Clean Intermittent Catheterization (CIC) Operation Manual Illustrated Step-by-Step Guide
Home-Based Clean Intermittent Catheterization (CIC)
Clean Intermittent Catheterization can be performed at home independently by the patient, or with the assistance of family members or caregivers. The key characteristic of CIC is that strict sterilization is not required; maintaining cleanliness is sufficient. However, because CIC requires inserting a catheter through the urethra several times a day to drain urine, it is a procedure that demands proper technique. Without adequate skill, patients may experience pain, urethral trauma, or infection. Therefore, it is essential to become familiar with the procedure, master the correct techniques, and minimize unnecessary urethral injury and bleeding.
Catheterization Procedure
1.Preparation of Supplies: Hydrophilic catheter, hand soap, sterile gloves, cleansing wipes, urine collection bag (or urinal), and voiding diary (for recording urination).
2. Hand Hygiene: Wash hands thoroughly with soap under running water. (It is recommended to use the seven-step handwashing method. If this is not possible, alcohol-based hand sanitizer may be used as an alternative.)
3. Hydrophilic Coating Activation:
For water-filled catheters, break the water capsule to allow the catheter to be moistened with sterile water and let it stand for at least 60 seconds. For standard catheters, immerse in sterile water or saline for at least 60 seconds to ensure the coating on the catheter surface is activated, achieving proper lubrication.
4. Cleaning and Disinfection:
Use a disinfectant wipe to clean the urethral opening by wiping in a circular motion from the inside outward, to prevent bacteria from entering the body and causing infection.
5. Catheter Insertion:
5.1.Male catheterization: The male urethra is 18–20 cm long. Hold the penis with one hand and lift it so that it forms a 60° angle with the abdominal wall, straightening the pubic bend.
5.2.Female catheterization: The female urethra is 3–5 cm long. Once urine is observed, advance the catheter an additional 1–2 cm. Due to the anatomical characteristics of the female urethra, the external urethral orifice cannot be directly visualized without assistance. Choose an appropriate position that facilitates successful exposure of the urethral opening to ensure successful catheterization.
5.3.Tiemann-tip Catheter:The tiemann-tip catheter has a bent head, suitable for individuals with prostatic hyperplasia or elevated bladder neck. Position the curved part toward the ventral side, closely following the anterior urethra during insertion.
6.Precautions:
1. When removing the catheter, pulling out too quickly may leave residual urine. Slowly withdrawing the catheter helps ensure complete bladder emptying.
2. During insertion, use gentle movements, especially for male patients. Avoid applying excessive force to prevent injury to the urethral mucosa.
3. For female catheterization, take care to avoid inserting the catheter into the vagina. If this occurs, replace the catheter and perform catheterization again. Do not reuse the same catheter to prevent infection.
4. Before using a catheter, check the packaging for moisture or damage. If any abnormalities are found, stop using it and obtain a replacement at a hospital.
5. The frequency of daily catheterization should be based on post-void residual urine volume, but always follow your doctor’s guidance. Even if residual urine is below 50 ml, do not stop catheterization based on your own judgment. Consult your doctor to decide when to stop self-catheterization. Patients without urinary urgency should follow a scheduled catheterization plan (coordinate with your attending physician to develop a voiding schedule).