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Thread: Can I use distilled water for catheter irrigation?

  1. #1

    Can I use distilled water for catheter irrigation?

    I am a female C4/5 complete quad age 51 and 36 1/2 years post. I think I have been a member of this community since 2001 but it has been so long I can't remember and I don't frequent this community as often as I would like to since I get the answers to my questions via my doctors, my urologist [who is familiar with neurogenic bladders and my bladder specifically], my home health agency nurses and caregivers and my own common sense.


    WARNING: There is a lot of information that is irrelevant to my question but because it seemed to flow with what I was trying to get across... I left it in. As well as answering questions that you might ask and therefore I will I have provided in this post. So I will bold my actual question.


    I could ask this question to my wonderful urologist of 10 years and I was just there but forgot to ask her. I have had to your gate my Foley catheter off and on since the 1980s for different reasons. Right now I am producing quite a bit of sediment because of having a pathogenic bacteria [Proteus Mirabilis] present in my urine/bladder since 2011. I had PM before in 2006 but got rid of it by removing bladder stones and being on IV antibiotics.

    I had 10 bladder stones removed in August 2012 (after my husband passed away and who used to be a Chief Med Tech and often talked with my urologist about bacteria and what to do in certain situations with my urinary health).


    Anyway, when I began to produce more sediment in my urine in 2011 [before my husband passed away] he was urinating and instilling my bladder with a sterile water/vinegar with a ratio that I can tolerate. We suspected that Proteus Mirabilis was present in my urine again so we had a urine culture taken again and, sure enough, it was present. My same urologist ordered a pelvic CT scan [the only way to see bladder stones] and my husband took me to have been pelvic CT scan done and it showed 10 bladder stones so we had them removed (like I said above) and was on IV antibiotics for Proteus Mirabilis and after the stones were removed my urologist had me do a "Gentamicin wash" irrigating with Gentamicin for 7 or 10 days [can't recall now]. But even after using all those 3 big guns to try to get rid of that nasty bastard of a pathogenic bacteria... it was still present after a urine culture. Fortunately, I have not been symptomatic (fever or pain) except for the sediment coming back with a vengeance.


    This time around my husband was gone and, needless to say, not only was he my life and my primary caregiver [with caregivers coming in to do my morning care and some evening care and having a home health agency like always, I changed my catheter every 3 weeks and hiring teenagers to clean our home since he couldn't do everything] but I had nowhere to go because he was with me 24/7/365 for the most part.


    I moved in with my sister and brother-in-law (who was in the Northeast) and lived with them for 3 years but since they were getting older and I have very little family left (basically only 3 family members who are still alive and active with communicating with me) they asked me "to move on" after my sister acquired so lower leg problems and they basically wanted their house back despite me hiring morning and evening caregivers 7 days a week along with having a great home health agency come in to change my catheter and any skilled nursing needs -- especially after acquiring a Stage III wound in 2009 which kept me bedridden but during those 3 years my husband and I were basically homebodies anyway so with home health agency skilled nursing help and my husband's knowledge of wounds and caring for my wound... my wound healed and my husband and I getting ready to start our active life again with me up in the chair only for him to completely unexpectedly pass away one morning. THIS IS ALL IRRELEVANT INFORMATION but it does seem to fall into the story. Sorry!


    Anyway, I have continued to irrigate and instill my Foley catheter with the sterile water/vinegar every morning and evening. I tried Renacidin for a brief amount of time but it was too caustic for my bladder and, for the first time in my life, I had blood in my urine despite diluting it. Since I had to move and the home health agency I have now (and the only one I could find to take me on as a Medicare patient and as a quad) is poor at getting supplies to me... I was wondering if I could use distilled water in place of sterile water.


    I just recently moved back to Arizona where my husband and I lived for numerous reasons and the nurse who came to change my catheter asked me why I was not using saline. I just responded that I had always used sterile water... even way back in the 1980s when I had a problem with sediment. It did not occur to me to ask my urologist when I went to see her for the second time since last week after moving back here in January if I could use distilled water because I thought the sterile water would have been delivered to my home by now as it has been a week and a half. I have contacted the agency and, unlike the one I had in Pennsylvania (which put all these agencies down here to shame) who had all of my supplies delivered to me via FedEx the next day or the day after they were ordered and after my nurse's visit to change my catheter. They have not yet responded to my call. They were supposed to start giving me a home health aide 2-3 mornings a week to give my live-in caregiver a break but they haven't even done that yet.


    Medicare started making cuts with home health care back in 1999 when they switched to the "Prospective Payment System" whereby I used to get 2 morning CNA visits for 2 hours each morning and 2 evening CNA visits for 2 hours each evening. That got worse and now, I am lucky if I get 3 home health aide visits a week! This occurred just 2 years after my husband and I married. We surely did not expect it and when it got worse over the years we were forced to start hiring our own caregivers. My financial income because of, god forbid I had a job and my husband was an expert in the software manager field working for NASA and other government agencies with good incomes, is now way over me being accepted for any Medicaid help. Been there, done that.


    I am between a rock and a hard place because I make too much money for Medicaid help but not quite enough for 24-hour care. For the first time in my life I was lucky to find a live-in caregiver whereby she accepts when I can pay her and I pay for her room and board. This is all irrelevant to this thread also and please do not respond to anything but my question regarding using distilled water.


    One last thing... if you are wondering why I am using a Foley catheter after 36 1/2 years... it is a "why fix what is not broke" issue. My urologist says that my bladder looks like a bladder that has never had an indwelling catheter in it for 36 1/2 years... and like an able-bodied person's bladder. I drink a lot of water all day long [understatement] but I have had to be careful since a little over a couple of years ago I was hospitalized for drinking myself into the hospital by drinking too much water to wash out my all of my electrolytes and felt really sick. I was only hospitalized for a couple days to get probiotics in me and then have been okay. I now add Powerade to my drink jug and add cranberry juice to some of my water in the morning or evening.


    Sorry for all the extra information that is completely irrelevant to this question!

    Thanks in advance!
    ~Lori
    Last edited by Brinda41; 04-09-2016 at 05:07 PM.

  2. #2
    I forgot to add that Original Medicare is my only insurance [alone with no supplemental insurance because of my finances] and they pay for sterile water or saline and that is why I have been using it but, again, the agencies down here are so laissez-faire at getting supplies to me (and I am not used to that) that if I ran out of sterile water... that is why I am wondering if I could use distilled water.

  3. #3
    This article written by members of the Urological Network of ACI (Agency of Clinical Innovation) indicates Sterile Saline or Sterile Distilled Water is appropriate for bladder irrigation. See the entire article at: http://www.nsgmed.com/nursing-proced...complications/

    It is worth noting that once a bottle of Sterile Saline or Distilled Water has been opened, they are no longer sterile (clean, but not sterile).

    You might want to consider irrigating the bladder with HydroCleanse or MicrocynAH, which is a electrolized water that even after the bottle has been opened effectively kills bacteria. See these threads:
    http://sci.rutgers.edu/forum/showthr...t=HydroCleanse

    http://sci.rutgers.edu/forum/showthr...t=HydroCleanse

    http://sci.rutgers.edu/forum/showthr...t=HydroCleanse

    I use HydroCleanse and I dilute it with Saline (80% HydroCleanse and 20% Saline). I use contact lens saline that is ONLY saline, NOT contact lens cleaning solutions. If you squeeze the Contact Lens Saline out of the bottle and don't touch the tip, it is less likely to be contaminated. Similarly, there are some saline ONLY products sold in drug stores, in an aerosol spray can, that remains sterile use after use because the liquid is expelled from the can under pressure and never exposed to the air. Spray saline is generally used for would cleaning and can be used as contact lens rinse and insertion liquids. I know many of you have read my posts about HydorCleanse, Microcyn and MicrocynAH before, but many newer members may not have seen these threads. I mention this product because I have had good success in helping to prevent colonization and urinary tract infections. Your decision to use these products or not should be made after you read these threads and judge for your self the efficacy of these products for your personal use based upon the anecdotal evidence I and other Care Cure members have provided.

    Bladder irrigation- purposes, equipments, procedure, complications

    Journal Published: November 29, 2014

    DEFINITION

    Bladder irrigation can be defined as a process of flushing out or washing out the urinary bladder with specified solution

    PURPOSES

    • To flush clots and debris out of bladder
    • To instill medication to bladder lining
    • To restore patency of the catheter.

    INDICATION

    • Post TURP (Trans urethral resection of Prostate)
    • Post ESWL (Extracorporeal shockwave Lithotripsy)


    EQUIPMENTS NEEDED

    • Disposable gloves
    • Disposable ,water resistant,sterile towel/mackintosh
    • Three way retention catheter in-situ
    • Sterile drainage tubing and bag in place
    • Sterile antiseptic swab
    • Sterile receptacle
    • Sterile irrigating solution Normal saline or Distilled water or Solution as prescribed by physician


    • Infusion tubing
    • IV pole
    • Kidney basin



    All the best,
    GJ

    PS: I'd perfer saline over distilled or sterile water, and much prefer HydroCleanse diluted slightly with saline.
    Last edited by gjnl; 04-07-2016 at 12:13 PM.

  4. #4
    Senior Member lynnifer's Avatar
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    You have had a shit time of it! I'm so sorry.

    I've been using a foley cath since 2009 and my bladder has shrunk big time. Probably looking at a mitro augment now. Urethra is damaged. Flaccid paralysis so prolapse too .. tried to fix, but no go.

    I always wash out with saline. Once you get stones, I think you're going to get them and get them.

    If you're wanting the sterile water, I guess you would have to find some studies that show it works over saline and show them to your medical provider?
    Make America Sane Again. lol

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  5. #5
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    Some of the nurses here didn't recommend using distilled water. I think it was said that it can cause bladder damage. Sterile or saline water is what was recommended to me.

  6. #6
    I am having a hard time with my home health agency getting money supplies to me on like never before. Because of my insurance I can only have certain "Medicare certified home health agencies."


    After I had my sister call them and tell them it has been over a week and a half since I saw my nurse and I have not received any of the supplies ordered (leg bag, night bag, extension tubing, sterile water, Foley catheters, insertion kits and hear occasion kits) and my nurse left a bottle of sterile water on my doorstep last evening and did not even not then my door but called me to let me know what she did! She then gave me a guilt trip by saying "I had to pay $14 and get this from a compound pharmacy." I have always received sterile water or saline from my home health agencies over the last 36 years and I can barely find a Medicare certified home health agency to take me on and it is... bottom line... discrimination. Then I am treated like this for the first time in my life! My urologist said that saline is fine so I told my nurse that and from now on that is what they will order but I have gone to hell and back just to get back but not the rest of my supplies. My doctor has contacted numerous home health agencies in Tucson Arizona (a big city) but they do not like to take me on because I am a quad with these needs and use Medicare YET THEY ARE IN BUSINESS FOR DOING JUST THAT! Nurses from other agencies prior to moving here without my husband of always checked in on me to see how I am doing and have had to do supervisory visits but this agency first told me they had a home health aide for me and now they are telling me they do not.


    Again, I have gone through several and because I need at least 2 morning home health aide visits let alone the skilled nursing (and that is not asking for much) they will not take me on but just provide excuses. I am going to make a complaint with my my state ombudsman but the few times that I have had to make a complaint (which have been probably 3 times over three decades) I get repercussions and they dropped me.

  7. #7
    Thank you GJ for the great articles that have been previously discussed here.
    I however, the articles basically say that HydroCleanse or Microsyn come in a spray bottle for wounds. I do most of my online shopping through Amazon and they carry it but it comes in a spray on like sterile water or saline. Therefore, I am assuming that you just twist off the cap to not use it as a spray but to get the liquid out to irrigate a Foley catheter with?


    Thank you much in advance!
    ~Lori

  8. #8
    In a pinch you can use sterile distilled water. I would not use it routinely. In my opinion, I would recommend using sterile saline, which can be made at home. I am not sure of the "recipe", but I am sure you could find it online.
    ckf

  9. #9
    here's the recipe for cooking up home saline
    Attached Images Attached Images

  10. #10
    Normal saline is much less irritating to your bladder than sterile water. Distilled water is not necessarily sterile. There really is no good evidence that routine irrigation of indwelling catheters reduces your risks for either UTI or stones...the CDC and APIC recommends against it, and has since the 1980s.

    (KLD)

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