Self-catheterization can be daunting, especially if you are new to it. If you are self-catheterizing in a wheelchair and are looking for some tips do it right, here are 12 tips to help you avoid infections, ensure safety, and achieve complete drainage.

1. Self-catheterize where you can wash your hands

Washing your hands with soap and warm water before self-catheterization is extremely important because it decreases your chance of getting a catheter-associated urinary tract infection (CAUTI). If you handle the catheter and your genitals with unwashed hands, you might accidentally introduce germs either onto the catheter tube or the opening of your urethra. Then, the germs may travel inside your urethra as you insert the catheter, causing a urinary tract infection (UTI). 

If you choose to drain into a drainage bag instead of a toilet, you may catheterize in any private space. But try to choose a space that allows you to wash your hands immediately before and after self-catheterization. 

2. Carry hand sanitizers and clean gloves

If you are in a situation where you cannot wash your hands immediately before self-catheterization. You may wish to carry hand sanitizers and clean gloves. Disinfect your hands and/or put on the gloves right before you start catheterization.  

When you are self-catheterizing in a public bathroom, you may need to wheel yourself into a stall after you have washed your hands at the sink, at which point you would’ve touched both the wheels and the bathroom door, thus contaminating your hands with germ. Therefore, you may want to use hand sanitizers and/or gloves to make sure that your hands are clean.

3. Use a new catheter when you’ve accidentally touched it

If you’ve accidentally touched the exposed catheter tube with your hands, skin, clothes or anything nonsterile, please replace the catheter with a new one. Also, remember to never use the same catheter twice.

4. Use non-touch and pre-lubricated catheters 

A non-touch catheter doesn’t require you to touch the catheter tube during insertion. Using a non-touch catheter may better prevent catheter-associated urinary tract infections because even washed or gloved hands can have bacteria on them. There are two main types of non-touch catheters: the first type has a plastic sheath you can hold on to and glide up and down the catheter tube;

the second type has a plastic sleeve that encases the entire length of the catheter tube.

For women using 5 to 6-inch catheters, they might be able to guide a standard catheter by the catheter funnel without touching the tube.

The pre-lubricated catheter eliminates the hassle of carrying and using lubricant packets. Also, the bacteria on your hands and the lubricant packet may get onto the catheter while you are lubricating it, so using the pre-lubricated catheter can potentially lower infection risks.  

5. Clean your urethra opening with an antiseptic towelette

This is another important step in avoiding catheter-associated UTI. Even when the catheter tube is completely uncontaminated, if there are bacteria on your urethra opening, you can still get a UTI by pushing the bacteria inside your urethra during self-catheterization. 

For men, wipe the tip of your penis with an antiseptic towelette in a circular motion. 

For women, remember to wipe from front to back to avoid pushing bacteria into your urethra. If you have trouble finding your urethra opening, try opening your legs (like a frog) and using a mirror to visually guide yourself. 

6. If you have limited dexterity in your hands, choose an easy-to-navigate catheter

You may find it troublesome to deal with hard-to-open packages and hard-to-guide catheters. Look for catheters that have an easy-open feature, such as a hoop that you can hook onto to open the package. 

To find an easy-to-guide catheter, look for one with an all-around plastic sleeve. This kind of catheter lets you hold on to the entire catheter during insertion without contacting the catheter tube. As you are pushing the catheter in, just pinch and push the plastic sleeve back. 

Here is a more comprehensive guide for how to choose the right catheter—covering catheter size, tip, lubrication, and discretion. 

7. Catheter length for women in wheelchair

For women in wheelchairs who prefer to drain directly into the toilet, they can purchase a male catheter. The only essential difference between male and female catheters is the length. The standard length for the male catheter is 16 inches while for female is 5-6 inches. The 16-inch male catheter makes it easier for women to drain into the toilet while sitting in wheelchairs. As long as she purchases the correct catheter size and tip for her body, she can use a male catheter without a problem. There are also unisex options available that have adjustable lengths that fit both men and women. Catheter extensions are also available. 

8. Gentle movements

Use slow and gentle movements to avoid hurting yourself. The urethra is delicate. If you need to catheterize repeatedly for an extended amount of time, it’s even more important to be gentle every time. If you use force and feel intense, abnormal pain, it could be a sign that you have made a false passage in your urethra (among other possible complications). If you suspect that an injury has occurred, call your doctor or go to the emergency room. 

9. How to ensure complete drainage

When you first insert the catheter and see the fluid starts flowing out, insert 2-3 inches more. Then, wait for the fluid to completely drain and no more is flowing out. When that happens, pull the tube out by around an inch, wait for fluids to completely drain, then slowly pull out an inch or more. Repeat until no fluid is coming out, and the catheter has left the urethra. It’s important to wait until all fluid is drained each time you pull out the catheter by an inch. Also, while you are pulling out, try spinning the catheter a little bit to get more complete drainage. Do not spin the catheter if it has a coude tip, as the curved tip should always be pointing upwards. 

10. Watch out for pain, blood in urine, and injuries

A catheter whose size and tip is wrong for your body, insufficient lubrication, and incorrect catheterization techniques can all lead to problems. Consult your doctor if you feel sharp or persistent pain, see blood in your urine, or otherwise suspect that your urethra has been injured. On the other hand, mild discomfort for people new to self-catheterization is usually normal and may decrease over time. 

11. Watch out for UTIs and infections of the bladder and the kidneys 

As we have discussed, incorrect catheterization techniques can lead to UTIs. Furthermore, if you need a catheter because of urinary retention, the condition can put you more at risk of bladder and kidney infections. Watch out for these symptoms of infections. 

• Feelings of pain or burning during urination
• Frequent urination
• Blood in urine
• Cramping or pressure in the groin or lower abdomen
• Fever
• Chills
• Lower back pain or pain in the sides of your back
• Nausea or vomiting
• Feeling the need to urinate despite having an empty bladder

If symptoms are extreme, such as having a high fever or excessive nausea and vomiting, you might want to go to the emergency room. Please note that having these symptoms does not necessarily mean you have an infection or a catheter-related complication. Always consult your doctor for more information.

12. Throw catheters away in trash cans

Avoid flushing catheters down the toilet since this will clog the toilet. Put the catheter back in the packaging it came with and throw it in the trash. Wash your hands when you are done. 

If you are looking for a catheter that is touch-free, pre-lubricated, discreet, and accessible to people with a lower dexterity level, you should check out CompactCath and get a free sample now. 

Check out CompactCath!

CompactCath offers discreet, compact and easy-to-use intermittent catheters in various tips and sizes. Try them out for yourself by clicking the blue button below.