Clean Intermittent Catheterization at Home: Female

Clean intermittent catheterization is a way to empty your bladder by using a new catheter each time and using clean technique to catheterize yourself. By emptying your bladder regularly, you can help prevent urinary tract infections (UTIs), bladder stones and renal damage.

Catheterize at these times:

1. When you wake up in the morning
2. Every 4 hours during the day (your health care provider might give you a more specific schedule)
3. Before you go to bed

1. Gather the equipment:
   1. Catheter (Size: ___________Fr.)
   2. Soap and water and a clean washcloth or disposable wipes
   3. Water-soluble lubricant (such as K-Y Jelly). Do NOT use petroleum jelly, such as Vaseline
   4. Chucks or towel to place under yourself while catheterizing
   5. Urine collection container (if not catheterizing into the toilet)
   6. Gloves, if needed
2. Place all equipment on a clean surface.
3. Make sure your clothes are away from your body and you have enough light to see well.
4. Wash your hands well with soap and water. This reduces bacteria and prevents infection.
5. Open the catheter package and lubricate about 2 inches of the tip of the catheter with the water-soluble lubricant. Do NOT use petroleum jelly, such as Vaseline, because it doesn’t dissolve. 
6. Separate the labia and wash the urinary (urethral) opening thoroughly with soap or a disposable wipe. Wash starting at the urethral opening and wiping down towards the rectum. This prevents infection by helping to keep bacteria from your rectum from reaching your bladder. Rinse clean with water.
7. Place the drainage end of the catheter into a toilet, urinal or container.
8. Spread the labia with your fingers and insert the catheter slowly about 2 to 3 inches. When urine starts to flow, insert the catheter about 1 inch more.
9. If no urine comes out of the catheter, you might have placed the catheter into your vagina. If the catheter is in your vagina, you may leave it there as a guide. Then take a new catheter and insert it into your urethral opening. (See illustration.) If the urethral opening is blocked, you might need to gently rotate the catheter or gently push the catheter a little further into the bladder. Never force the catheter.
10. Allow urine to drain until the flow stops. Then slowly withdraw the catheter, allowing any remaining urine to drain so the bladder completely empties.
11. When you’re ready to remove the catheter tip, hold it so the urine drains down from the tip of the catheter and not onto you.
12. Look at your urine and take note of its color, odor, characteristics and amount. Record the amount if you’ve been instructed to do so by a health care provider. Then dispose of the urine and catheter. Wash your hands with soap and water.

It’s very important to set a schedule for catheterization. To establish a routine, keep a daily record of the time of catheterization, the amount of urine collected, and whether you’re wet, damp or dry. Setting an alarm reminder on a cell phone, watch or other electronic device might be helpful.

Setting a routine might take several months. Once a routine is working well, you won’t need to measure the amount of urine you collect each time you catheterize.

To gain independence, you should learn to self-catheterize, if possible.

Because some patients have poor hand-eye coordination, it’s important to practice activities that will help you guide the catheter into the urethra. Ask your health care provider for examples of activities that will help with this.

You should learn to catheterize from a seated position, so you can do it in a wheelchair, car or bed, or while you’re on the toilet. To make it easier to pull clothing down for catheterization, consider sewing Velcro fasteners or zippers into seams at the sides or in the crotch area of pants.

Your urologist or primary health care provider will recommend when to schedule follow-up visits. Bring your daily record of catheterization to your clinic visits, if directed to do so.

Notify your health care provider if:

• You can’t pass the catheter through your urethra
• You leak urine between the times you catheterize
• You see blood in your urine
• You produce unusually small or large amounts of urine without a significant change in your eating or drinking activity 
• You experience symptoms of a urinary tract infection, which might include:
  • Pain or a burning sensation during catheterization
  • Lower abdominal pain
  • Fever higher than 101.5 F
  • Increased leaking between the times you catheterize
  • Increased odor of your urine