The bladder is a ‘pouch’ that stores urine until it becomes full and we need to use the toilet to urinate.
The kidneys produce urine, where urine is then passed from the kidneys down two tubes called ureters into the bladder.
When the bladder becomes full, the muscle around the outside of the bladder called the detrusor muscle gives us the sensation to pass water.
If the detrusor muscle doesn’t work properly or the urethra is blocked, this can cause  back flow pressure effect on the kidney and in the long term can cause kidney damage.
There are thousands of people who use CISC on a daily basis, as there are more benefits e.g. prevention of recurrent urine infections, patients remain dry, healthier kidneys and bladder and a more comfortable lifestyle.

Depending on your doctors advice, CISC is usually carried out 3-4 times a day, depending on how much you drink and what your condition is. You should drink at least 2 litres of water a day and research also shows that drinking cranberry juice is good to prevent urinary tract infections. However if you are on warfarin or have been having non-bacterial infections please consult your urologist or GP when drinking cranberry juice.

CISC is a safer option to take for both male and females. If thought correctly by a nurse adviser or continence adviser or doctor.
CISC should be painless, but may be abit  uncomfortable at first, this can be due to being nervous or anxious.
It will take practice getting the catheter into the bladder, especially females. Females will usually need a mirror at first to see where to put the catheter, with more practice and support from your nurse advisor, CISC should become much easier to do.
Also if you notice bloody, cloudy, strong smelling or dark urine, contact your doctor and who may test your urine.

Your nurse advisor will advise you on the right type of catheter to use. The catheters are usually lubricated, which makes them easier to insert..

• Try to pass urine normally first
  
• Then wash hands with soap an water and dry well. Prepare catheter as per manufactures instructions.
  
• Wash and dry genitals or use wet wipes.
  
• Choose a position that may be comfortable for you e.g. sitting on a toilet seat or lying down with knees bent. If you are not over a toilet have a jug or container ready into which you can drain the urine form the catheter.
  
• With one hand spread the labia (the lips at the entrance of the vagina) apart. Some women may need to dig deeper with a mirror, find the urethral opening above the vagina and below the clitoris.
  
• When found, insert catheter gently into urethra, move gently upwards until flow of urine begins into the toilet or container. Do not force the catheter.
  
• When urine stops flowing, slowly remove the catheter from the urethra , slowly remove catheter from urethra and throw away. Do not use the same catheter again as this will cause infection.
  
  
• Wash hands before and after doing CISC.
  
• Please contact your doctor if you have:
  
• Cloudy urine
• Strong smelling urine
• A lot of blood in urine
• Fever. (hot and cold flushes).
• Loss of appetite or generally feeling unwell
• Lower abdominal discomfort or cramps.

1. Try to pass urine in toilet first if able.
   
2. Wash hands with soap and water and dry well.
   Prepare catheter as per manufactures instructions.
   
3. Wash and dry genitals or use wet wipe.
   
4. Choose a comfortable position either sitting or standing. If you are not over a toilet, have a jug or container ready to catch urine form catheter.
   
5. Gently pull back the foreskin if not circumcised and wash and dry the penis always return the foreskin to its normal position after CISC.
   
6. Hold penis up towards your stomach.
   
   
7. Slide catheter slowly and smoothly into the urethra until urine starts to flow into toilet, gently insert a liitle more to make sure that you are completely in the bladder. Never force the catheter into the bladder.
8. When urine stops draining into jug or toilet, remove catheter slowly.
9. Throw away catheter. NEVER REUSE THE SAME CATHETER
10. Wash your hands after CISC

1. Please contact your GP if you have:
   

• Cloudy urine
• Strong smelling urine
• A lot of blood in the urine
• Fever. (hot and cold flushes).
• Loss of appetite or feeling generally unwell.
• Lower abdominal discomfort or cramps.

If you have any other concerns following your discharge, please contact
Your GP, Urologist or Michelle on 091-785771 mon-fri 9am to 5pm

Compiled by: Michelle O’Brien
Mr. S. Jaffry
Consultant Urologist
June 2006
With reference to The Nursing Standard April 3 2002, Volume 16, No. 29.