What does the word ‘intermittent’ mean?

An action that is repeated intermittently or ‘again and again.’ The insertion and removal of catheters quite many times a day refers to ‘Intermittent Catheterization.’ The purpose of the same being adequately draining out the urinary bladder, which otherwise is incapable of doing the same on its capacity! This is often the case with patients who suffer from incomplete bladder emptying due to certain medical conditions. 

Conditions that may lead to incomplete bladder emptying

Medically referred to as ‘urinary retention,’ incomplete emptying of the bladder may take place due to a lot of factors. Firstly, urinary retention is of two types: acute and chronic; the former is an emergency condition where the patient cannot urinate at all even after the bladder is full. This creates a life-threatening situation accompanied by pain and discomfort. The latter, on the other hand, is a long-lasting medical condition about which the patient is often even not aware of! 

So, what causes urinary retention?

To enlist, some of the critical causes of urinary retention are: 

1. Certain medications – Certain medications interfere with the nerve signals to the bladder and prostate. This may lead to either urinary incontinence or retention issues. 

2. Obstruction of the urethra – This refers to blockage of the normal flow of urine from the entire body to the bladder. Physical anomaly such as a urethral stricture, urinary tract stones, constipation, certain tumors can lead to this. Benign prostatic hyperplasia (BPH) in men in their 50s and 60s due to enlargement of the prostate may lead to this condition too.

3. The weakening of the bladder muscles – The weakening of the bladder muscles is mostly due to aging. They do not allow the bladder to empty the urine fully, which leads to urinary retention.   

How does intermittent catheterization aid in the case of urinary retention? 

Intermittent catheters mimic the functioning of a healthy urinary bladder. Therefore, the function of filling and emptying of the bladder takes place entirely with this device. But the question is: Why Intermittent Catheters?

There are primarily two significant advantages of ICs for which both patients and medical professionals prefer them. They are - 

1. ICs have a lower risk of infection and other management complications. This is because since they are not used for a prolonged period, they don’t run the risk of causing an infection. 
2. They are not permanent as they are not left inside the bladder.

However, there are some issues with self-catheterization also! So, what are the cons associated with this self-intermittent catheterization?

1. The process is initially time-consuming as it requires the expertise of one’s hands.
2. The amount of liquid intake, including – beverages, alcohol, and water intake, too, should be controlled so that your urine output does not exceed the desired level.

Nevertheless, self-intermittent catheterization is a popular form of catheterizing patients. Individuals in different conditions may require catheterization, since finding a professional to do so is not always feasible. 

How to self-catheterize?

Hospitals and nursing homes usually train individuals on self-catheterization, those who would need it even after being released from institutional medical care. Self-catheterization needs a few things at hand: a catheter, a water-based lubricating gel, a measuring container (if available), clean flannel, soap, and water. 

Most people prefer to undergo the process inside the toilet or bathroom. Make sure you have a mirror in that venue. The procedure is naturally slightly different in males and females. To start with, follow these steps in common:

1. Wash your hands thoroughly and dry them with a clean towel. Even turn off the faucet with that same towel to avoid any more contamination. Alternatively, you can use a wet towelette.

2. Take the catheter, lubricate one of its ends (3 to 4 inches on one end) with a water-soluble lubricant jelly.

3. Place the other end in the toilet or washbasin (if you’re doing it in the bathroom) or inside a container (if you are not doing it in the toilet)

4. From the next step, the male-female segmentation takes place.

5. For males, the penis needs to be cleaned thoroughly, and its tip dried. Insert the catheter with the hand that’s more firm and hold your penis with the other hand at a 45-degree angle, preferably.

6. The catheter needs to be pushed until the urine is seen to come flowing out. To ensure full insertion, even after the urine is noticed flowing out, the tube should be pushed an inch further.

7. The device should be held in that same position unless the urine flow stops.

8. For females, the procedure is a bit different. Spread the labia (the two folds on either side of the vaginal opening); use the mirror or index finger to locate the urethra (urinary opening); slowly insert the catheter with the lubricated side. Stop the process, if you feel a sharp pain and try doing it all over again! 

9. The following steps are all the same – insert until you see your urine to start flowing and hold it still unless the urine stops flowing.  

Remove the catheter once you’re done. Even while doing this, you need to pour in that extra dose of care. The device should be cleaned with soap and water after washing your hands. The catheter should be dried before you keep it in place. Remember, it should look clean and dry; a catheter that looks cloudy should be disposed of and not reused anymore. 

Does self-intermittent catheterization need your doctor’s consultation?

Self-catheterization is rather simple. Carrying out the procedure yourself saves both time and extra medical expenditures too. There are only a few untoward incidences that you should be aware of and call the doctor right away if any of these surfaces:

1. Fever above 100 degrees Fahrenheit along with chills 

2. Nausea and vomiting 

3. Sediment-like formation of mucus in the urine 

4. A burning sensation in the urinary tract or pubic area

5. Aching lower back, or 

6. Foul-smelling pinkish or reddish urine 

The conditions mentioned above are alarming situations when you need to see your doctor on an emergency basis. Do not try handling such cases at home under any circumstances! 

The Two Main Types of Intermittent Catheters For self-intermittent catheterization, a knowledge of the design of intermittent catheters are essential. Broadly categorized, intermittent catheters are of two types: Coated and Non-coated.

Coated

Coated catheters are created to give the user a better experience of lubrication and comfortable insertion. This influences the psychology of the user - less trauma and lesser chances of urinary tract infections. The most popularly used coating is hydrophilic. They have been remarkable in preventing the most common catheter-associated complications.  

Additionally, its packaging includes the integration of all necessary equipment - catheter, water-based lubricant, and collecting bag into one compact system! Knowledge of the various types is essential, especially for the user to make the right choice.

Noncoated

Non-coated catheters, as their name quite suggests, require gel lubrication that is to be done separately before insertion. Uncoated catheters are usually red rubber catheters; they are not appropriate for patients with latex sensitivities! Moreover, due to their flexibility, they are difficult to insert.  

The type of catheter packaging is decisive in the choice of a catheter. The general clinical condition of a patient - hand firmness, any injury, visual impairment, urethral positions, gender, and age, are all to be considered before the type of self-catheterization is opted.

He or she may need to try several catheters before zeroing in upon the preferred type. Often more than one type of intermittent catheters are also used according to the situation in which the user is - home, office, traveling and so on!