Intermittent Self-Catheterization (Female)

Sometimes a child cannot empty her bladder on her own. When this happens, a small tube called a catheter is used to drain the urine. This is called intermittent self-catheterization, or “in and out cath.” Doing this helps prevent infections, protects the urinary tract, and can help prevent accidents or leaking. A nurse will teach you and your child how to do it.

The bladder stores urine until it leaves the body. A tube called the urethra runs from the bladder to the outside of the body to drain urine. During catheterization, a catheter is gently placed into the urethra and moved into the bladder so the urine can drain out.

Your child’s nurse or doctor will tell you how often to catheterize her. It’s important to do it on a regular schedule. Most children need to be catheterized about every 4 hours, or more often if they drink a lot. If your child is in school, share the schedule with the school nurse.

You may need to catheterize your child when she:

• Seems restless
• Starts sweating without exercising
• Has chills
• Has a headache
• Has a swollen lower belly
• Says she feels “full”
• Has urine leakage or wets herself

• Your child suddenly needs catheterization more often than usual
• The urine looks cloudy
• The urine smells bad
• You see blood in the urine
• You have trouble putting the catheter in or taking it out
• There is unusual discharge from the urethra

• A sterile, nonlatex catheter (your nurse or doctor will tell you the type)
• Watersoluble lubricant (helps the catheter go in)
• Something to clean with (choose one):
  • Soap, water, and two clean washcloths
  • Moist towelettes
  • Baby wipes
• A container to collect urine
• A mirror (if your child is doing it herself)

Children as young as 4–5 years old can learn to catheterize themselves with practice and guidance. A nurse will help teach your child when she is ready.

1. Wash your hands with soap and water. Dry them well with a clean towel.
2. Open your supplies.
3. If you are using washcloths to clean, wet both. Put soap on one of them.
4. Have your child lie on her back with knees bent (like a frog) or sit with legs apart.
5. Gently separate the labia. (See Figure 1). Clean the area from front to back using:
   • The soapy washcloth (then wipe the labia with the clean wet washcloth), or
   • Moist towelettes (use each only once), or
   • Baby wipes (use each only once)
6. Place the container where it can catch the urine when it comes out of the catheter.
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 all over the tip.
8. Gently insert the catheter into the urethra. When urine starts to flow, insert the catheter about another ½–1 inch.
9. When the urine stops, slowly pull the catheter out. If more urine comes out as you pull, pause and let it drain before continuing.
10. If your care team wants you to track urine amounts, write down how much urine came out.
11. Pour the urine into the toilet.
12. Wash your hands again.