20/10/2025
Clean Intermittent Catheterization (CIC)
Clean Intermittent Catheterization is the periodic insertion of a catheter into the urinary bladder to empty it completely and then removing it immediately afterward. It is termed “clean” rather than “sterile” because it uses clean (not sterile) technique and equipment that is reused after proper washing and storage.
Purpose:
To ensure complete bladder emptying
To prevent urinary tract infections (UTIs)
To maintain renal function
To promote urinary continence and social independence
It is the standard bladder management technique for children with neurogenic bladder (e.g., in spina bifida, spinal cord injury).
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Preparation
Equipment Needed
1. Appropriate-sized catheter (usually 6–12 Fr depending on age)
2. Clean container (for urine collection if needed)
3. Lubricant (water-soluble, sterile gel)
4. Clean towels and soap or wipes
5. Handwashing supplies
Environment
Use a clean, well-lit area (bathroom or bedside).
Maintain privacy and comfort for the child.
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Step-by-Step Technique
1. Hand Hygiene
Wash hands thoroughly with soap and water (both caregiver and child if self-catheterizing).
Dry with a clean towel.
2. Preparation of Equipment
Gather all supplies in advance.
Lubricate the catheter tip generously with water-soluble lubricant.
3. Positioning
Infants: Supine position with legs gently separated.
Older children: Can sit on a toilet, commode, or wheelchair with legs apart.
4. Cleaning the Ge***al Area
Use mild soap and water or clean wipes to cleanse the urethral area.
Girls: Wipe front to back.
Boys: Retract fo****in (if not circumcised) and clean the g***s.
5. Catheter Insertion
Hold the catheter 2–3 cm from the tip.
Girls: Gently separate the l***a and insert the catheter into the urethral meatus until urine flows.
Boys: Hold the p***s upright, gently straighten it, and insert the catheter until urine starts to flow (usually 6–8 inches).
Once urine flow begins, advance the catheter about 1–2 cm further.
6. Bladder Emptying
Allow all urine to drain completely into the toilet or container.
Gently press the lower abdomen to ensure complete emptying if needed.
7. Catheter Removal
When urine flow stops, slowly withdraw the catheter.
Boys: Return the fo****in to its normal position after removal.
8. Aftercare
Wash the catheter with soap and water, rinse thoroughly, and air dry.
Store in a clean, dry container or pouch.
Wash hands again after completion.
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Frequency of Catheterization
Usually every 3–4 hours during waking hours (4–6 times a day).
Night catheterization is not always necessary unless advised by a physician.
The schedule may vary depending on fluid intake and bladder capacity.
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Education and Training
Parents and, eventually, the child should be trained by a nurse or urologist.
Use demonstration and supervised practice sessions.
Teach signs of infection or complications.
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Complications to Watch For
1. Urinary tract infection – most common (ensure hygiene).
2. Urethral trauma or bleeding – avoid forceful insertion.
3. False passage – especially in boys.
4. Latex allergy – use latex-free catheters if needed.
