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Urinary retention
Urinary retention is the inability to completely empty the bladder. Some people have a poor urinary stream with intermittent flow, straining, a sense of incomplete voiding, and hesitancy. This means that there is a delay between the time they try to urinate and the flow actually begins. A possible solution may be intermittent urinary catheterization, done by the patient themselves or another person, such as a nurse or relative. This procedure allows the patient to empty their bladder, and also helps protect their kidneys from damage.
Intermittent catheterization is considered to be an effective method of emptying the bladder and can offer patients independence and even improve their quality of life. In recent years, intermittent catheterization (IC) has become the preferred therapy for treating patients with neurogenic bladder dysfunction who have diseases such as paraplegia, spina bifida or multiple sclerosis.
The main benefit of IC is that it preserves the bodily function of alternately filling and emptying the bladder. This stabilizes the structural integrity of the inner layer of the bladder (urothelium), protects the urinary tract anatomy and promotes blood flow in the bladder tissue. All of which reduces the likelihood of urinary tract infections.[1,2]
Intermittent self-catheterization is a possible solution for many people affected by urinary neurological dysfunction. Please be aware that intermittent self-catheterization should be carried out only under medical advice and only in accordance with the given instructions.
The person introduces the catheter into their bladder themselves to empty it. The catheter is removed immediately after a complete drainage of the bladder. For each catheterization a new catheter has to be used.[3]
Self-catheterization may give the patient control of their bladder and rebuild their self-confidence as they become independent from family and healthcare assistance. In addition, self-catheterization can prevent urinary tract infections if used properly, since the bladder is drained effectively and emptied in full.
Everyone is different. You should discuss your individual needs and habits, the times of day you should catheterize, and how everything best fits into your lifestyle with your healthcare professional.
Children with neurogenic bladder dysfunction can be catheterized by their parents or a professional care service before they start to self-catheterize on their own. Both, the children and their parents must be carefully educated and trained in IC by healthcare professionals, especially if the children are still too young to do it on their own.The age at which a child can begin to self-catheterize will depend on their own development and confidence. Catheters of 2.0 to 2.7 mm diameter (Ch06 to Ch08) are typically used for infants and small children.
[1] Lapides J, Diokno AC, Silber SJ, Lowe BS. Clean, Intermittent Self-Catheterization in the Treatment of Urinary Tract Disease. J Urol. 2017 Feb;197(2S):S122-S124. doi: 10.1016/j.juro.2016.10.097. Epub 2016 Dec 21. PMID: 28012758.
[2] Saadat SH, Shepherd S, Van Asseldonk B, Elterman DS. Clean intermittent catheterization: Single use vs. reuse. Can Urol Assoc J. 2019 Feb;13(2):64-69. doi: 10.5489/cuaj.5357. Epub 2018 Jul 31. PMID: 30138101; PMCID: PMC6363567.
[3] Chartier-Kastler E, Chapple C, Schurch B, Saad M. A Real-world Data Analysis of Intermittent Catheterization, Showing the Impact of Prelubricated Versus Hydrophilic Catheter Use on the Occurrence of Symptoms Suggestive of Urinary Tract Infections. Eur Urol Open Sci. 2022 Mar 4;38:79-87. doi: 10.1016/j.euros.2022.02.008. PMID: 35495281; PMCID: PMC9051966. Catheter Care. Guidance for health care professionals. London, UK; Royal College of Nursing. https://www.rcn.org.uk/professionaldevelopment/publications/catheter-care-guidance-for-health-careprofessionals-uk-pub-009-915.
