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Clean
Intermittent Catheterization
What
are the steps for clean intermittent catheterization for girls and boys?
If your child
cannot empty his or her bladder completely, or has a problem with urine leakage,
your child may need to start a catheterization program. These problems are
commonly seen in children with spina bifida, spinal cord injuries, or some
urinary tract defects.
The following
information explains the steps for CIC. This should not take the place of
one-to-one teaching. If your child needs CIC, contact your pediatrician, doctor,
or nurse practitioner for more information.
CIC for
girls
-
First
wash your hands with soap and water, then dry them. You also can use a waterless
cleaner, such as an antibacterial cleanser that does not require water.
-
Next
have your box of supplies within easy reach.
-
Place
your daughter on her back or position her on the toilet or in her wheelchair.
You should practice CIC in the position you will be using most often. If
she is on the toilet, separate her legs widely enough to be able to clearly
see her urethra. If she is doing her catheterizations herself, she will
practice identifying her urethra by touch. When your daughter is learning
to catheterize herself, she can use a mirror to see where her urethra is
located.
-
Clean
your daughter's genitalia with a washcloth or disposable wipe.
-
Separate
the labia and wipe thoroughly from front to back.
-
Place
a generous amount of the water-soluble lubricant on the end of the catheter
with the holes.
-
Place
the other end of the catheter into a container or let it drain into the
toilet.
-
Find
your daughter's urethra. Gently insert the lubricated end of the catheter
into the urethra about 2 to 3 inches. It may become slightly more difficult
to insert just prior to entering the bladder. That is because a muscle called
the sphincter sits at the opening of the bladder and is naturally tightly
contracted. The sphincter will relax as you continue to gently insert the
catheter until you reach the bladder and see urine flow.
-
Once
the catheter is in the bladder, hold it there until the urine flow stops.
Then move the catheter slightly, or insert it a little more, to see if the
flow continues. Gently press on your daughter's lower abdomen with your
hand or ask your daughter to lean forward to be certain there is no more
urine in the bladder.
-
Slowly
remove the catheter, holding your finger at the tip or pinching the catheter
end before removing the final portion. Pull catheter out in a downward movement
to prevent backflow of urine.
-
Wash
your hands. Clean and store your catheter as directed.
-
First
wash your hands with soap and water, then dry them. You also can use a waterless
cleaner, such as an antibacterial cleanser that does not require water.
-
Next
have your box of supplies within easy reach.
-
Place
your son on his back or, if it is easier for both of you, have him sit on
the toilet or in his wheelchair. If he is doing his own catheterization,
he may stand or sit on the toilet or in his wheelchair.
-
Clean
the tip of his penis with a washcloth or disposable wipes in a circular
motion starting at the center and working outward. If your son is uncircumcised,
pull back the foreskin so that the tip of his penis is visible before cleansing.
-
Place
a generous amount of the water-soluble lubricant on the end of the catheter
with the holes.
-
Place
the other end of the catheter into a container or let it drain into the
toilet.
-
Hold
your son's penis upright. Gently insert the lubricated end of the catheter
into the urethra (see picture below) about 4 to 6 inches until urine begins
to flow. You may need to lower the penis as you continue to insert the catheter.
It may become more difficult to advance the catheter as you get closer to
the bladder. Do not worry, this is normal. Continue to gently insert the
catheter with steady pressure until you feel the catheter slip into the
bladder. Once urine flow begins, insert the catheter about an inch farther
to allow the urine to flow better.
-
Hold
the catheter in place until the urine flow stops. You may gently press on
your son's lower abdomen or ask him to squeeze his abdominal muscles or
lean forward to be sure the bladder is empty.
-
Remove
the catheter once the urine flow stops completely. Hold your finger over
the end of the catheter while removing it. This will prevent any urine in
the tube from dripping out.
-
If your
son is uncircumcised, gently replace the foreskin over the end of his penis
by pushing it forward.
-
Wash
your hands. Clean and store your catheter as directed.
Supplies
needed
It is best
to have all of your supplies organized and ready when you need them. Keep the
following items in a clean, dry container such as a plastic shoe box or cosmetic
case.
- Catheters. Your
doctor will give you a prescription for the appropriate catheter size for
your child.
- Disposable wipes or
a washcloth. Your child's genitalia will need to be cleaned before CIC.
- Lubricant. Use
only a water-soluble lubricant. You can buy the lubricant at pharmacies or
drug stores. Do not use oil-based lubricants such as petroleum jelly because
they do not dissolve in water.
- Container. You
may need a container to drain the urine into if you are not doing the catheterizations
on the toilet, or if you need to keep a record of how much your child drains.
- Syringe. You will
need a syringe for cleaning the catheter.
Published online: 3/07
Source: What is Clean Intermittent Catheterization? (Copyright ©
2003 American Academy of Pediatrics)
Healthcare professionals
may order
this publication in multi-copy packs.
Parents can find more information on this topic in Caring for Your Baby and
Young Child: Birth to Age 5. To order a copy of this book visit the AAP
Bookstore.
--------------------------------------------------------------------------------
The information contained
in this publication should not be used as a substitute for the medical care
and advice of your pediatrician. There may be variations in treatment that your
pediatrician may recommend based on individual facts and circumstances.
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