SELF-CATHETERIZATION

You are being instructed on a simple and safe procedure of inserting a well
 lubricated clean tube known as a catheter, through your urethra (tube
leading from the bladder out) into the bladder in order to drain urine from
your bladder at regular intervals. This procedure is most often called for in
patients who either temporarily or long term have the inability to completely
empty their bladder of urine. By periodically placing this soft rubber tube up
the urine channel (urethra) into the bladder, you will evacuate your bladder
and thus prevent damage to the bladder muscle or back up of urine into
the kidneys. The procedure is a clean and not sterile technique. Bacteria
may enter the urine. This is known as bacteriuria which is different than a
urinary tract infection. A urinary tract infection occurs when infected urine
is not properly drained from the bladder and attacks the walls of the
bladder and ultimately the kidney causing a systemic infection with pain
and fever.


This procedure of intermittent self-catheterization is employed by patients
over a variety of age groups and both genders. This procedure is
preferable to the placement of a permanent indwelling catheter, as
systemic infections with indwelling catheters are higher, scarring of the
urine tube is greater with the indwelling catheter, and discomfort is
experienced with the long term indwelling catheter.  Ultimately, if your
bladder is able to return to its normal function, the intermittent
catheterization will promote the return of that function and will allow you to
determine when complete emptying has occurred.


Where you catheterize yourself is your decision. Many people do it while
on the toilet; others do it in the privacy of their bedroom. Women may find
a mirror helpful. The frequency of catheterization and the periodic use of
antibiotics will be established for you. An initial catheter or prescription
will be provided to you. Lubricating jelly should be used liberally and
should always be water based; i.e. never use a petroleum based lubricant
such as Vaseline. One of the most commonly used water based and
therefore permitted lubricants is K-Y jelly.


Catheters and lubricating jelly are often available at well stocked
pharmacies or medical supply houses. Consult your yellow pages for the
location and call ahead to make sure the supplies you desire are in stock.


It is quite natural to initially be concerned that you "will not be able to do it";
however, after reading over the instructions and after assistance
in the initial performance of the procedure of intermittent self
catheterization, you will become quite skilled at performing it safely and
officially.


Occasionally you will be asked to keep a record of your urinary
output. At times you will be instructed to attempt to urinate first and then
catheterize thereafter to obtain what is known as the post-void residual
amount. Those measurements can be performed in medical measurements
such as cc's or milliliters as well as common measurements such as
ounces. When your catheter is not is use, storage should be done in such
a fashion that the catheter will be easily relocated for its next use. You
should always carry a catheter and lubricant with you when you are
outside of the house. Between uses, make sure that you clean your
catheter with plain soap and water and rinse thoroughly. It is important that
the catheter dries before its next use.


Please feel free to write out questions to be addressed to
Dr. Bertini, Dr. Harris, or Maria.


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