Self-Catheterisation: Is it suitable for me?

Self-catheterisation, also known as intermittent self-catheterisation (ISC), might be one of the options urologist suggests. But what is it, exactly, and is it the right choice for you - and if you feel uncomfortable about it, how can you overcome those feelings?

What is self-catheterisation?

Self-catheterisation is a process where a thin, flexible tube (a catheter) is inserted into the urethra to empty the bladder. The catheter goes directly into the bladder to allow urine to drain out. For some of us, the thought of self-catheterisation can be an uncomfortable or daunting prospect and it’s understandable if you feel that way. Fortunately, with practice, it can be manageable and even liberating for many women. 

Self-catheterisation is sometimes recommended if you have difficulty emptying your bladder completely. It's often suggested for conditions that cause urinary retention (where the bladder doesn’t empty fully or at all) or neurogenic bladder (where there’s a loss of bladder control due to a nerve problem). While the idea of using a catheter might feel strange or intimidating at first, many find it allows them greater freedom and independence by managing their condition more effectively.

What options are available for self-catheterisation?

There are several types of catheters available, and designed to meet different needs and preferences. Some of the most common include:

• Intermittent Catheters: These are single-use catheters that we insert several times a day to empty our bladder. They are often preferred for self-catheterisation as they are relatively simple to use and minimise the risk of infection when used correctly.

• Pre-Lubricated Catheters: These catheters come ready-lubricated, which can make insertion smoother and more comfortable. Some pre-lubricated options are hydrophilic catheters, which have a coating that becomes slippery when exposed to water. These can be less likely to cause irritation and are easier to use discreetly.

• Compact Catheters: Designed to be small and discreet, these catheters are ideal for those of us who need to catheterise when we're out and about. They are easy to carry in a handbag or pocket, making them a popular choice for those of us who want to maintain an active lifestyle.

Your urologist can help guide you to the best type of catheter for your needs,and will take into consideration your lifestyle, physical limitations, and any underlying health conditions.

When is self-catheterisation recommended?

Self-catheterisation may be suitable if we have certain bladder conditions that affect the way our bladder stores or empties urine. Some of the conditions where ISC is commonly recommended include:

• Urinary Retention: This occurs when the bladder doesn't empty completely. It can be caused by factors such as pelvic organ prolapse, previous surgeries, or certain medications. ISC can help ensure the bladder is fully emptied, reducing the risk of infections or kidney damage.

• Neurogenic Bladder: Conditions like multiple sclerosis, spinal cord injuries, or diabetes can damage the nerves that control the bladder, leading to problems with bladder emptying. Self-catheterisation can help manage these symptoms effectively.

• Bladder Outlet Obstruction: This could result from scar tissue, previous surgeries, or other anatomical abnormalities that restrict urine flow. ISC can offer a way to manage symptoms without more invasive interventions.

What are women’s common concerns with ISC?

Many of us feel uncomfortable with the idea of self-catheterisation, and that's completely understandable. It's natural to feel self-conscious or anxious about the process, especially if it's new to us. Some common worries include concerns about intimacy, cleanliness, smell, or the idea of inserting a catheter ourselves.

Sue, a member of our Jude and Friends Community recently shared her experience of self-catheterisation.

She said: “Having had an OAB (Overactive Bladder) for over 40 years, I have been offered self-catheterisation several times, throwing my hands up in horror and refusing BUT when I finally relented I must share I don’t know why I made such a fuss. Yes, I needed to be taught how to use it but I was given the choice of several different types. 

I chose Compact Eve which looks from the outside like a tube of mascara. It didn’t take long to get used to it and my life changed. Being blunt, the catheter means I can now leave the house 'empty', I can use it away from home which means fewer loo stops and it makes me more confident to go to places where I know finding an empty loo might be difficult because of queues (eg theatre) so I can ensure I don’t need the loo as frequently.”

Firstly, it's important to remember that self-catheterisation is a safe and hygienic procedure if  done correctly. If it feels strange at first, that’s totally normal - and for many women it quickly becomes a routine part of the day when they feel and see the benefits of ISC. Asking your urology nurse to explain the procedure and show you how to ISC with patience and understanding of your concerns will help you to feel more confident doing it yourself. 

For some of us, the idea of our ‘self’, our sexuality and femininity can make us feel unsure about ISC. It’s important to know that self-catheterisation is mostly a discreet and private process and many of the catheters now available are no bigger than a lipstick in your bag. If you are worried about the idea of smell, it’s good to know that modern catheters are designed to be hygienic and you can quickly freshen up by carrying a kit including pants, wipes and hand cleanser in a similar way that we do with leaks.

Weighing up whether ISC is right for you

Like any medical intervention, self-catheterisation has its pros and cons, and it's important to weigh these carefully to decide if it's the right option for you. Let’s take a quick look together:

Pros of Self-Catheterisation:

• Greater independence, allowing us to manage our bladder health on our own terms. 

• Reduces the risk of bladder infections, UTIs and kidney infections that can result from incomplete bladder emptying. 

• Reduces the need for an indwelling catheter which can carry a higher risk of infection

• Self-catheterisation can also help avoid the need for more invasive surgical procedures

Cons of Self-Catheterisation:

• An idea to overcome mentally if you feel uncomfortable

• A  risk of urinary tract infections if the procedure isn’t carried out properly (usually minimised with proper hygiene and care)

• Those with physical limitations may find it tricky. 

Next steps 

If you’re considering self-catheterisation or have more questions, speaking to your GP or urologist is the best next step. They can provide tailored advice, guide you through the options, and help ensure that whatever decision you make, it is the right one for you. You can also discuss your concerns and the procedure with women like you in our Jude & Friends community for further advice and support.

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