What is Clean Intermittent Catheterization (CIC)?

It is the regular process of emptying the bladder in children who are unable to do so themselves—such as in cases of neurogenic bladder—using a sterile catheter through the urethra or a Mitrofanoff channel.

What are the Goals and Objectives of Clean Intermittent Catheterization (CIC)?

The goal of CIC is to prevent urinary tract infections caused by residual urine remaining in the bladder. In this way, kidney damage and kidney failure are avoided. Additionally, the procedure prevents urinary incontinence, helping the patient stay dry. This improves the patient’s quality of life and helps prevent potential psychological and social problems.

Which Children are Suitable for CIC?

CIC may be applied to patients with neurogenic bladder, those who cannot control urination, those with very high intravesical pressure, and patients with small bladders.

How is the CIC Method Applied

In small children, CIC is performed by the parents or caregiver. The method is first taught by a trained nurse or physician while the patient is hospitalized. The procedure is carried out by carefully following the steps listed below.

1. A catheter suitable for the child's age is selected.
2. Hands are washed thoroughly with plenty of water and, if possible, with soap.
3. The catheter is prepared; pre-lubricated catheters designed for this procedure are used. If the catheter is not disposable, it is cleaned thoroughly. The use of disposable catheters is preferred.
4. The appropriate position is arranged: the child sits or lies in a comfortable position; if necessary, especially for girls, a mirror can be used to assist with the procedure.
5. The catheter is carefully inserted through the urethral opening and advanced 1–2 cm further after urine begins to flow.
6. Wait until the bladder is completely emptied; do not rush to remove the catheter.
7. The catheter is removed, cleaned, and placed in its container. Disposable catheters are discarded into medical waste bins

How Often Should the Procedure Be Performed?

The frequency of the procedure depends on the child’s age, bladder capacity, and fluid intake. In general, it is sufficient to perform it every 4–6 hours.

What Should Be Considered While Using CIC?

The CIC procedure should be carried out with coordination among the physician, trained nurse, patient, and the person performing the procedure. Otherwise, the success rate decreases, and complications may arise. Hygiene must be maintained. After the age of 7–8, the child should begin to be trained to perform the procedure independently.

Is CIC Safe for Children?

Yes, CIC is extremely safe when performed correctly.

Should CIC Be Performed Continuously?

Although it depends on the underlying condition requiring its use, it usually needs to be continued permanently (for a lifetime).

Is It Necessary or Possible to Perform CIC Outside the Home?

Since more than 4–6 hours of daily life is spent outside the home, it will usually be necessary to perform the procedure once or twice a day in public settings. When hygiene is maintained, it can be easily performed outside. Older children and young adults can do the procedure in a clean public restroom. For younger children, it should ideally be done in the infirmary, or if unavailable, in the cleaner staff restrooms at school. Necessary materials should always be carried with the child.

How Can I Be Sure That My Bladder Is Completely Emptied?

During training, the volume of urine emptied should be measured, and this amount should later be used as a reference. However, remember that urine volume may vary depending on fluid intake and environmental conditions.

Is Blood in the Urine Normal During Catheterization? What Should Be Done

A small amount of blood is not a problem and can occur due to contact of the catheter with the urethra and bladder. To minimize trauma, use pre-lubricated catheters or apply sufficient lubricant. However, blood in the urine may also be a sign of a urinary tract infection. If bleeding persists or is observed during every catheterization, consult your doctor.

Is There Anything Else I Should Watch Out for Regarding CIC?

Pay particular attention to the color and smell of the urine. Any unexpected changes may indicate a urinary tract infection, and you should consult your physician.

*** The information provided here is intended to inform visitors—especially families—and should not be considered as medical advice or used to make any medical decisions. Families must consult a pediatric surgery specialist for examination and personalized medical advice.