Clean Intermittent Catheterization at Home: Male

Sometimes a person cannot safely empty their bladder on their own. When this happens, a small tube with holes at the end, called a catheter, is used to drain the urine. This is called clean intermittent catheterization (also called “in and out catheterization”).

Doing this regularly helps:

• Prevent infections
• Protect the urinary tract
• Prevent leaking and accidents

With practice, catheterization becomes a quick and manageable part of your daily routine. A nurse will teach you how to do this safely.

The bladder stores urine until it leaves the body. Urine travels through a tube called the urethra to exit the body.

During catheterization, a catheter is gently placed into the urethra and moved into the bladder so the urine can drain out.

Your nurse or doctor will tell you how often to catheterize. It’s important to follow a regular schedule.

Most people catheterize about every 4 hours, including:

• When waking up
• Before going to bed

Your catheterization schedule should be shared with school, work, or caregivers as needed.

You may need to catheterize sooner if experiencing:

• Urine leakage or wetness between catheterizations
• Fullness, discomfort, or swollen lower belly
• Restlessness
• Sweating without exercising
• Chills
• Headache

If you have a spinal cord injury with autonomic dysreflexia:

Catheterize immediately if you have:

• Headache
• Sweating
• Increased blood pressure
• Chills

• A sterile or clean non‑latex catheter (size: ___________ Fr)
• Water‑soluble lubricant (helps the catheter go in). Do NOT use petroleum jelly, such as Vaseline.
• Something to clean with (choose one):
  • Soap, water, and two clean washcloths
  • Moist towelettes
  • Baby wipes
• A container to collect urine
• Gloves, if needed
• Chucks or towel to place under while catheterizing if needed
• A mirror (if needed for self-catheterization)

Children as young as 4–5 years old can learn to catheterize themselves with practice and guidance. A nurse can help teach self-catheterization when ready to learn.

Disclaimer: If you are self-catheterizing, please disregard reference to another person and refer to yourself.

1. Wash your hands with soap and water. Dry them well with a clean towel. This reduces bacteria and prevents infections.
2. Open and place supplies on a clean surface.
3. Make sure clothes are away from their body, and that you have enough light to see well.
4. If you are using washcloths to clean, wet both. Put soap on one of them.
5. Have the person being catheterized sit or stand—whichever works best.
6. Gently pull back the foreskin of a penis that is not circumcised. Wash the penis in a circular motion, starting from the opening (tip) out to the base of the glans. (See Image 1). Use a soapy washcloth followed by a clean, wet washcloth, moist towelettes, or baby wipes.
7. While keeping the catheter clean, put the tip of the catheter into the water-soluble lubricant. Move the catheter around to spread the lubricant over the top 2 inches of the tip.
8. Place the drainage end of the catheter into a toilet, urinal, or container.
9. Using your nondominant hand (for example, if you’re right-handed, use your left hand), hold the penis erect, up and outward from the body. Grasp the sides of the penis rather than pinching the top and bottom. 
10. Hold the catheter with your other hand and insert it slowly about 6 inches into the opening of the penis (urethra), and continue to advance into the penis until urine flows through. When urine starts to flow, insert the catheter about 1 inch more. If you’re using a coudé tip catheter, insert it with the curved tip pointing upward. Continue to hold the catheter in place until urine flow stops. 
11. If you feel resistance, just stop for a second. Have the person receiving catheterization take a deep breath. Then gently resume the insertion using gentle but firm pressure until the sphincter muscle relaxes and the catheter becomes easier to push. The sphincter muscle controls the opening of the bladder. Never force the catheter. 
12. Allow urine to drain until the flow stops. Then slowly withdraw the catheter, allowing any remaining urine to drain so the bladder completely empties. If more urine comes out as you pull, pause and let it drain before continuing.
13. If the penis is uncircumcised, pull the foreskin back over the head of the penis after you finish catheterization. If the foreskin is not returned, circulation can be affected, which can lead to tissue damage. If the foreskin is stuck and cannot be returned, this is a medical emergency. Go to a nearby emergency room.
14. When you’re ready to remove the catheter tip, hold it so the urine drains down from the tip of the catheter to avoid urine leaking onto the body or clothing.
15. Look at the urine and take note of its color, odor, characteristics (e.g., cloudy, sediment), and amount. Record the amount of urine if you’ve been instructed to do so. Then dispose of the urine and catheter.
16. Wash your hands with soap and water.

It’s very important to set a schedule for catheterization. To establish a routine, keep a daily record of the time of catheterization, the amount of urine collected, and whether urine leaks (small, medium, or large amount) or remains dry (no urine leaks between catheterization times). Setting an alarm reminder on a cell phone, watch, or other electronic device might be helpful.

Setting a routine might take several months. Once a routine is working well, you won’t need to measure the amount of urine you collect each time you catheterize.

To gain independence, people learn to self-catheterize, if possible. Ask your healthcare provider for examples of activities to improve hand-eye coordination to make it easier to handle and guide the catheter into the urethra. Referral to occupational therapy may be considered if needed.

Learning to catheterize in a seated position will help with catheterization in a wheelchair, car, bed, or on a toilet/commode. To make it easier to pull clothing down for catheterization, consider sewing Velcro fasteners or zippers into seams at the sides or in the crotch area of pants.

Your urologist or primary health care provider will recommend when to schedule follow-up visits. Bring your daily record of catheterization to your clinic visits, if directed to do so.

Notify your urology provider when the person being catheterized:

• Can’t pass the catheter through the urethra
• Leaks urine between scheduled catheterization times
• Has blood in their urine
• Produces unusually small or large amounts of urine without a significant change in eating or drinking activity 

Seek care with your primary care provider, urgent care, or emergency department for urinary tract infection symptoms:

• Pain or a burning sensation during catheterization
• Lower abdominal pain
• A fever higher than 101.5 F without another apparent cause
• Increased leaking between catheterizations
• Lower flank (lower back) pain
• Nausea and vomiting without another apparent cause
• Feel the urge to catheterize more frequently without a change in drinking activity