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There are additional appliances available on prescription that may help an individual to retain continence such as urinals and bedpans. Please check these in the Drug Tariff.
Male funnels may be helpful for individuals to direct urinary flow into the toilet.
Female urinals, to which a non-sterile catheter leg bag can be attached, are available on prescription. These should be replaced on a six monthly basis.
There has been much controversy around the use of anaesthetic gel versus lubricant. Currently the use of lubricating gel is recommended, but an anaesthetic gel might be considered where there is a history of difficult catheterisation, autonomic dysreflexia or by patient request.
For all children / young people please refer to the Paediatric Bladder and Bowel Care Specialist Nurses.
Notes
Catheter patency solutions is the term referred to in the British National Formulary (BNF). The group of medicinal products have previously been referred to as Bladder Washouts and Catheter Maintenance Solutions.
Regular bladder irrigation interrupts the closed drainage system and should only be undertaken if the risk of obstruction is greater than the risk of infection associated with interrupting the closed system.
Research is divided on the effectiveness of catheter patency solutions. Further guidance on their use can be obtained from bladder and bowel nurse specialists. However, it is acknowledged that the use of catheter patency solutions may be appropriate following individual patient assessment. All patients who require the intervention using a catheter patency solution must have a care plan.
Sodium chloride 0.9% (saline) is intended to flush out urinary catheters only; it may be helpful for removing small blood clots, debris and mucus.
Citric acid 3.23% (solution G) will dissolve crystals/encrustations, and may be recommended if the patient's catheter blocks on a regular basis (more than once a month), but should not be used without consulting the Bladder & Bowel Care Service.
Citric acid 6% (solution R) may dissolve persistent encrustation, and is also indicated for dissolving crystals on encrusted catheter tips immediately prior to catheter removal to aid removal and reduce the risk of damage to the urethra. Solution R should only be used under specific circumstances and in discussion with the Bladder and Bowel Care Service.
Chlorhexidine or mandelic acid catheter patency solutions are not recommended
Please refer to section 7.4.4 Bladder instillations and urological surgery for product information
These may include:
These retainer devices are for extra support and comfort, and help to keep the catheter in place. The leg or abdomen should be measured to ensure the correct size is ordered. Abdominal straps may be cut to fit the leg.
These may be used as an alternative to a leg bag. Valves should be changed every 7 days. They may be attached to a night bag to allow drainage overnight.
During the day the valve will need to be opened at regular intervals as per patient assessment.
It is essential that a full assessment is carried out prior to valve use, ensuring that the patient fully understands. Cognitive function and dexterity need to be considered when assessing for a catheter valve.
If the patient has no bladder sensation please discuss with the Bladder and Bowel care team.
Catheter valves should be changed every 5-7 days. No more than one packet (5) should be prescribed every month
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