The most important part of self-catheterization after bladder surgery is hygiene. The process involves putting a catheter into the urethra and up to the bladder to allow emptying of the urine. The process should be done as hygienically as possible to prevent infection. Self-catheterization after bladder surgery, while seemingly difficult and complicated, need not be so with the correct training.
After bladder surgery, catheterization may be needed, either short-term or forever, depending on the surgery that was performed. Catheters may be permanently necessary, changed on a weekly or monthly basis, or intermittent self-catheterization may to be performed. This involves inserting the catheter every four to six hours to void the bladder and then removing it again.
Self-catheterization after bladder surgery is slightly more easy for men than women, as the penis is more available and the urethra can be seen. Self-catheterization for women is performed using a mirror initially to allow a good view of the process, as the urethra is hidden from plain sight. After a while, the mirror will become unnecessary and many women are able to do it by feel.
Catheters come in various sizes and materials. The type used will be determined by the medical practitioner. Depending on the bladder surgery that was performed, the intermittent self-catheterization may be performed after normal urination to clear out the bladder.
The process of self-catheterization after bladder surgery should be explained to the patient by a trained nurse. The nurse will go through the process and guide the patient each time, until the patient is more confident. Before performing self-catheterization all supplies should be gathered in a clean place. Supplies include baby wipes or cotton wool with soap and water, aqueous-based lubricant, the catheter, a collection container if necessary and a mirror for women.
Some people empty the urine directly into the toilet, so they would perform self-catheterization in the bathroom. Others collect the urine in a container, so they can perform the process anywhere private and comfortable. In the case of self-catheterization after bladder surgery, the doctor often wants to know urine output, so urine may be collected in a measuring cylinder.
Hands should be washed carefully, and the patient should find a comfortable position for self-catheterization. The easiest position for women is with one foot up on the commode or lying on a bed in the "frog position," with the collection container between the legs. For men, positioning next to the toilet is easiest. Some of the lubrication gel should be squeezed onto a clean surface or onto the tip of the clean catheter.
Using the mirror, the women should carefully open the lips of the labia and clean the area with soap and water or the baby wipes. For men, the penis should be washed with soap and water, and the foreskin moved back if the man is uncircumcised. When the area is clean, the catheter should be dipped into the lubricant gel if this step has not already been taken, and gently guided into the urethra. This may, initially, be slightly painful but with practice should become painless. Local anesthetic is sometimes used in patients who find the pain uncomfortable.
When urine starts flowing through it, the catheter should be pushed about an inch (2.5 cm) further in. Once the flow has stopped, the person should strain or push the stomach slightly to void any residual urine. Once the urine flow is completely finished, the catheter can be pulled out gently, stopping if more urine flows out. The penis or vagina can be wiped with toilet paper to remove lubricant gel.
Urine should be measured, if necessary, and discarded, and the container should be washed thoroughly. The catheter should be washed in warm, soapy water and allowed to dry before being stored in a clean, dry, bag. The final step is to wash the hands.