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.
CIC For Boys
- 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 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.