Intermittent catheterisation: an option for managing bladder dysfunction

摘要

Intermittent catheterisation (IC) is a safe and effective way of preserving renal function in people with bladder dysfunction. IC involves the insertion and removal of a catheter to drain the bladder. It can be used as a one-off intervention to measure residual urine if a bladder scanner is unavailable, or as a long-term option to manage dysfunction of the bladder (Abrams et al, 2003;Vahr et al, 2013). IC can be performed by the individual (intermittent self-catheterisation, ISC) or performed by a health professional or carer. IC is a clean technique when used by the individual (ISC) and a sterile technique when performed by health professionals or carers (Seth et al, 2014). Potential complications Although IC is the preferred option for bladder drainage in bladder dysfunction, complications and adverse events can occur, especially when IC is performed long-term. Complications include stricture formation (more common in men), pain, urinary tract infection (UTI), bladder stone formation (Joshi and Mittal, 2014), urethral trauma, urethral bleeding and urethritis in both sexes (Newman and Wilson, 2011; Vahr et al, 2013). Urethral bleeding is particularly common in women, especially when learning the ISC technique (Turi et al, 2006; Igawa et al, 2008). Any persistent bleeding should be investigated as this may indicate urethral trauma or UTI. Long-term use of IC can increase the risk of bladder calculus formation. The pathogenesis relates to the introduction of pubic hair when the catheter is inserted, which acts as the origin (nidus) for the stone formation (Joshi and Mittal, 2014).