Intermittent Self Catheterisation (ISC) Uro Gynaecology

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Intermittent self-catheterisation (ISC) is a term used to describe the process of regular catheterisation which you carry out yourself to remove urine from the bladder. It is a safe and effective procedure. A catheter is a thin plastic tube designed to empty your bladder artificially. There are many reasons why some people cannot pass urine without help from catheters.

It may be caused by:

• Damage to the nerve supply to your bladder
• The result of back problems
• An operation
• A condition you were born with

Whatever the reason, urine must not be left in the bladder for too long as it becomes stale and may lead to an infection.

What are the benefits of ISC?
Intermittent self catheterisation (ISC) will help you to empty your bladder completely and regularly which will help protect the kidneys and prevent the reoccurrence of UTIs (urinary tract infections). Using ISC will help you determine when and where to empty your bladder giving you greater control and increasing confidence.

Sexual activity is not restricted by the use of an intermittent catheter. Catheterisation before sexual activity removes the fear of sudden urinary leakage

How frequently will I have to perform ISC?
It can be from a daily basis or several times per day depending on the volumes passed and the reasons why you need to do it.

The ISC clinic
The ISC clinic runs once a week and this is where you will be taught ISC. Please come with a comfortably full bladder as the nurse will ask you to pass urine for measuring and testing on arrival. The clinic is run by a specialist nurse. Here you will be assessed; ISC will be demonstrated and taught enabling you to pass a catheter into the urethra (the tube that you pass water from) to empty your bladder.

How much should I have to drink during a normal day?
You should drink around 1.5-2 litres (2.5-3.5pints) of fluid per day. However do try and avoid drinks which contain caffeine such as coffee, tea and cola. The colour of your urine will help to tell you if you are drinking enough and should be a pale straw colour.

Are there symptoms I should look out for?
Yes, if your urine is cloudy, dark coloured, has an unpleasant odour or if you feel a burning sensation when you go to the toilet or catheterise, or if you are noticeably going to the toilet more frequently and urgently. If you feel feverish, this could be a sign of infection please seek medical advice.

What if I see blood?
Don’t worry. It is quite common to see a few drops of blood which can be caused by the catheter itself- this is usually only temporary. However if the bleeding is continuous, seek medical advice

All catheters are:
• Ready to use
• Pre lubricated, requiring no added water or gel
• Individually packaged
• Sterile
• Designed for single use after which they must be discarded

Easy guide to ISC
1. Wash your hands with soap and water
2. Always try and empty your bladder before trying ISC measure and record amount passed. Wash you hands spread the labia apart and wash the urethral orifice (see step by step diagrams in the booklet). Wash from the top to the bottom to prevent bacteria being transferred.
3. Break the seal/ label by twisting the top.
4. Keep catheter vertical and pull. It is now ready to use.
5. Gently insert the catheter into the urethra until it reaches the bladder and the urine starts to flow.
6. When the flow stops ease out the catheter 2-3cm to make sure the bladder is completely empty. Remove the catheter completely and dispose of in the waste bin. Do not flush down the toilet.
7. Wash your hands.

It is important to maintain a regular Input and output fluid chart.

When can I stop ISC?
The normal volume of urine left in the bladder should be less than 100mls. You can consider stopping ISC when the residual drained in the catheter bag following urination and subsequent ISC is <less than 100 ml for at least three consecutive days with normal drinking (the normal drinking volume for most people would be to drink is1.5-2 litres per day). For many ISC is a temporary measure, particularly for women with post-operative urinary retention. The ISC reduces the need for hospital re-admission and subsequent discharge with an indwelling catheter.

Useful Contacts
Consultant Secretary 01908 996318
Urogynaecology Nurse Specialist 01908 997119 Bleep 1863

Agencies & Support Groups
Bladder and Bowel Foundation
The Cystitis & overactive Bladder Foundation
Continence Specialist Nurse (Community) 019080650470