![]() Long-term suprapubic catheterisation is needed when urethral catheterisation is no longer feasible or in certain neurological diseases. Once efficient urethral drainage is achieved, the SPC can be removed and the fistula will promptly close. 4–6 In these situations the SPC is a temporary measure. In hospital, short-term suprapubic catheterisation is used for AUR management when other methods have failed or for lower urinary tract diversion after surgery or trauma. However, IDC changes should never persist beyond three months. Scheduled IDC changes may vary according to individual needs. 4 Safe community practice ensures IDCs are changed every 4–6 weeks. In rare situations, when a suprapubic catheter (SPC) is contraindicated and other methods have failed, a chronic IDC may be needed. Long-term IDC should be avoided and is not a substitute for nursing care for incontinence management. ![]() Multiple failed, appropriately timed, voiding trials warrant specialist referral. This allows the bladder to regain its tone before attempting a voiding trial. 4 Individuals presenting with AUR may require an IDC to remain in situ for several days before attempting a voiding trial. Short-term IDCs are commonly used in hospital for management of acute urinary retention (AUR), urine measurements, bladder irrigations, diversion and drainage of urine after surgery, or for patients requiring epidural anaesthesia. Indwelling urethral catheterisation (short term and long term) 4 Education and assessment can be obtained from continence nurses and doctors specialising in urinary issues. These patients require adequate knowledge and competency to safely perform self-catheterisation. Depending on the indication, self-catheterisation can vary in frequency from weekly to multiple daily insertions. Individuals with certain neurogenic or detrusor muscle dysfunction may have regular self-catheterisation regimens. Indications for intermittent catheterisation include relieving urinary retention, drainage of post-void residual urine, urethral stricture dilatation and obtaining sterile urine specimens. Intermittent ‘in and out’ urethral catheterisation 3 Initially, the least invasive form of catheterisation should be chosen and only advanced once a method is no longer appropriate. To prevent complications, catheters should be used only when clinically indicated. As a result, patients present to emergency departments unnecessarily or are placed on long specialist outpatient clinic waiting lists when most IDC-related problems can be adequately managed without specialist input. 1 Limited exposure to IDCs in formative years and reliance on specialist nursing care poses a risk of de-skilling doctors. However, the literature has shown that IDC insertion and management is poorly taught in medical schools and to junior medical staff. ![]() Nursing staff are often responsible for basic IDC management, with escalation to doctors when complications arise. Indwelling catheters (IDCs) are common devices used for urinary drainage. ![]()
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