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Thread: Spinal Nurse JM - Betadine Solution Washout

  1. #1

    Spinal Nurse JM - Betadine Solution Washout

    In the whirlwind of activity here it must be hard to keep up!
    On 09/19/05 you had given the recipe of a betadine solution to
    flush out indwelling caths. I had some further questions on it
    but the post must have bypassed you.

    You wrote in thread

    "Options include bladder washouts with various solutions: Essentially you can take a 1/4 stength betadine solution (take a liter of saline, dump out 250 cc and add 8oz of betadine). Irrigate your catheter with 30-60cc of this solution twice. Then take another liter of saline and irrigate your catheter with 30-60cc of the saline until the liter is gone. You can do this 1-2 times a day for 3-5 days. This will essentially clean out your bladder environment. The problems with it though is that it may cause bladder spesms due to the betadine. If it does, you can try just saline (total of 1 liter 2 times a day) to rinse vs wash your bladder.
    Hope this helps.

    After that I wrote/inquired:

    Your saline/betadine solution as an irrigant sounds like a good idea.

    You said you can do this for 3-5 days.

    * When is the best time to do this?
    * After completing an antibiodic dosage for a UTI?
    * Just before changing the foley or the day after? Or when?

    * Also ... is it good or ok to do this every month for 3-5 days and as a routine?

    Further ... irrigating with just saline goes against another spinal nurse's comment that irrigating was found not to be such a good idea (outlawed so to speak) since the 1980s. Unless obstruction occurs.

    Being 26 yrs post with a foley ... I flushed ALOT when I had constant gravel/sand/sludge but NO UTIs for years. But now with frequent UTIs (symptomatic and pathogen caused) I'm going to have some tests done.

    But in the meantime ... I hope you can answer my Qs above on when to use the betadine solution.

    Thanks in advance!

  2. #2

    Betadine solution washout

    Brinda 41 - I will need to get the assistance of my SCI team members and will report back. CRF

  3. #3

    Betadine Solution Washout

    Brinda 41 - The consensus of the SCI Nurse team is that the recommended protocol for managing indwelling catheter is that of the CDC (Center for Disease Control). Further, use of betadine is "way too caustic and could cause a chemical cystitis. The only solutions we use for bladder irrigation are saline and renacidin...."

    The CDC report follows:
    "The CDC publishes reports on prevention of infection periodically. This one is several years old, but based on many research articles. You might want to print this and share it with your providers...even people at leading centers may not be familiar with CDC guidelines:

    (the catagories below indicate the strength of the research evidence. Category I is strongest, with II and III following).


    6. Irrigation
    1. Irrigation should be avoided unless obstruction is anticipated (e.g., as might occur with bleeding after prostatic or bladder surgery); closed continuous irrigation may be used to prevent obstruction. To relieve obstruction due to clots, mucus, or other causes, an intermittent method of irrigation may be used. Continuous irrigation of the bladder with antimicrobial has not proven to be useful (28) and should not be performed as a routine infection prevention measure. Category II
    2. The catheter-tubing junction should be disinfected before disconnection. Category II
    3. A large-volume sterile syringe and sterile irrigant should be used and then discarded. The person performing irrigation should use aseptic technique. Category I
    4. If the catheter becomes obstructed and can be kept open only by frequent irrigation, the catheter should be changed if it is likely that the catheter itself is contributing to the obstruction (e.g., formation of concretions). Category II

    Hopefully this clarifies the confusion that arose. Please let me know if you need further information. CRF

  4. #4
    Hi CRF,

    I DID read somewhere else on the forum abt the irrigation protocol and agree with it too. No irrigation unless necessary. But with my bugs that are stubborn and either keep coming back or never really went away ... I think they are sticking to cells lining the bladder wall (one theory at least). And pseudemonas does this.

    So when I read JM's advice on the betadine washout to the one gentleman in the thread
    I was excited to try this but not until I asked my other questions on doing it.

    So the concensus then withdraws using the betadine solution trial to wash out the bladder?

    And that advice by JM is totally out of the question to use?

    If so ... maybe the member in that thread needs to know as well.

    And I need to know too. I'm kinda disappointed if it's not recommended now.
    Last edited by Brinda41; 10-04-2005 at 08:47 PM.

  5. #5

    Betadine solution washout

    brinda41 - Have you explored with your SCI urologist other options due to the problems that you describe? Has your urologist considered consulting with an infectious disease specialist as to an appropriate course of action? Often times, in other conditions, such as persistent pressure sores, consulting with the specialist seems to be down on the priority list and yet is often does have a positive outcome.

    SCI-Nurse team member RAB notes that if irrigation is needed, it is with saline and renacidin. He also cautioned strongly that betadine can cause a chemical cystitis and/or urethritis. Betadine is a caustic agent.

    I will refer the other person, who asked the original question, to review this dialogue in this post. Thanks for bringing this to my attention. CRF

  6. #6
    An "SCI Urologist" is like finding a nedle in a haystack! I asked one of Tucson's leading physiatrists for a referrasl to a Uro who was familiar with SCI. They quickly olffered a referral.

    I went to her and what a mistake! I had many questions but she let me know that "20 minutes was enough of her time." In my 26 yrs as a quad NOT ONE fist-time consult was under 30 or 60 minutes. She hurried on to her next patient.
    She billed Medicare $341 for those precious 20 minutes! A dollar a second! With me having tol pay a percentage.

    I have a girl-friend quad who goes to a regular Uro and likes him so I'm off to him next.

    How DO quads find "SCI Uros" in many towns?

    Also ... I noticed JM has suggested irrigations in other older threads.


    I'm *wary of net advice* but thought this was a better site than most.

    I hope you can give advice on finding an SCI URO without going through megabucks doing so. :-)
    Last edited by Brinda41; 10-10-2005 at 10:16 PM.

  7. #7
    RE; SC urologists- not necessarily only SC but maybe one who has experience with SCI pts. The physiatrists in your area would be the best ones to know whom to recommend.

    Re: bladder irrigation- again only for those who need it due to mucuous, sediment, etc...and those who have found it effective for preventing recurrent and dangerous UTI's.
    Irrigation itself could also give more chance for UTI.

    The use of the NS/Betadine irrigation is RCI's protcol. the bladder is irrigated with the NS/Betadine(250ccs) solution, then irrigated again and again with plain sterile solution to wash out the Betadine that can be irritating to the bladder.

    I will try to find out if RIC has research associated with it.


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