Health Education | A Home Guide to Clean Intermittent Catheterization for Women

Cervical cancer is one of the most common malignant tumors of the female reproductive system. Patients who undergo radical surgery for cervical cancer are at risk of urinary retention to varying degrees. Before discharge, our nursing team guides patients in mastering an important self-care technique — Clean Intermittent Catheterization (CIC).

Traditionally, indwelling urinary catheters have been used to manage post-operative urinary retention after cervical cancer surgery. In recent years, we have actively promoted CIC as an effective approach for patients experiencing urinary retention following radical hysterectomy. CIC helps restore bladder function, reduces the risk of urinary tract infections, and improves patients’ quality of life.

What Is Clean Intermittent Catheterization?

Clean Intermittent Catheterization (CIC) refers to the scheduled insertion of a catheter into the bladder under clean (non-sterile) conditions to regularly drain urine. The International Continence Society (ICS) recommends CIC as the gold standard treatment for neurogenic bladder dysfunction.

Goals of Clean Intermittent Catheterization

In terms of bladder function recovery, CIC promotes detrusor muscle contraction, maintains normal intravesical pressure and blood circulation, facilitates early restoration of bladder function, and effectively helps patients develop the habit of spontaneous voiding.

Advantages of CIC Over Indwelling Catheterization

• Effectively promotes voiding, reduces urinary tract infections, and improves the prognosis of urinary retention.
• Avoids the inconvenience and discomfort of carrying an indwelling catheter in daily life, and prevents psychological distress.

What Is a Fluid Intake Plan?

• Prepare a graduated measuring cup to ensure accurate fluid intake. The recommended daily fluid intake is approximately 1,500 ml.
• Avoid drinking fluids within 3 hours before bedtime to prevent excessive bladder distension overnight.
• Avoid diuretic beverages such as tea, alcohol, sugar-sweetened drinks, watermelon juice, and barley water.

Recommended Frequency of CIC

It is recommended to catheterize every 4 to 6 hours, with each catheterization draining 300–400 ml. The specific frequency is determined based on the patient’s post-void residual (PVR) volume:

• Residual urine < 100 ml: No catheterization required.
• Residual urine ≈ 200 ml: 3–4 times per day.
• Residual urine ≈ 300 ml: 4–5 times per day.

The catheterization interval should be adjusted based on bladder capacity (spontaneous void volume + catheterized volume).

Recommended Catheterization Schedules

• Five times per day: 7:00 AM • 11:00 AM • 3:00 PM • 7:00 PM • 11:00 PM
• Four times per day: 7:00 AM • 11:00 AM • 4:00 PM • 10:00 PM
• Three times per day: 7:00 AM • 3:00 PM • 10:00 PM
• Twice per day: 7:00 AM • 10:00 PM
• Once per day: 10:00 PM

Procedure

• Hand hygiene: Thoroughly wash both hands with running water and soap. Open the catheter packaging and use immediately.
• Cleansing: Gently spread the labia apart and clean the urethral opening. Wipe from front to back to prevent bacteria from entering the urethra and bladder. Each cleansing wipe should be used only once — do not reuse.
• Insertion: Keep the labia separated and the urethral opening fully exposed. Relax the body and gently insert the catheter into the urethra, advancing approximately 2 cm at a time until urine begins to flow.

Source: Daxan Medical — Patient Education Series | daxanmed.com