Formulary

7.4.4 Bladder instillations and urological surgery

First Line
Second Line
Specialist
Hospital Only

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 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.

Please refer to Chapter 18 Continence

Citric acid should not be used without consulting the Bladder and Bowel Service.

Uro-Tainer saline

(Sodium chloride)

  • Irrigation solution 0.9%, 50ml (£3.79)
Uro-Tainer Twin Suby 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)