Clean intermittent catheterization - male; CIC - male

You will use a catheter (tube) to drain urine from your bladder. You may need a catheter because you have urinary incontinence (leakage), urinary retention (not being able to urinate), prostate problems, or surgery that made it necessary.

Urine will drain through your catheter into the toilet or a special container. Your doctor will show you how to use your catheter. After some practice, it will get easier.

Sometimes family members, a school nurse, or others may be able to help you use your catheter.

Your doctor will give you a prescription for the right catheter for you.

There are many different types and sizes of catheters. You can buy catheters and other supplies at medical supply stores. Others supplies may include towelettes and lubricant, such as K-Y jelly or Surgilube. Do NOT use Vaseline (petroleum jelly).

Ask your doctor how often you should empty your bladder with your catheter. Usually, you will need to empty it every 4 to 6 hours, or 4 to 6 times a day.

Always empty your bladder first thing in the morning and just before you go to bed at night. You may need to empty your bladder more frequently if you have had more fluids to drink.

Avoid letting your bladder get too full. This increases your risk of infection and other problems.

Follow these steps to insert your catheter:

• Wash your hands well with soap and water.
• Collect your supplies: catheter (open and ready to be used), towelette or other cleaning wipe, lubricant, container to collect urine if you are not planning to sit on the toilet.
• You may use clean disposable gloves if you prefer not to use your bare hands. The gloves do not need to be sterile, unless your doctor says so.
• Move back the foreskin of your penis if you are uncircumcised.
• Wash the tip of your penis with Betadine (an antiseptic cleaner), towelette, soap and water, or baby wipes the way your doctor or nurse showed you.
• Apply the K-Y Jelly or other gel to the tip and top 2 inches of the catheter. (Some catheters come with gel already on them.)
• With one hand, hold your penis straight out.
• With your other hand, insert the catheter using firm, gentle pressure. Do not force it. Start over if it is not going in well. Try to relax and breathe deeply.
• Once the catheter is in, urine will start to flow.
• After urine starts to flow, gently push in the catheter about 2 more inches, or to the "Y" connector. (Younger boys will push in the catheter only about 1 inch more at this point.)
• Let the urine drain into the toilet or special container.
• When urine stops, slowly remove the catheter. Pinch the end closed to avoid getting wet.
• Wash the end of your penis with a clean cloth or baby wipe. Make sure the foreskin is back in place.
• If you are using a container to collect urine, empty it into the toilet. Always close the toilet lid before flushing to prevent germs from spreading.
• Wash your hands with soap and water.

Most insurance companies will pay for you to use a sterile catheter for each use, and some catheters are meant to be used only once. Many other catheters, however, can be re-used if they are cleaned correctly.

If you are reusing your catheter, you must clean it every day. Always make sure you are in a clean bathroom. Do NOT let the catheter touch any of the bathroom surfaces (such as the toilet, wall, or floor).

Follow these steps:

• Wash your hands well.
• Rinse out the catheter with a solution of 1 part white vinegar and 4 parts water. Or, you can soak it in hydrogen peroxide for 30 minutes. You can also use warm water with soap. The catheter does not have to be sterile, just clean.
• Rinse it again with cold water.
• Hang the catheter over a towel to dry.
• When it is dry, store the catheter in a new plastic bag.

Throw away the catheter when it becomes dry and brittle.

Call your doctor or nurse if:

• You are having trouble inserting or cleaning your catheter.
• You are leaking urine between catheterization.
• You have a skin rash or sores
• You notice a smell.
• You have penis pain.
• You have signs of infection (a burning sensation when you urinate, fever, or chills).

Cespedes RD, Gerbec JL. Other therapies for storage and emptying failure. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 75.