As a user of intermittent catheters, you may be wondering how frequently to empty your bladder. Additionally, if you have an underlying condition such as spinal cord injury or other forms of nerve damage, you may have reduced sensation and not “feel” the urge to urinate. In these situations, your healthcare provider may recommend a cathing schedule. Today we will discuss the benefits of adhering to a catheterization schedule and some tips to help you get started and stay on track.
Benefits of Cathing Schedules
The primary goal of a cathing schedule is to make sure your bladder does not overfill. If the bladder is too full, this creates a high-pressure urinary system. The high pressure of an overfilled bladder can cause urine to leak out of the urethra or back up into the kidneys. Over time, high pressures caused by overfilling the urinary tract can weaken the bladder and damage the kidneys, increasing your risk for complications such as urinary track infections (UTI) and renal failure. Adhering to a cathing schedule can reduce the chance of overfilling your bladder. It can also reduce the occurrence of urinary leakage, improving quality of life.
Before you begin, it is good to remember that cathing schedules are not one-size-fits-all. It may take some trial and error to determine an ideal cathing schedule; but rest assured, it has been successfully accomplished by many, many people.
Getting Started
Your fluid intake and the condition of your bladder and kidneys will impact how frequently you should self-cath. Talk to your urologist about how often to cath. Certain bladder function tests are helpful in determining how much urine your bladder can hold and how often it should be emptied.
After you’ve talked to your healthcare provider, it is time to think about supplies. Make sure you have the supplies you need and know how to use them. Consider that you may need to bring your supplies with you when you leave the house. A small backpack can be ideal for discretely storing and transporting supplies. If you are having difficulty deciding what type of catheter might work best for your lifestyle, ABC Medical can send you samples of different products to try. Having a product that is comfortable and easy to use is an important aspect of any bladder management plan.
Tips to Stay on Schedule
Consider using a cellphone alarm to remind you when to cath. Most people cath between 4-6 time per day. To make a schedule, you can divide the day into segments based on how many times per day your healthcare provider wants you to self-cath. For example, if your healthcare provider recommends that you empty your bladder 4 times per day, divide 4 into 24 hours – which means self-cathing approximately every 6 hours. Most people start their daily cathing schedule by self-cathing first thing in the morning. It can also be helpful to cath right before going to bed to minimize sleep disruptions.
TIP! – Keep track of the amount of urine you get out each time you cath. This can help your urologist determine if the schedule is ideal or needs adjustment. Generally, the amount of urine drained when cathing should not exceed 500mLs. Regularly obtaining amounts that are greater than this can indicate that your bladder is becoming too full between catheterizations, and you may need to drain it more often.
Keep in mind that your fluid intake will impact the amount of urine you produce. Do not restrict fluids, as it is important to stay hydrated for overall bladder health – chronic dehydration can contribute to UTIs. However, timing your fluid intake can be helpful. Aim for slow, steady hydration throughout the day instead of large amounts of fluids all at once. Many catheter users limit their fluid intake after dinner to prevent excessive bladder filling during the night. Even so, you may not be able to make it through the night without self-cathing. If you need to empty your bladder at night, set an alarm and keep your supplies nearby and ready to use. This will help make nighttime cathing a quick process and avoid prolonged sleep disruption.
Clues That Your Bladder Is Full
Increased episodes of urinary incontinence can indicate that your bladder is very full. If you notice frequent bladder leaks and are draining high volumes of urine, this is a clue that you may need to adjust your cathing schedule so your bladder does not overfill.
If you have nerve damage, you may not be able to feel your bladder at all. However, there may still be signs that your bladder is ready to be emptied. Some people with higher level spinal cord injuries experience autonomic dysreflexia when their bladder becomes full. Autonomic dysreflexia is a nervous system reaction caused by painful or uncomfortable stimuli below the point of paralysis. Symptoms of autonomic dysreflexia include sweating, chills, high blood pressure, facial flushing, and headaches. One of the more common causes of autonomic dysreflexia is a full bladder. If you experience the onset of dysreflexia symptoms, you should perform self-catheterization right away. If the symptoms of dysreflexia fade once you have drained your bladder, it was likely a sign your bladder was full. If the symptoms of dysreflexia continue, you may need to seek medical attention to determine the cause, as the symptoms will not stop until the painful or uncomfortable stimuli is removed. Unrelieved autonomic dysreflexia can result in dangerously high blood pressures, leading to seizure or stroke.
Peer Support for Users of Intermittent Catheters
Having a catheterization schedule may seem overwhelming, especially if you are new to using catheters. Setting reminder alarms and finding catheter products that work well for you can help smooth the process. However, it is normal to feel anxious or have unanswered questions about how to best adapt a cathing schedule to fit your lifestyle and specific needs. Connecting with a peer support specialist is a great way to explore options. ABC Medical has a no-cost program for customers called Navigator, which includes several peer support specialists. Peer support specialists are real-life catheter users with spinal cord injury who have years of experience helping others get comfortable with their catheter routines. Because they themselves use intermittent catheters and understand where you are coming from, you may find it helpful to get tips directly from them. If this is of interest to you, please contact ABC Medical’s Navigator program and speak to a peer support specialist today.
Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. For medical advice, please speak with your healthcare provider.
Reference
Newman, D. (2021, March) Best Practices for Management - Intermittent Catheters. UroToday. https://www.urotoday.com/urinary-catheters-home/intermittent-catheters/description/ic-best-practices-for-management.html
