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Thread: Intermittent catheterization question

  1. #1

    Question Intermittent catheterization question

    Question: I came home from the hospital after being treated for a urinary infection and the doctor wants me to intermittent catheterize each morning when I change my condom catheter. He sent me home with three catheterization complete trays. I suspect you do not use a new catheterization tray each time you catheterize as many of you do it three or four times each day.
    So what's the skinny? Should I keep the catheter and use it over? How should I keep it sterile? What's your procedure?
    Thanks
    Wayne

  2. #2
    Hos, I believe you are on Medi-Cal, correct? They will pay for a touchless type catheter kit that your attendant can use new each time. I would suggest you call your physician (either the urologist or your SCI physician) to get the prescription for this. The physician or discharge planner should have given you the prescription before sending you home.

    Until then, catheters can be reused, but this is a controversial topic. Medicare requires it unless you have had 2 febrile UTIs in the last 12 months. If you have more than that on intermittent cath, you may be able to get a new catheter each time, but not a sterile kit. To reuse catheters, wash well with soap and water, rinse well and shake dry. Fold in a dry bath towel and allow to air dry for a full 24 hours before reuse. After the drying time, they can be stored in a clean new brown paper lunch bag. Avoid soaking or cleaning with disinfectants or storing wet. Avoid using latex catheters...silicone or PVC are preferred.

    Attendants can do modified clean technique. The meatus and penis should be washed with soap and water. Betadine is not needed. Lubricant can be put on a new clean paper towel and the first 6-8" of the catheter should be lubricated (for males). Be sure to use a separate tube from the one you use for bowel care. The attendant should wear exam gloves (sterile gloves are not needed). Drain into a urinal, then discard.

    (KLD)

  3. #3

    Vinegar Cleaning?

    I was just coming on to ask this question and I saw this thread. While i beleive in single use I know there are a lot of people reusing and I want to ask specifically about people using vinegar to soak their catheters in. I cannot imagine what this does to the urethra. Are there any papers on this? Thanks

    SW

  4. #4
    The study that the procedure above is based on looked at vinegar too, but it did not kill all the bacteria as this procedure did. I was involved in a separate study that looked at vinegar as a method of cleaning urinary bags and we found it did not kill pseudomonas, which is a common urinary pathogen in people with SCI (in fact the pseudomona LOVED the vinegar!).

    We have seen urethritis commonly in those who attempt to clean/soak catheters in vinegar, bleach, Betadine, Lysol, Listerine, etc. etc. even when the catheter is well rinsed with water.

    We recommend soap and water ONLY for catheters, and 10% bleach only for urinary bags.

    (KLD)

  5. #5

    Thanks

    Could I get a copy of that study about the vinegar? There a lot of Urology practices back east that tell the patients to soak their catheters in white vinegar and I would like to send them this info. A lot of patients could be suffering because of this simple error in their cleaning method. I talk to a lot of patients who have been cathing for years and their urine samples come back fine but they are in pain and feel like they are infected. They either have inflamed urethras or in my case prostitis that is hard to detect. Almost 2000 times a year our urethra is being exposed to a foriegn object being pushed in our urethra and over years the urethra says thats enough and forms strictures and points of inflamation. I keep hearing how well hydrophillics are and in my case it saved me from a urinary diversion but are their studies that one could claim with ebm that the friction on the urethra is much less than a standard catheter that is lubed? i was told that by the time the catheter hits the shincter the lube is gone and that is why it is hard to make the final push. With the SCI patients that were hurt in the 70's it would be a great survey to find out how all is doing. We were the first generation of SCI patients who used intermittant catherization as our primary bladder maintenance. Twenty or thirty years later I have noticed increased discomfort and have had strictures that have been operated on. Is this common for IC patients that have been cathing for years. Sorry for all the questions. I will blame myy ADD on this post but for me when my bladder feels good my whole quality of life is much better.In fact it seems like the bladder is our main problem from a health point of view

    SW
    SW

  6. #6
    The urinary bag study was never published, although it was presented at several research conferences. I will need to get you the one reference on catheter cleaning next week when I am at work.

    (KLD)
    Last edited by SCI-Nurse; 01-05-2008 at 02:13 PM.

  7. #7
    Senior Member jb's Avatar
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    i use rubbing alcohol, peroxide and water to clean my caths. should i not be doing that?

  8. #8
    One thing I have learned the hard way is without full sensation we think we are getting away with something but the damage is being done under the radar. It would be good to know what not to use.

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