Self catheterising and irrigating your continent urinary diversion

If you have a continent urinary diversion pouch, you will need to learn how to empty it and irrigate it.

You will begin doing this after the pouch made during your bladder surgery has healed. This is normally 2 to 3 weeks after your operation. Your stoma nurse will show you how to do this. This is just a check list to help you get used to it.

A catheter is a medical name for a tube. So catheterising means putting a tube in to the pouch to empty out the urine. To start with you will need to do this every 2 hours or so. As your pouch stretches, you will be able to cut down to about every 4 to 6 hours during the day.

You will need

• A disposable catheter
• Some lubricating gel
• A container to drain urine into

At first, your nurse may ask you to drain the urine into a container. This is so that you can keep a record of how much urine you are passing each time. After a while you will be able to drain the urine straight into the toilet. You don't have to worry about keeping anything sterile (completely free from all germs) when you catheterise. But try to be as clean as possible. You want to keep the risk of introducing an infection as low as you can. It is best not to touch the end of the catheter that you are going to put into the stoma.

• Wash your hands
• Open the catheter packaging
• Open the gel
• Take out the catheter and moisten the blunt end with water or gel (unless it is pre lubricated)
• Gently feed the catheter into your stoma
• Keep feeding the catheter in until urine starts to come out
• Drain the urine into the container or toilet
• When no more urine comes out, gently draw the catheter out of the stoma
• Throw the catheter away
• Wash your hands

If you have trouble getting the catheter in, try pulling it back a bit and gently pushing it in again. It can help to roll the catheter between your fingers as you put it in.

Irrigating means washing out the inside of your pouch. You do this to flush out the mucus that collects inside. If you don't irrigate it regularly, the mucus could stop the stoma draining properly.

As well as the catheter and gel for emptying your pouch, you will need

• Boiled, cooled water for irrigating
• A 50ml catheter syringe

First, empty the urine out of your pouch with the catheter as described above. But leave the catheter in after the urine has all drained out. Then

• Pull up the irrigating solution into the syringe
• Fit the syringe onto the end of the catheter
• Gently push the end of the syringe in so that the water is pushed into your pouch
• Withdraw the water back into the syringe by slowly pulling out the plunger
• Disconnect the catheter and empty the contents into the toilet
• Fill the syringe again and repeat
• Keep irrigating and emptying the syringe until there is no more mucus and the fluid that comes out is clear
• Gently pull out the catheter and throw it away

Your doctor or stoma nurse may prefer you to use sterile saline solution or bottled water. Different surgeons may prefer one solution or another, but they are all okay to use. If you are away from home, you can use bottled water to irrigate.

Your stoma nurse can advise you about how often you need to irrigate. The amount of mucus your pouch produces may decrease with time. So you may be able to irrigate less often.