For information on solutions used for bladder infection, dissolution of blood clots, bladder cancer and interstitial cystitis see current BNF.

Glycine

• Irrigation solution 1.5%

Sodium hyaluronate

• 40mg/50ml

Catheter patency (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 care 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.

They should only be used where proactive catheter changes are not suitable for the patient. They are treatment preparations for dissolving encrustation only and should only be prescribed for 4 weeks, then reviewed. They are not to be used prophylactically or to attempt to unblock a non-draining catheter.

Prescription - amount will depend on frequency of catheter irrigation.

Chlorhexidine or mandelic acid catheter patency solutions are not recommended.

Potential Adverse Reactions

These may include:

• Bladder irritation
• Urinary tract infection
• Patient discomfort
• Haematuria

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 bladder and bowel care specialists.

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 bladder and bowel care specialists.

Citric acid should not be used without consulting bladder and bowel care specialists.

Please refer to Chapter 18 Continence.

Uro-Tainer saline

(Sodium chloride)

• Irrigation solution 0.9%, 50ml (£3.79)

Uro-Tainer Twin Suby G (Solution G)

(Citric acid)

• Irrigation solution 3.23%, 2 x 30ml (£5.42)

Uro-Tainer Twin Solution R

(Citric acid)

• Irrigation solution 6%, 2 x 30ml (£5.42)