What do you most want to tell families about intermittent catheterization?
I would like to emphasize the difficulty in getting over the initial hurdle regarding catheterization, the reasons why catheterization is being recommended, the ease with which it can be done once it is learned, and its rapid effectiveness in gaining control over urinary incontinence and the resolution of urinary infection.
It’s important for families to know that this is not being instituted due to a failure of prior treatments or anything that the families did or didn’t do appropriately in the past. It is just another way of making their child healthy and well. We emphasize for children without neurological impairments that this is a temporary management program: eventually the child will urinate normally and can come off catheterization. We also stress to parents that this will help their child become accepted by their peers due to reduced wetting and infection. We especially emphasize that parents should relay these messages to their child, and possibly relate to families or friends or schoolmates or even school personnel why this is being instituted, and ask that all the individuals involved be very positive in their approach when they talk about it with the child. It doesn’t have to be a stigma, that these children have a handicap – this is just their way of emptying the bladder. I think once families accept this caveat, it makes everything so much easier.
Stuart Bauer, MD, Senior Associate in Urology
I would say that it is a life-saving maneuver. I staffed a clinic yesterday and I told a few families just that. They want to understand why this is necessary, because it is a huge commitment and it is a huge adjustment, but we reassure them that once they do it most families find that it’s very doable and kids settle into it very well. They can generally do it themselves after adequate teaching and as they age. And it is life-saving.
Carlos Estrada, MD, Physician
I want to reassure families that it’ll be a step-by-step process, and that we will support them and supply them with whatever they’re going to need. We’re also here to help them afterwards, and to give anticipatory guidance. We’re here for them, and at any time along the process, they can call and we can discuss what’s going on and help them through it.
Diane Manning, RN, Department of Urology
I want to tell families that they are not alone: there are other people like them, and we’re looking out for their best interest. And it can be done! It’s not going to be a big flag, like, “Oh, I cath.” It can be very discreet, and you would probably surprised by the number of people that do it. Just from me working here I can tell you, “Oh, a lot of people cath, you know.”
Rebecca Sherlock, PNP, Clinical Coordinator, Myelodysplasia Program
Why do people need to catheterize?
People need to empty their bladder on a regular basis in order to preserve kidney function, maintain bladder capacity, and prevent infections and accidents. There are many medical reasons people might not be able to empty their bladders on their own. If there is an anatomical issue, functional issue, or neurogenic issue that prevents the bladder from completely emptying, then one will need to catheterize via the urethra or continent stoma to drain the bladder. This may be needed for a short period of time, or this may be permanent, needing catheterization for life.
Diane Manning, RN, Nurse