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Do I Really Need to Catheterize on a Schedule?

The short answer to our title question is Yes.  More importantly, the reason to perform intermittent catheterization on a schedule is to protect the kidneys and to lessen the chance of getting the dreaded urinary tract infection.  Some basic knowledge your kidney and bladder function helps illuminate this need.

Your bladder can hold approximately 400-500 milliliters of fluid.  That's about two glasses of liquid.  When the kidneys and bladder function properly, the kidneys produce fluid continuously throughout the day and when the bladder fills to about 250-300 milliliters, the urge to urinate is felt.  Assuming average intake of fluids, the urge to urinate occurs every 3 or 4 hours.  In conditions such as spinal cord injury or condition where there is a disruption of nerve supply to the bladder, the urge is not felt yet the kidney continues to produce urine.  Others may feel the urge but not make time for proper urinary care.  The bladder capacity fully extended is only slightly more than 500 milliliters; therefore, without scheduled intermittent catheterization, the bladder volume becomes overwhelmed within only a few hours and urine begins to back up into the kidneys.  This is called hydronephrosis.  This causes the pressure in the kidneys to rise.  The tissues and structures of the kidney are very sensitive to increased pressures and thus can be easily and quickly damaged.  Also, severe bladder distention may cause the bladder to actually rupture.

Is kidney damage serious?  Yes, our kidneys do more than just produce and excrete urine.  They are also responsible for maintaining the pH balance throughout the body, regulating the amount of water the body retains and excretes, and helps regulate electrolyte (Potassium, Sodium, Chloride, etc.) balance in the body among other functions.  So damage to the kidneys can become serious or even catastrophic quickly.

Bacteria normally live around the opening of the urethra, so each time we catheterize (even with the best technique), we push some bacteria into the bladder.  Bacteria (germs) can increase in numbers very quickly, and with only a few missed catheterizations, can produce symptoms of infection.  The presence of bacteria can also increase the pressure in the bladder, ureters, and kidneys if left untreated.

Your urologist or urology nurse will help you determine the right amount of water to drink each day and the right number of times to catheterize each day.  Improving the way we take care of our bladder and kidneys can have a very positive impact on the quality of our everyday lives.

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