Instruction Guide to Clean Self-Intermittent Catheterization For Men Using the Hydrophilic Cure Catheter®

This educational material is provided by Cure Medical in an effort to answer questions and address possible concerns about the intermittent catheterization process. By following the simple steps for clean self-intermittent catheterization with a hydrophilic catheter, it is possible to quickly master the technique and make the process part of your daily routine for bladder management and urinary tract health.

Cure Medical wishes to thank Anne Boisclair-Fahey, DNP, RN, CPNP for writing this educational material. She is a nurse practitioner in pediatric urology at the University of Minnesota.

This instruction guide is not a substitute for medical advice from your healthcare provider.

November 2015 • 900,053 - A2

The Urinary System

The urinary system contains two kidneys, two ureters, the bladder and the urethra. The kidneys filter the blood and produce urine. The urine travels from the kidneys down the ureters and into the bladder where it is stored until emptied during urination or catheterization. The urethra is the tube that empties the urine out of the body.

When the bladder is full, the brain sends a signal down the spinal cord to the bladder, causing it to empty. For people with spinal cord issues, the signal from the bladder to the brain gets interrupted, making them unable to empty their bladder.

When people are unable to empty their bladder on their own, they are at risk for urinary tract infections, as well as incontinence or involuntary loss of urine. When urine stays in the bladder and is not emptied, bacteria can grow, causing infections which can lead to illness. Research has shown that self-intermittent catheterization helps reduce urinary tract infections, control urinary leakage (incontinence) and prevent urinary tract damage.

Introduction to Self-Intermittent Catheterization

Intermittent catheterization is the periodic emptying of the bladder by the insertion of a hollow plastic tube (catheter) into the urethra, past the sphincter muscles and into the bladder. Urine then passes out of the bladder through the catheter.

Intermittent catheterization is used when a person is unable to empty his bladder. Medical conditions that often require intermittent catheterization include spinal cord injuries, spina bifida and multiple sclerosis, to name a few.

Intermittent catheterization must be done at regular intervals each day to keep the bladder healthy.

Your healthcare provider has recommended clean self-intermittent catheterization with a hydrophilic catheter to help empty your bladder and keep your urinary system healthy. A hydrophilic catheter is pre-lubricated.

How Often Should I Catheterize?

Your healthcare provider will let you know how often you will need to perform clean self-intermittent catheterization and the size of the catheter you will need. Normally, self-intermittent catheterization is performed every four hours starting when you wake up in the morning and continues every four hours until bedtime. Some people catheterize on a more frequent schedule. Most people who catheterize do not need catheterization at night. Your healthcare provider will let you know if you need catheterization at night.

Where Do I Get Hydrophilic Catheters?

You will be taught clean self-intermittent catheterization by your healthcare provider who will decide the size and style of catheter that you will need. Your healthcare provider will provide a prescription for the catheter supplies. The prescription will be sent to a medical supply company that will provide you with the supplies.

Hydrophilic Catheterization Instructions for Men

Self-intermittent catheterization with a hydrophilic catheter can be performed in a sitting, standing or lying position. Do what is most comfortable for you. If possible, stand in front of the toilet, sit nearby on a chair or wheelchair, or sit on the toilet with your legs spread apart.

1. Before you begin, urinate if you can. Then, gather the following materials:
   • A Hydrophilic Cure Catheter® in sealed wrapper
   • Something to cleanse the area: soap, water and washcloth, or unscented disposable wipes
   • A container to collect the urine if not cathing on or near a toilet
   • Hand towel

The Hydrophilic Cure Catheter® is available in Straight and Coude tip designs with smooth, polished eyelets. They feature a textured advancer sleeve and include a purified water pouch.

Cure Medical catheters are not made with DEHP, BPA, or natural rubber latex.

2. Inspect the catheter and package. If either one is damaged, do not use the product.
3. Wash hands thoroughly with soap and water, or if not available, use an antibacterial hand cleaner.

Hydrophilic Catheterization Instructions for Men continued

4. From the outside of the package, squeeze, or press down on, the pouch to distribute purified water throughout the package – lubricating the catheter for comfortable insertion.
5. Remove the paper which covers the adhesive area on the catheter package and press the package adhesive area firmly to the wall. Then, open the package.
6. Position yourself comfortably. Arrange clothing so it is out of the way. If sitting on the toilet, spread your legs apart. If lying down, knees can be straight or bent.
7. Hold the penis upright on the sides so that the urethra is not pinched.
8. Wash the tip of the penis as instructed by your medical professional. You may have been directed to retract the foreskin if the penis is uncircumcised. Wash the glans penis from the urethral opening (tip) to the base of the glans with soap, water and washcloth or unscented disposable wipe. Wash with a circular motion from the tip outward. Do not wash back and forth over the urethral opening. Repeat the washing two more times with different areas of the wash cloth or with a new unscented wipe each time.
9. Remove the catheter from the package. A unique, textured advancer sleeve is provided to enable you to easily grip the catheter.

Hydrophilic Catheterization Instructions for Men continued

10. While holding the penis at a 45 to 60-degree angle from your body, insert the lubricated catheter with your dominant hand. Once half the length of the catheter is in the urethra, lower the penis and continue until you meet resistance at the sphincters. Do not pull the catheter when you meet resistance; just apply firm continuous pressure until it advances into the bladder.
11. Continue to insert the catheter until urine begins to flow. If you are standing in front of the toilet or sitting on it with legs spread apart, the urine can drain into the toilet. If you are lying down, place the funnel end of the catheter into a container to collect the urine. Hold it in place until urine stops flowing.
12. When urine stops flowing, slowly rotate the catheter between your fingers while withdrawing it. If urine starts to flow again, stop withdrawing the catheter and let the urine drain. Continue the process until the bladder is empty and the catheter is removed. If you are uncircumcised, make sure you bring the foreskin back over the glans penis when you are finished.
13. Consult your healthcare provider if you notice any unusual odor and/or cloudy, hazy urine.
14. The Hydrophilic Cure Catheter is intended for one-time use.