flow starts, continue to advance the catheter another 1 inch and hold it in place until the urine flow stops and the bladder is empty.
9. Withdraw the catheter in small steps to make sure the entire bladder empties.
10. Wash the catheter with soap and water. If the catheter is disposable, discard it right away. If it is reusable, rinse the catheter completely and dry the outside. Store the catheter in a clean, dry, secure location.
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.
- Your health care provider may recommend other cleaning or insertion techniques if you often get infections.
Potenial Complications- Complications of catheter use include: Allergy or sensitivity to latex, Bladder stones, Blood infections (septicemia), Blood in the urine (hematuria), Kidney damage (usually only with long-term, indwelling catheter use), Urethral injury, Urinary tract or kidney infections.
- Contact your health care provider if you develop or notice: Bladder spasms that do not go away, Bleeding into or around the catheter, Catheter draining very little or no urine, despite drinking enough fluids, Fever or chill, Leakage of large amounts of urine around the catheter, Skin breakdown around a suprapubic catheter, Stones or sediment in the urinary catheter or drainage bag, Swelling of the urethra around the catheter, Urine with a strong smell, or that is thick or cloudy.
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