Intermittent Self-catheterization for Men

Urinary retention is the term used to describe the inability to urinate.

How does the urinary system work?

The urinary tract begins with the kidneys. The kidneys, one on each side, sit high on the upper abdomen partially underneath the rib cage. They filter the blood to extract excess waste products and fluid to form the urine. Urine once formed in the kidneys travels through a tube on each side, called the ureter, down to the bladder. Urine is constantly being made by the kidneys and being transported through the ureters into the bladder. The bladder stores urine until full and then empties to the outside through the urethra. The urinary system is the same in both men and women from the level of the kidneys to the bladder. In men the urethra is longer and encircled by the prostate which is a gland that is part of the reproductive system

What does the bladder do?

The bladder has two jobs. First, it stores urine until it is full, and then second, it empties to the outside. When the bladder can’t empty, then urinary retention develops. The bladder is a muscle - as the kidneys make urine, the bladder muscle stretches to hold the increasing amounts of urine. As the bladder fills, the urinary sphincter, a separate muscle that wraps around the urethra (the pathway to the outside), squeezes the urethra shut to keep the urine from leaking to the outside. When it is time for urination to occur and the bladder is ready to empty, the following occurs - the urinary sphincter muscle relaxes to open the urethra and the bladder muscle contracts to push the urine to the outside.

Why can’t I urinate?

There are a variety of reasons why urinary retention may develop. There may be blockage on the pathway to the outside. The bladder muscle may not work. When urinary retention is present, the bladder can do its first job, which is to store the urine, but is unable to do its second job, which is to empty urine to the outside.

If I cannot urinate, how can I get rid of the urine?

If the bladder is unable to empty on its own, there are two ways to drain the urine: an indwelling catheter attached to a bag, or intermittent self-catheterization.

How do I do self-catheterization?

Self-catheterization is one of the safest ways to provide drainage of the urine. Although it sounds frightening, and it seems as if it would be painful or embarrassing, it can be done relatively easy with minimal discomfort. Self-catheterization reduces the risk of infection compared to an indwelling catheter attached to a bag. For self-catheterization, it is not necessary to use sterile technique. Cleanliness is all that is needed. Research has shown that if the bladder is emptied regularly and completely before it gets overstretched, there is little likelihood of infection. Self-catheterization should be carried out on a schedule during the day to empty the bladder before it has more than 350 to 400 cc (approximately 12-14 oz). Keeping track of the amount of urine which is drained by self-catheterization helps a person determine how often catheterization should be performed

This Is The Equipment You Will Need:

! Catheter - Usually a clear, soft plastic or soft red rubber tube.
! Lubricant - Men must always use a water-soluble lubricant, not a petroleum jelly.
! Cleansing packet or wash cloth - Use a cleanser that is mild.
! Container to drain urine in - You only need this if you are not close to a toilet.
! Plastic bag or plastic lined pouch to store the catheter

You may catheterize yourself while standing over the toilet, sitting on the commode, sitting in a wheelchair, reclining in a chair, or lying in bed. If you cannot get up close to a toilet or a place to drain the urine, there are long extension tubes to attach to the catheter.

This Is The Procedure:

• Wash your hands with soap and water.
• Hold the penis with your non-dominant hand. (That is the hand you do not write with or use to feed yourself.) Wash the head of the penis.
• Lift the penis gently upward and outward. With your dominant hand (the hand you write with or feed yourself with), grasp the catheter 2" to 3" from the tip. Dip the catheter tip into lubricating jelly. Pass the lubricated tip of the catheter into the opening in the penis and slowly advance the catheter with constant, steady pressure until the catheter reaches the bladder and urine begins to drain. When the catheter reaches the area of the prostate, it may be difficult to continue. Take some deep breaths to relax and be patient. For some men, a special catheter with a slight curve at the tip may be helpful. Leave the catheter in place until all urine stops draining and then slowly pull the tube out, stopping whenever urine begins to drain again until it stops completely each time. The urine may be drained into the toilet or into a container.

What If I See Blood?

Occasionally there is a small amount of bleeding if the catheter has irritated your urethra. Usually there is no cause for alarm

Is This Expensive?

Medicare Part B and other insurance companies usually cover the cost of the catheters (at least 80% in most policies). Speak to the supplier where you get your catheters. You may need a statement of medical necessity or prescription signed by your doctors or nurse practitioner.