Dr Angie Rantell
Lead Nurse, Urogynaecology King’s College Hospital and Faculty Member, The Bladder Interest Group
Dr Angie Rantell, Lead Nurse, Urogynaecology King’s College Hospital demystifies intermittent self-catheterisation, a useful solution to support people who may need assistance to empty their bladder.
What is intermittent self-catheterisation (ISC)?
ISC involves using a catheter (a thin hollow tube) to drain the bladder, after which the catheter is removed. It is performed by a person independently (or by their designated carer) and it is considered the gold standard for urine drainage.
Why do people have to perform ISC?
People who may have to perform ISC in the long-term include those with neurological disorders such as a spinal cord injury or multiple sclerosis. They rely on this procedure for bladder emptying, or to help control bladder function. In the short-term, this may also be used for managing post-operative voiding difficulties or to instil medication directly into the bladder.
According to a report by the Unplanned Admissions Consensus Committee (2019), in 2016/2017, there were 5.8 million emergency admissions due to urinary tract infections (UTI).
What are the benefits of ISC?
There are many advantages to performing ISC compared to the alternative methods of bladder emptying which include indwelling urethral (via the water pipe) or supra-pubic (through the tummy) catheterisation (i.e. catheters that stay in situ). One of the main advantages for ISC is the reduced incidence of catheter associated urinary tract infections (CAUTIs). CAUTIs are one of the most frequently acquired infections occurring in a healthcare setting.
According to a report by the Unplanned Admissions Consensus Committee (2019), in 2016/2017, there were 5.8 million emergency admissions due to urinary tract infections (UTI) and up to 56% of these were associated with catheterisation, costing the NHS £13.9 billion.
Some of the other benefits of ISC include:
- Increased independence and dignity
- Reduced urinary tract complications
- A healthier bladder, allowed to fill up and empty completely
- Increased ability to participate in leisure activities
- In the UK these devices are available on prescription
- Maintaining sexual relationships
Although for many, ISC has a positive impact on their quality of life, it’s important to note that this is not true for all. Some feel embarrassed, fearful and shame at having to perform the procedure and for those with mobility difficulties, performing ISC can be challenging especially when not in the home setting.
Getting the right support from an experienced health care professional can make a huge difference to patient experience and ongoing compliance performing ISC.
Dr Rantell is a faculty member of the Bladder Interest Group, an independent multi-disciplinary organisation dedicated to improving bladder health. The Bladder Interest Group website will be launched soon. The group receives funding from commercial organisations.
