Clean Intermittent Catheterization (CIC): Detailed Step-by-Step Instructions for Girls
CIC is a technique that helps children empty urine from their bladder, and needs to be performed several times throughout the day.
CIC stands for Clean Intermittent Catheterization, which refers to clean intermittent catheterization:
CIC Can Help Resolve Bladder Problems
When a child cannot empty the urine from their bladder on their own, experiences bladder leakage, or has excessively high bladder pressure, CIC must be used. If the bladder is not properly emptied, infections or other complications can occur.
CIC is not difficult, and if the child follows the nurse's instructions, it will not damage their bladder. After some practice, almost everyone, including children as young as 5 years old, can learn this technique.
Urine is produced by the kidneys. Urine flows from the kidneys through the ureters into the bladder. Urine is stored in the bladder. The bladder is a muscular sac that stores the body's urine.
At the bottom of the bladder is a strong muscle called the sphincter, which prevents urine from flowing out before you are ready to urinate.
When the brain sends a signal to relax the sphincter, urine is released and flows out through the urethra and exits the body. When the bladder is full, it sends a signal to the brain that it is full, transmitting this signal approximately every 2 hours. The brain then decides whether it is an appropriate time to urinate. If you do not empty the urine in your bladder after receiving the first signal, the signals will come more frequently and intensely. Finally, when the bladder becomes too full, it will empty itself.
If the bladder is not emptied, infections or other complications can occur. If the bladder is not emptied in time, urine can flow back into the ureters and kidneys. This phenomenon is called reflux, and reflux can lead to kidney infections, scar tissue, and permanent kidney damage. For many children, CIC can completely empty the bladder, stop reflux, avoid urinary tract infections, and prevent bedwetting.
Equipment Needed for CIC:
- Catheter
- Lubricant (if needed)
- Soap and water
- Washcloth or wipe
- Clean, dry towel
- Urine collection container (if needed)
- Hand mirror (if needed)
- Catheter storage container or bag
Ten Steps for Properly Performing CIC on Girls:
- Prepare all equipment and place it together within easy reach
- Have the child try to urinate as much as possible, but without straining too hard
- Have the child wash and dry their hands with soap and water. Keep the child's fingernails short and clean
- Ensure she is in a comfortable position. She can sit on the toilet or sit on a chair positioned over the toilet. Alternatively, she can lie down or stand with one leg on the edge of a chair or toilet
- Have her use one hand to separate the labia (vaginal folds) and clean from front to back with soap and water. Then rinse and dry
- Have the child apply lubricant to the tip of the catheter to lubricate it. Cover 5-8 cm (approximately 2-3 inches) of the catheter tip. She needs to use one finger to feel for her clitoris to help locate the correct urethral opening. When learning CIC steps, occasionally inserting the catheter into the vagina is normal
- While keeping the labia separated, have the child slowly insert the lubricated catheter into her urethra until urine begins to flow. Then gently advance the catheter another 3 cm (approximately 1 inch). The sphincter will offer some resistance, existing like a door within the bladder. It is important to have the child slow their breathing and relax their muscles
- Allow all urine to drain into the toilet or container
- When urination stops, slowly remove the catheter. Urine may still flow out and continue draining until no more urine flows
- Have the child wipe the perineal area clean and wash their hands.
Other Precautions:
Check the color, odor, and clarity of the urine. These can serve as indicators of infection and other conditions. If the urine changes, inform the doctor or nurse.
Record the amount of urine the child passes. This information can help the doctor and nurse work with you to establish an appropriate regular schedule for the child.
Possible Problems:
Catheter doesn't pass.During catheterization, if the child does not relax their urethral sphincter, the "bladder door" will remain closed. If the child cannot insert the catheter even though they are relaxed, you need to contact the doctor or nurse.
Catheter causes bleeding.During catheterization, a few small drops of blood may occasionally appear around the catheter. If this doesn't occur frequently, it may not be serious, but you should still inform the doctor or nurse.
If urine appears infected and the child has a fever. If the child has a fever and urine becomes cloudy and foul-smelling, you must contact the doctor immediately.
If urine appears infected but the child has no fever.If urine becomes cloudy and foul-smelling but the child has no fever, the child should drink more water. Ensure the child is catheterizing correctly. If the child shows signs of fever, contact the doctor.
Perform CIC 4-6 Times Daily：
Most doctors recommend performing CIC 4-6 times per day, with the specific frequency determined by the child's needs. The gap at night when the child is not performing CIC should not exceed 8 hours.
Choosing the Right Size Catheter for Your Child:
Your child's doctor will provide the catheter that is just right for your child.
Catheter thickness is measured in units called French (FR). Catheters used for clean intermittent catheterization range from 5-16 FR; the smaller the number, the thinner the catheter.
If necessary, the doctor will recommend changing the catheter size. For example, if emptying the bladder takes too long, it indicates the catheter being used is too thin.
Important Things to Know:
It is very important for the child to catheterize on schedule without missing times. Establish a regular daily schedule.
If a catheter falls on the floor, use another one.
Have the child drink plenty of water to help flush urine from the kidneys.
Disclaimer
- Some of the content in this article comes from online sources. If there is any infringement, please contact us for removal.
- The medical information provided here is for reference only and should not be used as a basis for clinical diagnosis or treatment.