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Clean Intermittent Catheterization

Up to 90% of children with myelomeningocele have problems with urinary functioning, including urine retention and stress incontinence. Most of them, however, can achieve social continence and lower the risk of urinary tract infections, through a program of clean intermittent catheterization and medications such as antispasmodics and possibly, anticholinergics.

Clean Intermittent Catheterization (CIC) is a method of draining urine via a disposable catheter inserted into the urethra at regular intervals during the day. Once the urine is drained, the catheter is removed. Even though this process is performed using not a sterile, but a clean technique, it is a ‘gold standard for bladder management in patients with spina bifida’ (Lapides, 1972).

An urologist prescribes CIC and teaches parents how to perform it. This is usually done every 2-6 hours throughout the day. In small children and babies, parents or caregivers usually do CIC. Once the child is old enough and developmentally ready, they should learn self-catheterization.

Older children self-catheterize. The transition to self-catheterization usually coincides with pre-puberty and takes place between the ages of 9 and 14 . Every child is different, so there are quite a few children who manage to do it on their own at the age of 6 or 7 and others who still need assistance or at least supervision in adulthood.

Despite the widespread use of CIC around the world for four decades now, in some countries, this technique is still not well known. To support the work of the healthcare staff and assistants, as well as to facilitate parents and children themselves, we present the main steps in CIC in girls and boys.

Sources: Multi-IN Manual for nurses and healthcare professionals on multidisciplinary care and inclusion of students with spina bifida and hydrocephalus at schools and kindergartens