Why ISC?

It is important that you empty your bladder regularly as prescribed by your doctor or nurse. If you cannot empty your bladder naturally, intermittent self-catheterisation is considered the gold standard.

Other bladder emptying methods include:

• Manually pressing down on the bladder (Credé)
• Inserting a more permanent catheter through the urethra (indwelling catheters)
• Inserting a catheter through the belly (supra-pubic catheters)

Why do doctors – and Coloplast advisers – recommend ISC as being superior to these options?

ISC has low risk of complications and infections

The reason why ISC is widely thought to be the preferred method is the low risk of short- and long-term complications.

One explanation is that most people using intermittent self-catheterisation find it more comfortable and convenient than indwelling catheters. And when you find a method, which you think is good and you master it, it is easier to stick to the schedule and empty the bladder as prescribed.

Surveys suggest that catheters that have a special smooth and low friction coating (hydrophilic-coated), are more comfortable, convenient and easy to use. They have also been linked with lower rates of infection and urethral damage when compared to other catheters. Other benefits include giving you greater independence and a better overall quality of life.

"Does it matter that I have to catheterise? I guess so… but not really. I just have to go through a slightly different way to do the same function that everybody else does." - Julian

Intermittent self-catheterisation helps you maintain a healthy bladder through the low risk of short- and long-term complications – but it also has a number of other benefits. These include enabling you to have good control over your bladder, which offers you more independence and confidence because you – not someone else – can manage your bladder.

Throughout Coloplast Charter, you will encounter stories from people enjoying activities such as:

• Travelling
• Movies, theatres, concerts and sports games
• Shopping
• Camping or hiking
• Exercising and swimming

The main reason why all this is possible, is because ISC allows you to manage your bladder, when and wherever it suits you.

The flexibility to start going out

Mastering ISC offers you more independence and freedom in your daily life and the ability to schedule more social activities. Once you have an ISC routine that fits into your lifestyle, you can feel more confident about going out with your friends without having to worry about having an accident. If you are going out for many hours, you just need to think ahead and plan the day: will I need to catheterise before leaving the museum, or after we get to the restaurant? Always take extra catheters when you leave your house. Some may want to use a different catheter when not at home – maybe one with a bag attached or one that is smaller.

The freedom to take part in sports and exercise

Performing ISC is also a step towards more freedom when it comes to sports, because you can be active without the fear of leaking. If you stick to your ISC schedule you can engage in whatever activity your physical condition allows you to. Once you get a good routine, ISC only takes a few minutes, so even if you have to empty your bladder during sports, you will not be gone any longer than anyone else who has to use the bathroom.

For sport and active lifestyle we recommend a SpeediCath® Compact solution.

The confidence to enjoy an active sex life

On the contrary, catheterising yourself and emptying your bladder completely before having sex will prevent leakage during intimate activity.

The only thing you need to consider, is that ISC does not allow you to be completely spontaneous; always take the time to empty your bladder before engaging in intimate activity.

Intermittent Self-Catheterisation (ISC) or Clean Intermittent Self-Catheterisation (CISC) is the regular insertion of a hollow tube (catheter) into the bladder, to empty it of urine.

The catheter is inserted into your bladder through the urethra (the channel that leads urine from the bladder to the outside opening). ISC is simple to carry out and after a little practice can be done in just a few minutes.

The tip of the catheter is rounded with holes in both sides allowing the urine to enter the tube and drain out of the bladder.

A catheter is a plastic tube with eyelets (drainage holes), which are used to drain urine from the bladder. Catheters can be both permanent (indwelling catheters) and intermittent. The intermittent catheter – which is considered the preferred method – is inserted at regular intervals and removed immediately after the bladder has been fully emptied.

Uncoated and coated catheters

Catheters should be lubricated to minimise the friction between the catheter and the tissue in the urethra. You can get catheters that come with either a gel or a special surface treatment that activates with water (hydrophilic coating). The most advanced catheters are already immersed in water, and can be used straight from the packaging.

What length to choose?

In general, your catheter needs to be a bit longer than the urethra, which is 15-20 cm in men and 3-4 cm in women. This is because the catheter eyelets are not placed at the tip of the catheter. You can get both standard and compact sizes. Men with an enlarged prostate might benefit from a slightly curved tip version (Tiemann).

How to find the right size catheter (diameter)

It is important to select the right size to obtain optimal bladder drainage. Most adults start with a catheter size 12–14 Ch (1 Ch = 0.33 mm diameter). Your doctor or nurse can help you to decide on the right size for you.

The tube

Catheters are made of different materials, and some of these include:

• PVC, which is quite common in medical devices. It contains softeners (phthalates), which can potentially be harmful both to your body and to the environment.
• Silicone, which is a very flexible material by nature and has no need for plastic softeners.
• PU (polyurethane) is becoming increasingly popular because it’s firm yet flexible and doesn’t contain plastic softeners.

A slightly firmer catheter can be easier to insert, which is especially relevant if you have limited hand dexterity. When choosing a catheter reassure yourself with your doctor and nurse that the material used doesn’t compromise your health (like PVC- and phthalates), and is convenient for you to use.

The catheter typically has 2 holes punched into the end of the tube. Once the catheter reaches the bladder, urine will run into these holes and drain the bladder. To minimise the risk of damage to the urethra look for eyelets that are polished and coated.

Catheter connector/ handle

The connector at the end of the catheter allows the attachment of a urine bag, in case you can’t get to a toilet.

If you have any questions about our products, please feel free to call us.

"I went from being free to do whatever I want, to not being able to walk properly if at all, with little use of my hands. I started to be able to do some things again over the course of two weeks, but I couldn’t pee on my own. They taught me how to catheterise myself, which is not difficult. Do I want to catheterise myself? No. Do I enjoy it? No. But it is what it is - such is life. I can’t change that fact, so let me get on with it." - Julian

You need to be patient – with training and practice you will most likely be able to empty your bladder in a few minutes and catheterisation will then become a routine you barely think about in your daily life. It is natural to feel slightly insecure and nervous about having to learn intermittent self-catheterisation (ISC). The thought of having to insert a tube into your body – not just once, but many times during the day – can seem overwhelming at first.

But you can take solace in the fact that 1000s of people like you do it every day, and while they may have had the same worries, now it has become part of their daily routine – just as it will for you.

Here are some of the main concerns, some first-time ISC users have:

Is it difficult to learn?

Nearly anyone can learn to perform ISC, even people with reduced hand dexterity. It may feel a bit awkward at first but with practice it will become an ordinary thing in your everyday routines. Your nurse will help you find the right catheter and way of doing it. Make sure you get the catheter that matches your needs.

Will it hurt?

ISC may feel strange at first but it should not be painful. Please consult with your nurse if you are having problems or you are finding it painful.

What if I can’t insert or withdraw the catheter?

Firstly, try to relax. Most problems are related to muscles tensing up. Coughing may help insertion and withdrawal. Speak to your nurse if you are experiencing problems. Maybe you should try another catheter to find one that is more suitable. Our Coloplast Care team can advice you on the features of the different products.

Is it harmful?

If you still struggle with the thought of doing ISC, remember that there are people around you to support you: your nurse and doctor can demonstrate how to do it in a safe way and your Coloplast Care team is ready to address any concerns you may have.

Let’s have a talk.

Where can I do ISC?

A suitable place for doing intermittent self-catheterisation is somewhere where you feel comfortable and at ease. It might help to map out places that you go to regularly so that you can plan ahead. There are three things that determine whether a place is suitable for doing ISC:

Privacy

To have privacy when doing ISC is really important. Find out where the bathrooms are that give you the privacy you need. And plan your day so you can visit them as needed.

Cleanliness

When ISC is performed, there is always a risk of infection, but your own bacteria are rarely the main reason for getting urinary tract infections – the risk actually increases when other people like your nurse or helper do it on you.

Whatever the location or circumstance, do not forget to wash your hands immediately before touching the catheter. If you need to touch anything (wheelchair rims, crutches, a bathroom door handle) after you’ve washed your hands, use hand sanitising gel or an antiseptic wipe before touching the catheter.

If you often suffer from urinary tract infections (UTIs) you might be concerned about doing catheterisation outside your home. Nevertheless, is important that you empty your bladder regularly, as urine left in the bladder is one of the main reasons for getting UTIs. So when you are out and about it is not a good idea to skip catheterisation – even though it can be difficult to find a clean bathroom.

Facilities

How much space do you have, is the sink placed separately from the toilet room or – if you’re in a wheelchair – is there a ramp (and how steep is it) or how wide is the door?

You can use the smartphone app “WheelMate” to find the bathrooms that suit you the best.

It is important that you empty your bladder 4−6 times a day, or as recommended by your doctor or nurse, and ensure that your bladder is completely empty each time.

Why? If you do not empty your bladder often enough, the urine can become stale. Bacteria in the urine will multiply, which may lead to an infection of your bladder or urinary tract.

Letting your bladder get too full can overstretch your bladder wall, making it weak or unable to hold urine. It will increase pressure in your bladder with a risk of urine flowing back to the kidneys. Backflow of urine can lead to an infection or long-term damage of your kidneys. Increased pressure in the bladder may also lead to overflow e.g. urine leakages (incontinence).

With a SpeediCath® compact catheter there is no excuse to stay at home. They are available in two versions – one for catheterising directly into the toilet and one for if you find it difficult to get onto a toilet and need an all-in-one catheter and bag solution that is simple and convenient to use.

• Discreet – our catheters are small and discreet so you can carry them in your pocket or bag anywhere you go. No one needs to know it’s a catheter but you.
• If you’re away for long, you can bring as many as you need, because they are compact.
• Instantly ready to use – to ensure catheterisation takes as little time as possible, our catheters are pre-lubricated so that they are instantly ready to use, with no mess or fuss.
• Easy to use – with easy grip handles, so there’s no need to touch the catheters, and they are simple to open and re-seal for easy disposal, when and where it suits you.
• The catheter is placed inside an airtight and sturdy case.

The benefits of SpeediCath Compact catheters can of course also be appreciated at home.