by A. Royall Pito
Printable PDF: Download Male Self Catheterization
Recently, problems with obstructive uropathy led my urologist to suggest that I self-catheterize myself twice daily. After a few weeks of doing so, I asked him if he had ever catheterized himself, and he admitted that he had never done so. Hearing about another person’s experiences may help some men embarking on this procedure since it is unlikely that your urologist has catheterized himself and can give your first-hand advice.
Self-catherization is a technique that one is unlikely to want to discuss with others. Certainly, I have shied away from mentioning it to most of my friends and colleagues. There is a certain feeling of shame associated with this that is totally unwarranted, but nonetheless it’s not a subject that others will relate to.
There are some good guides online which describe how to do this, but few (if any) relate personal experience. Here are some basic guidelines that may augment what is available.
You can start by reading the good overview on MedLinePlus (a service from the National Library of Medicine). I will use this as a template for fine-tuning the process.
Supplies:
Catheters: Your urologist will suggest one or two types.
Lubricating jelly
2x2 gauze
Non-sterile exam gloves (Latex of Nitrile)
Disposable non-sterile surgical towels (~ 12 x 18”)
Modified from:
MedLinePlus: Self-Catheterization Male
Follow these steps to insert your catheter (ARP's additions are bolded):
Wash your hands well with soap and water.
Collect your supplies, including your catheter (open and ready to be used), a towelette or other cleaning wipe, lubricant, and a container to collect the urine. I feel that draining the catheter into the toilet, as suggested, introduces the potential for contamination so I recommend a container.
I prefer to use clean disposable gloves. If you are allergic to latex, then use nitrile gloves and let your urologist know since some catheters contain latex. The gloves do not generally need to be sterile unless your doctor says so.
Move back the foreskin of your penis if you are uncircumcised.
Wash the tip of your penis with Betadine (an antiseptic cleaner), a towelette, soap and water, or baby wipes the way your doctor or nurse showed you. I used 2x2 gauze pads and mild soap and water.
Apply the lubricating gel to the tip and top two to three inches of the catheter. (Some catheters come with gel or saline already on them.)
I place a clean towel on the toilet seat and on the floor in front of the toilet where the container sits to keep urine from spraying on the floor.
With one hand, hold your penis straight out or up towards your abdomen. With your other hand, insert the catheter using firm, gentle, steady pressure. Do not force it. Start over if it is not going in well. Try to relax. I have found that doing this very slowly is important to avoid injuring the urethra. After a few times, you will be able to feel a slight resistance as the catheter enters and passes through the prostate. I try to hold the penis with one hand and advance the catheter with the other to avoid contamination.
Once the catheter is in the bladder, urine will start to flow.
After urine starts to flow, gently push in the catheter about 2 more inches, or to the "Y" connector. I have not found this to be particularly helpful.
Let the urine drain into the toilet or special container. As I’ve said above, I prefer using a container. The urine may splash on the floor, so I use a small non-sterile drape under the container (see photos). I also put a clean drape on the toilet seat.
When urine stops, slowly remove the catheter. As you start to withdraw the catheter you may get some more drainage. This only happens when you start to remove the catheter. After withdrawing the catheter 1 – 2 incles, pinch the catheter’s end closed to avoid getting wet.
Wash the end of your penis with a clean cloth or baby wipe. Make sure the foreskin is back in place if you are uncircumcised.
If you are using a container to collect urine, empty it into the toilet. Always close the toilet lid before flushing to prevent germs from spreading.
Wash your hands with soap and water.
Once you have gotten comfortable with the procedure it should take 8 – 10 minutes.
Cleaning Your Catheter
Some catheters are meant to be used only once. Many others can be re-used if cleaned appropriately. Most insurance companies will pay for you to use a sterile catheter for each use.
If you are reusing your catheter, you must clean it every day. Always make sure you are in a clean bathroom. Do not let the catheter touch any of the bathroom surfaces; not the toilet, wall, or floor.
Follow these steps to clean a reusable catheter:
Wash your hands well.
Rinse out the catheter with a solution of 1 part white vinegar and 4 parts water. Or, you can soak it in hydrogen peroxide for 30 minutes. You can also use warm water with soap. The catheter does not have to be sterile, just clean.
Rinse it again with cold water.
Hang the catheter over a towel to dry.
When it is dry, store the catheter in a new plastic bag
Throw away the catheter when it becomes dry and brittle.
With a little practice, this will become easy. The health benefits if you have obstruction are important.