Practice self-catheterizing in the position you will be using the most -- sitting, standing, in a wheelchair or lying down. Completely empty your bladder of urine each time, and as often as directed by us. It's OK to be early, but never be late. Have a catheter with you at all times. Keep one at school, at work and in the car. Don't miss a catheterization. It is more important to catheterize on schedule than to worry about catheter cleanliness.
- Gather the necessary equipment: Towelettes (or a soapy washcloth and a wet washcloth for rinsing), a towel, a container for collecting the urine (if toilet is not available), water-soluble lubricating jelly, and a catheter (size is usually the No. 16 French, but catheter size may vary). You may use a coude‚ or elbow-shaped catheter. You may also have on hand an anesthetic lubricant, such as lidocaine jelly. Do not use petroleum jelly or Vaseline!
- Wash your hands, then assume a comfortable position in bed or on the toilet. If you are in bed, place a towel under your hips to protect the bedding.
- Wash the head of the penis with a towelette or soapy washcloth. Then rinse with a wet washcloth.
- Apply lubricant to the insertion end of the catheter. Lubricate about two inches of tubing. If you lubricate more than that, you may have trouble firmly holding the catheter as you insert it. Use a water-soluble lubricant, such as KY Jelly or Lubafax (not Vaseline or petroleum jelly).
- Use your non-dominant hand to hold the shaft of the penis straight and upward (about a 45 degree angle from the stomach). This position makes catheter insertion easier.
- Hold the catheter in your dominant hand and insert it into the urinary opening about eight to 10 inches into the bladder. Lengths vary, but when the bladder is reached, urine will flow easily. The sphincter muscle is at the "door" to the bladder. Sometimes the "door" is closed (or tight) and the catheter cannot easily enter the bladder. Gently "knock" on the "door" with the catheter by using constant gentle pressure on the sphincter muscle. Take a deep breath or try changing the position in which you are holding the penis in order to get the muscle to relax. When it relaxes, the "door" will "open" and the catheter will slip into the bladder.
- When urine starts to flow, let the penis return to its natural position. Hold the catheter in place until the bladder has been drained. When the urine flow begins to taper off, slowly withdraw the catheter. (As you do, you may note an increase in urine flow as urine pockets are drained.)
- Remove the catheter. Wash it in warm, soapy water, and rinse it thoroughly. Then air dry it and store it in a dry paper or cloth towel until you need it again. At the end of one week, discard the catheter. If it becomes hard to clean before then, use a new one. Store the catheter in a rolled-up towel or facecloth, a toothbrush holder, or anywhere that is convenient.
- Observe the urine drainage for changes. If you note any change in color or odor, or if the urine appears cloudy, contact your nurse or doctor. Also call if you have bleeding, sediment in the urine, back or abdominal discomfort accompanied by a fever, trouble passing the catheter, or increased discomfort when passing the catheter.
- Catheterize periodically to maintain bladder volumes around 12-13 ounces (or a bit more than half a pint), which is the best volume for maintaining a healthy bladder and kidneys.