Living with a urinary catheter

Intermittent self catheterisation (ISC): doing it

If a person has good use of their hands (manual dexterity) a doctor may recommend intermittent self catheterisation (ISC) because it is the safest way to empty the bladder if it can’t be done naturally (see 'What is ISC and why is it used?'). We talked to a number of people who had used or were using ISC and who had managed it successfully.

Peter has multiple sclerosis (MS).He finds that ISC is an excellent way to manage his incontinence. He also uses a Conveen® (a condom catheter) during part of the day.

Some people said they used ISC at first but, as their condition got worse, it became harder to do. In the United Kingdom permanent indwelling catheters are used by 3% of people who live in the community and 13% of care home residents (Royal College of Physicians. 2005). This site focusses specifically on experiences of indwelling catheters, so we looked for people to interview who had an indwelling catheter. It is not surprising, then, that we found people who had tried ISC but had found it difficult or impossible.

Charles used ISC for about four years, and managed it successfully. Then in 2009 he developed brachial neuritis, which meant that he had poor use of his hands. This made it difficult for him to pass the catheter, so he had to have an indwelling catheter.

Iain was diagnosed with Multiple Sclerosis (MS) in 1994 at the age of 18. He used intermittent catheterisation for a while but eventually had to have an indwelling catheter.

Urethral stricture (a narrowing of a section of the urethra) is another reason why doctors may suggest ISC. Urethral stricture may be caused by an enlarged prostate.

Some people we interviewed said that, when they first had bladder problems, their GP prescribed medication. Several of them, for example, had been prescribed oxybutynin, a medicine used to relieve urinary and bladder problems by reducing muscle spasms of the bladder. When their urinary problems had continued, ISC was recommended. John Z became incontinent after surgery for bowel cancer.

Sometimes the bladder outlet fails to open sufficiently to allow the passage of urine through it. Urinary retention (inability to pass water normally) occurs in Fowler’s Syndrome, a condition sometimes seen in young women. Jennifer, who had Fowler’s Syndrome, tried ISC but had to go into hospital a few times when she couldn’t withdraw the catheter from her bladder.

Narelle, who cared for her husband David before he went into a nursing home, said that David was advised by a doctor to use ISC several years before he was diagnosed with prostate cancer. David couldn’t see the need for it.

Some of the people we talked to tried to use ISC but found it impossible. Alex, who had MS, tried but couldn’t do it because she couldn’t get her legs apart. She was later fitted with a suprapubic catheter (see ‘Indwelling catheters: suprapubic catheters’).

Some people we spoke to had a spinal injury and were paralysed. They didn’t have sufficient use of their hands to be able to self catheterise or transfer to the toilet to do it.


Reference: Royal College of Physicians. 2005. Report of the National Audit of Continence Care for Older People (65 Years and Above) in England, Wales and Northern Ireland. Royal College of Physicians Clinical Effectiveness and Evaluation Unit, London.

Last reviewed June 2015.
Last updated June 2015.

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