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Home > Patient Education Repository > 12043--Clean Intermittent Catheterization (CIC) for Boys

patient education : 12043--Clean Intermittent Catheterization (CIC) for Boys

Information from Pediatric Urology about how to drain urine from a boys bladder when it is unable to empty completely.

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    Clean Intermittent Catheterization (CIC) for Boys

    What is CIC, or clean intermittent catheterization?

    CIC is a way to drain urine from your child’s bladder when it is unable to empty completely. It is performed by inserting and removing a catheter several times a day.

    Why does my child need CIC?

    The doctor has decided your child needs CIC to completely empty their bladder. It is important to your child’s health to empty their bladder fully and CIC will:

    • Keep the bladder muscle healthy and functioning properly; it must be completely emptied each time it is filled. If it is not emptied completely, it can make the problem worse. If the bladder is not fully emptied, it can also damage the kidneys.
    • Help prevent urinary tract infection. If the urine is not emptied completely from the bladder, bacteria can grow and cause a UTI.
    • Prevent wetting episodes and keep your child dry. This will protect their skin from irritation and breakdown.

    How often should I perform CIC?

    • CIC is usually performed every 3-4 hours from morning until bedtime, or as directed by your physician. Sometimes children will have different schedules based on a child’s individual needs.
    • Unless you are told otherwise, you do not need to perform CIC during the nighttime. Always make sure you catheterize your child before bed.
    • You should never restrict fluids in order to catheterize your child less. This is dangerous to their health.

    Who should learn to catheterize my child?

    Anyone who will be caring for your child on an ongoing basis for more than 3-4 hours at a time should be trained on CIC. The more people who know how to catheterize your child, the better, but it should always be someone the child feels comfortable and safe with. This will prevent any issues if you are delayed or need to be somewhere else. If your child is school aged, they will most likely be catheterized by the school nurse and will require an order from the physician to be sent with them to school.

    Will my child need to be on medication for CIC?

    Some children who need CIC also need medications to help their bladder remain flexible and prevent leaking or take a small dose of an antibiotic to help prevent infection. It is very important that you take these medications as directed.

    What equipment does it require?

    It is best to gather all the equipment you will need before you begin.

    • Catheter
    • Water soluble lubricant
    • Cleaning wipes
    • Container for urine being removed

    Make sure all of your catheters are latex-free.

    You will probably want a storage bag to keep all of the equipment together and organized. Some people use a make-up case or other small bag. This will also help when you need to leave the house, much like bringing a diaper bag when you go out.

    How do I perform CIC?

    1. Gather all your equipment.
    2. Wash hands well with soap and water. You do not need to wear gloves.
    3. Position your child as comfortably as possible. Depending on his age and ability to balance he can lie down, sit on the toilet with legs spread apart, or stand.
    4. Lubricate the tip of the catheter (which is rounded with small holes on the tip). Approximately the first four to six inches should be lubricated.
    5. Hold the penis upright on the sides so the urethra is straight and not pinched off. If your child is not circumcised, you will need to retract the foreskin.
    6. Wash the penis from the opening to the base using a circular motion. Never wipe back and forth across the opening. Take this time to examine the area for any redness, swelling, discharge, or other problems.
    7. Position the catheter so the end of the catheter rests in the urine container and the lubricated end is ready to be inserted into the urethral opening.
    8. Keeping the penis upright, gently insert the catheter into the urethral opening with your free hand.  When urine starts to flow, the catheter has entered the bladder. You should advance the catheter another half inch.
    9. You may feel the catheter stick or meet some resistance just before it enters the bladder. This is because of the muscle that keeps the bladder from leaking. Do not pull out the catheter, but maintain gentle but firm pressure until the muscle relaxes and the catheter slides easily in. Also, do not “poke” at the muscle by moving the catheter back and forth to try and force open the muscle. This will not work and may also cause damage to the urethra. It can help to have your child take a deep breath and let it out slowly.
    10. When urine stops flowing, start removing the catheter slowly, twisting as you do. More urine may start to flow again. If so, stop removing the catheter until the urine is done flowing. Repeat this motion until the catheter is out.
    11. Wash and dry your hands.

    If you encounter blood when you catheterize your child, stop catheterizing them and call the Division of Pediatric Urology (see below).

    How do I clean catheters after use?

    It is vital that you keep some catheters stored in case of emergency. Even if your insurance company will cover enough catheters that you do not need to reuse them, you should always make sure that you have enough catheters if they are unable to get them to you, or your order is held up for some reason (i.e. a storm makes roads unpassable, change in insurance or catheter providers, etc.).

    To clean catheters:

    Boil water in a pot (enough water to cover the catheters you are cleaning completely). Remove the water from the heat source and place the catheters in the water. Leave them in the water for ten minutes, off of the heat. Take the catheters out and allow them to dry completely before storing in a sealed bag, such as a zip lock bag.

    Important reminders:

    • Make sure your child is drinking plenty of fluids a day. Preferably water, unless they are still breast or formula fed. Avoid caffeine, soda, and other sugary drinks.
    • Call your physician if your child has a fever, side pain, cloudy, bloody, or foul smelling urine, or difficulty or pain with inserting the catheter.
    • Soon you will become an expert at catheterizing your child and your child will become more used to the procedure itself. It can seem scary at first, but many children must perform CIC daily. It will become routine, though it may seem difficult now.
    • Do not skip the lubrication; this can cause urethral irritation or bleeding. It can also cause a condition called “false passage” which can complicate CIC.
    • If a catheter becomes stiff, cloudy, discolored, or too soft to insert properly, always discard and replace with a new catheter.

    If you have any questions, please do not hesitate to call us. We are happy to help you. During the day call the Urology Clinic.  After hours,  call the UVA Operator and ask for the Urologist on call to be paged.

    434-924-2590             Pediatric Urology Clinic

    434-924-0200             Urologist on call

     

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