Finding the urethra and avoiding UTIs are two common problems encountered by female catheter users. Because the urethral opening is small, it is hard to see or feel it, and it is prone to be infected. But don’t worry, this guide will help you find your urethral opening and achieve quick and easy catheterization.
This is to avoid contaminating your urethral opening with bacteria on your hands, which can lead to a UTI.
Get a small mirror with a stand so you can easily adjust its position and angle. Make sure that the mirror reflects at the right angle and is close enough that you can see clearly. Recline on a chair or wherever it’s comfortable for you, and put the mirror directly in front of your vulva.
It’s important to have lights directly illuminating your vulva in order to see clearly. An overhead light may cast shadows and make visibility low. Either get a flashlight or face a bright lamp in close proximity.
When your spread open your vulva lips, you may immediately notice a hole. If the hole sits on the lower end of your vulva, it’s likely your vagina opening. When you see your vagina, look a little bit up. Your urethral opening sits above your vagina but below your clitoris.
For beginners, it’s better to use closed-system catheters for the first couple of times. A closed system catheter lets you drain into a urine collection bag. This way you don’t need to sit on a toilet to catheterize. You can recline anywhere and use a mirror to help you see your urethra clearly.
Now that you’ve found your urethra, here are a few more things you should know about self-catheterization before you start. One of the most common catheterization complications is the occurrence of UTIs. But what is UTI and how do you avoid it?
Higher UTI risk in women is due to two factors:
90% of UTI is caused by the bacteria E. Coli, which resides in the colon and moves to the anal area after bowel movements. E. Coli can make its way to the urethral opening when there’s any kind of movements that rub back and forth between the anal area and the genital area, such as sexual activities, wiping back to front after using the toilet, walking, and running.
People who use catheters are at an increased risk for UTIs. Catheter-associated UTIs happen when people practice incorrect catheterization techniques.
If you suspect that you have a UTI but are not sure, get tested at home with UTI test strips.
If you know you are going to be in a situation where there’s no soap and water, bring hand sanitizers, wet wipes, or clean gloves to keep your hands clean, or use non-touch catheters.
Even when you’ve thoroughly washed your hands, there may still be remaining germs that can get onto the catheter when you touch it, which causes a CAUTI when you insert the contaminated catheter.
Therefore, consider using a pre-lubricated, non-touch catheter for quick, hygienic catheterization.
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You can also wash your genitals with soap and water. Be sure to clean the urethral opening in particular. If there is any bacteria on your urethral opening, the catheter may push it in, causing a CAUTI.
Chronic incomplete drainage of the bladder can lead to the development of bladder stones and UTIs.
After the catheter has reached the bladder, you will notice that urine starts flowing out. To ensure complete drainage, insert 2 inches deeper and wait till all fluid has drained to slowly pull the catheter out by an inch. Wait till all fluid drains and pull out another inch. Repeat until no fluid remains and you have removed the catheter. If you are using a straight catheter, you can also rotate it a little bit to get complete drainage. Do not rotate if you’re using a coudé catheter (curved tip).
On another note, some studies have found that taking cranberry supplements (not drinking cranberry juice) can lower your chance of getting a UTI. Cranberries contain A-type proanthocyanidins (PACs), which can impede the bacteria’s ability to stick to the bladder lining, thus decreasing the chance of an infection. Cranberry capsules work instead of juice because capsules are highly concentrated whereas juice is not.
If the catheter is not sliding in, do not force it! Forcing the catheter can injure your urethra, resulting in hematuria (blood in urine), urethral strictures, and the creation of a false passage. Instead, remove the catheter and try again later with a new one. If you still cannot get it to insert and your bladder is full, you should go to the emergency room.
We have mentioned before that UTIs are caused by microbiome—bacteria, viruses, fungi. Studies have shown that silicone oil has anti-microbial properties (studies1, 2, 3). Furthermore, 90% of UTI is caused by the bacteria E. Coli, and silicone oil is also found to kill and suppress the growth of E.Coli.