Solving problems specific to intermittent catheterisations

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Problem Cause  Solution
Blood in urine or catheter This could be due to irritation caused by the bladder neck muscle closing around the catheter on insertion or removal Relaxation techniques
Tenderness or pain in renal/suprapubic area, pyrexia, confusion or increased confusion or change in behaviour

Catheter associated urinary tract infection (CAUTI) - refer to section on diagnosis of CAUTI.

Foul smelling or cloudy urine is not necessarily a symptom of a UTI.

CSU should be sent to the lab for culture.
Advise patient to drink 200mls of cranberry juice twice daily if not contraindicated.
Ensure patient is supported and continues with self catheterisation plan.
Consider a lemon drink per day as evidence suggests this may reduce infection.
Reduction/change in flow of urine Recurrence of urethral stricture Refer to Urologist.
Inability to insert catheter
  1. Tight bladder neck muscle
  2. Constipation
  3. Recurrence of urethral stricture.

Relax or leave for a few minutes and try tapered tip ISC catheter (i.e. Teleflex liquickbase ergothan catheter)

If the bowel is loaded it may be causing an obstruction therefore treat constipation.

Refer to Urologist Continence/Urology CNS Ballochmyle Suite.

Difficulty in removing the catheter Sphincter dyssynergia Relax and let the catheter fall out by gravity. Do not use force to pull out.