What is clean intermittent catheterization ( CIC ) at Home ?

What is clean intermittent catheterization?

Clean intermittent catheterization (CIC) is a procedure for people who have trouble urinating the “normal” way. In a CIC procedure, you insert a catheter, a thin, hollow tube, into your bladder to help you urinate.

People who need to perform CIC include those who have certain medical conditions, including:

• Stroke
• Parkinson's disease
• Multiple sclerosis
• Spinal cord injuries
• Spinal surgeries
• Erectile dysfunction
• Trauma/accidents
• Central nervous system tumors
• Cerebral palsy
• Heavy metal poisoning

If you have to perform CIC, you will be inserting and removing the catheter several times a day; your doctor will tell you how many times. By performing this procedure every day, you will not have to wear a catheter all the time. In addition, you will help prevent kidney infection and keep your bladder from stretching.

Key points

• Clean intermittent catheterization (CIC) is a technique that your loved one will have to do several times a day to help empty urine from his bladder.
• CIC is necessary when your loved one is unable to empty his bladder on his own, when his bladder leaks urine, or when very high pressure has developed in the bladder.
• Your loved one should empty his bladder using CIC four to six times per day (According to your doctor's) and should not go longer than eight hours without doing CIC at night.
• There are two steps to keeping your loved one's catheters clean. Step 1 should be done after each time the supplies are used and step 2 should be done once a day for sterilization.

Supplies you will need for to do a clean intermittent catheterization (CIC)

• Catheter
• Lubricant jelly such as Muko or K-Y jelly. Never use Vaseline or mineral oil.
• Soap and water
• Wash cloth or wipes
• Clean, dry towel
• Urine collection container, if desired
• Hand mirror, if needed
• Catheter storage container or bag
• Vinegar or a pot of water (this is for sterilization)
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• Ten steps to do a clean intermittent catheterization (CIC)
  

There are 10 steps to properly do a CIC for boys:

1. Get all the supplies and put them together in a place where you can easily reach them.
2. Ask your loved one to try to urinate without straining or trying too hard.
3. Ask him to wash his hands well with soap and water and dry. Try to keep his fingernails short and clean.
4. Have your loved one position himself in front of the toilet or in a chair across from the toilet, or propped up in a bed.
5. If your loved one is uncircumcised, have him pull back on his foreskin and keep it back during the catheterization. Have him wash the end of his penis well with soap and water.
   
6. Ask your child to put Muko or K-Y jelly on the catheter tip to lubricate it. Try to cover about 5 to 8 cm (about 2 to 3 inches) of the tip. Do not put the catheter into the jelly tube. Make sure the other end of the catheter is in a cup or is set to drain in to the toilet.
7. Have your loved one hold his penis straight out from his body. He should grasp the lubricated catheter as he would a pencil and slowly insert it into the urethra until urine begins to flow freely. Then gently push the catheter another 3 cm (about 1 inch) farther. There may be some resistance at the sphincter, which acts like a door into the bladder. It is important that your loved one breathes slowly and relaxes his muscles.
8. Allow all urine to drain into the toilet or container.
9. When the urine stops draining, slowly remove the catheter. Urine may still flow and continue draining until there is no more urine coming out.
10. Your loved one should wipe off his penis, push the foreskin back to its usual position, and wash his hands.

Other things to remember:

• Always clean and properly store the catheter. The instructions on how to do this are lower on this page.
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• Check the colour, smell and how clear the urine is. These can be signs of infection or other problems. If the urine is changed, you need to tell the doctor or nurse about this.
• Write down how much urine came out. This information will help the doctor and nurse work with you to set up a regular schedule that is right for your loved one.

Clean intermittent catheterization four to six times per day ( follow the your doctors instructions )

Most doctors say it is better to do CIC four to six times per day, depending on a loved one's needs. Your loved one should not go longer than eight hours without doing CIC at night.

The right catheter size for your lovedone

Your child's doctor will give your loved one the catheter that is just right for him.

The thickness of the tube of the catheter is measured in a unit called French (FR). Catheters used for clean intermittent catheterization range from 5 to 16 FR. The smaller the number, the thinner the catheter.

The doctor will suggest changes in the size of the catheter if needed. For example, if it takes too long to empty the bladder, the catheter your child is using may be too thin.

Some important things to know

• It is very important that your lovedone self-catheterizes on time and does not skip doing it. Try to have a set regular schedule from morning to night.
• If the catheter falls on the floor, use another one.
• Have your lovedone drink a lot of liquids to help the flow of urine through the kidneys.

Supporting your Loved one's.

When preparing your lovedone for an operation, the urology team recommends that whenever possible, your loved one and family members attend the Pre-Assessment Program offered at Sickpeople. For more information call 8358001429

A Touch on sehat Specialist can also help to prepare and support your loved one  if they are anxious about the operation