Suprapubic and Clean Intermittent Self-Catheterisation

Table of Contents

1. Introduction
2. Indications for suprapubic and intermittent catheterisation
   1. Suprapubic catheters
   2. Intermittent Catheterisation
3. Risks and complications of suprapubic catheters
4. Care and management of suprapubic catheters
   1. Managing the abdominal wound
5. Changing a suprapubic catheter
   1. Managing bypassing and suprapubic catheter blockage
6. Teaching patients to self-catheterise
   1. Frequency of catheterisation
7. Product choice
   1. Other information needs
8. Summary
9. References

Intermittent Catheterisation

Intermittent catheterisation (IC) may be undertaken as a clean procedure by the patient themselves (intermittent self-catheterisation (ISC)) or as an aseptic procedure by a carer or health care professional. It is used frequently to drain the bladder for people who require long-term catheterisation and as discussed above is associated with a significantly lower risk of infection (Turi et al, 2006) although many people will develop infections while learning the technique.

Task 3

1

What are the main indications for intermittent catheterisation? Enter your answer in the box below and then select Check answer. The main indications for intermittent catheterisation are the following: - Acute or chronic urinary retention - Post-operative urine drainage - Neurogenic bladder dysfunction and detrusor-sphincter dyssynergia

Task 4

2

Can you identify the possible advantages of intermittent self-catheterisation for the patient? Enter your answer in the box below and then select Check answer. The possible advantages of intermittent self-catheterisation for the patient are: - Increased independence - Maintains normal bladder filling and emptying, promoting normal bladder function - Improved privacy and dignity - Freedom from appliances increases clothing choices and social independence - Improved sexual relationships - Improved quality of life

The advantages and benefits of IC are well described, but the potential disadvantages are not so commonly identified. Introducing any device into the urethra is not without risk and both infection and urethral bleeding can occur. There are anecdotal reports of patients finding difficulty both inserting and/or withdrawing the catheter, although more modern devices reduce some of these problems. Some patients may never adapt to the thought of catheterising themselves and develop an aversion to the procedure (Woodward and Rew, 2003).

Task 5

3	Are there any contra-indications to ISC? Enter your answer in the box below and then select Check answer. Yes, this may be contra-indicated if false passages have developed or if the patient has injury, trauma or infection of the penis in males (RCN, 2008).