Clean intermittent catheterization (1798)

Children with urinary tract problems may need to have clean intermittent catheterization (CIC). CIC is the short-term placement of a catheter (tube) into the bladder to drain urine (pee). A parent or other adult will do CIC until the child learns how to do it.  This is often between 6 and 10 years old. 

Why is CIC needed? 

CIC helps your child empty their bladder. When done regularly, CIC can also help prevent:

• Urinary tract infections (UTIs)
• Kidney or bladder damage
• Wetting accidents (incontinence)

How is CIC done?

CIC is done by putting a catheter into the urethra (tube that carries urine from the bladder out of the body). Once the catheter reaches the bladder, urine drains out. CIC allows the bladder to empty all the way. Once the bladder is empty, the catheter is removed. 

Catheters are soft and flexible and they come in different shapes and sizes. Some are disposable and are thrown away after one use.  Others are reusable and washed after use. Your child’s healthcare team will help choose the best catheter for your child. The healthcare team will make sure you understand how to use the catheter. 

Steps for CIC:

1. Getting ready

Gather your supplies. 

• A catheter
• Lubricant
• Disposable wipes or a washcloth
• A container, diaper or pull-up for the urine if not near the toilet

Get your child ready.  Have your child sit on or stand over the toilet, sit in a chair near the toilet, or sit or lay in bed. Some children may find it easier to stand with one foot on the toilet rim.

2. Wash your hands with warm water and soap.

3. Lubricate the catheter.

For male anatomy 

• If your child is not circumcised, pull the foreskin back over the tip of the penis and keep it back during CIC. 
• Clean the tip of the penis using a disposable wipe or washcloth.
• Hold the penis on both sides, straight and away from the body 
• Gently insert the catheter until urine begins to drain.  Keep going for about 1 more inch. 
• Hold the catheter in place until urine stops draining. 

For female anatomy

• With one hand, separate the folds of skin (labia) that surround the vagina and urethra. Find the opening to the urethra. It is below the clitoris and above the vagina. 
• Keep the labia separated with one hand and use the other hand to clean the area with a disposable wipe or washcloth. Wipe from the urethral opening towards the vagina.
• Keep the labia separated and insert the catheter into the urethra until urine begins to drain. Keep going for about 1 more inch. 
• Hold the catheter in place until urine stops draining. 
  *If the catheter is placed in the vagina (no urine will come out), leave the catheter there as a marker. Get a new catheter and place this in the urethra, just above the vagina. 
  

4. Remove the catheter.  To make sure the bladder is empty:

• Remove the catheter a little bit and drain any more urine. 
• Continue to do this as you slowly remove the catheter. 

5. After CIC

• Wipe the area with a wipe or washcloth. 
• Wash your hands with soap and water. 
• If you used a disposable catheter, throw it away. 
• If you are going to reuse the catheter (and it is not a pre-lubricated catheter), wash it with soap and water, rinse it and then lay it to dry on a paper towel. When the catheter is dry, put it into a re-sealable plastic bag. 
• Pre-lubricated catheters should not be washed and re-used, unless you are directed by your care team to do so in certain situations. 
• Wash your hands again.

How often is CIC done? 

Your child’s health care team will tell you how often to do CIC. Most often, it is every 3 to 4 hours during the day. Your health care provider will let you know if you need to wake up your child during the night to do it.  

Tips for successful CIC

• At first, inserting a catheter seem scary for both you and your child.  You will have help from your child’s health care team. They will work with you and your child to teach CIC. 
• Your child may have some discomfort or be resistant to CIC when it is first started. This should improve with time.  CIC will become part of the daily routine. 
• Stick closely to the catheterization schedule suggested by your child’s provider. 
• Make sure your child drinks plenty of liquids. Your child may want to avoid them as a way to skip CIC. The schedule needs to be followed no matter how much or little your child drinks. 
• As your child becomes more comfortable with CIC, they can start to help. Start by letting them gather all of the supplies and washing their hands with you. When your child feels ready, the health care team will work with you on how to teach them to do CIC. 

Call your health care team if your child has any of the following: 

• In any child, a fever that lasts for more than 24 hours or a fever greater than 102. 
• Large blood clots in the urine. Small clots and pink tinged urine is normal.
• Pain in the lower back or abdomen. 
• Trouble inserting the catheter. 
• Pain when inserting the catheter. 

For more health and wellness information check out this resource: https://kidshealth.org/ChildrensWi/en/parents