Intermittent catheterization is the "gold standard" for assisting bladder emptying in patients with non-reflexive or low-reflex detrusor muscles. It is clinically applicable to various conditions such as neurogenic bladder, bladder outlet obstruction, urinary incontinence surgery, or controllable urinary diversion surgery, which cause permanent or temporary bladder emptying disorders. 

 

1. Analysis of the therapeutic effect of catheterization cleaning

1.1 In clinical practice, the main causes of bladder emptying disorders are neurogenic bladder secondary to neurological disorders, bladder outlet obstruction, and various pelvic and urethral surgeries. 

1.2 Temporary use of a urinary catheter through the urethra is often carried out during the acute stage of bladder dysfunction. However, prolonged use of a urinary catheter through the urethra can lead to serious complications such as severe lower urinary tract infections, urethral stricture, epididymitis, etc. 

1.3 Intermittent catheterization is the "gold standard" for assisting bladder emptying. For incomplete bladder functional disorders, intermittent filling and emptying of the bladder helps restore bladder reflexes. Intermittent catheterization includes sterile intermittent catheterization and clean intermittent catheterization. Sterile intermittent catheterization is more conducive to reducing the occurrence of urinary tract infections and bacteriuria, but it is generally only used by professionals in hospitals, and patients or their family members usually do not have the relevant conditions for self-care or home care. 

1.4 Studies have shown that clean intermittent catheterization is feasible and safe for patients with bladder emptying disorders, and it has the advantages of low environmental and equipment requirements and a short learning curve. 

 

2. Precautions for cleaning catheterization

2.1 The primary purpose of intermittent catheterization is to protect the function of the upper urinary tract. Therefore, during each follow-up visit, blood creatinine levels must be rechecked to assess kidney function; ultrasound examination is used to determine if there is dilation, hydronephrosis, or worsening of hydronephrosis in the kidneys and ureters. 

2.2 Since patients or their family members are not professionals, it is not easy to fully and accurately implement intermittent catheterization. Therefore, in addition to providing education on intermittent catheterization, regular follow-up visits are very important. They can promptly correct the errors in the operation and are crucial for monitoring the patient's condition dynamically. For example, urinary tract infection is a common complication of clean intermittent catheterization. Teaching patients to observe the symptoms of infection, such as cloudy urine, sediment, hematuria, or fever, and promptly returning to the hospital for treatment to avoid further deterioration of the condition. 

2.3 The prognosis of neurogenic bladder is highly dependent on the primary disease. For example, patients with diabetic neurogenic bladder and those with cerebral infarction neurogenic bladder can recover their ability to urinate spontaneously more quickly as the primary disease improves. However, patients with spinal cord injury-induced neurogenic bladder recover their ability to urinate more slowly. Patients with complete spinal cord injury cannot recover and require long-term catheterization and lifelong follow-up. 

2.4 Intermittent catheterization should be carried out under the guidance of a specialized nurse for intermittent catheterization, and careful follow-up is necessary to ensure that the procedure is safe and effective, thereby truly benefiting the patients. 

 

In conclusion, intermittent catheterization is a feasible and safe procedure for patients with bladder emptying disorders such as those caused by nerve damage. The short-term efficacy is also definite. However, more practical cases are needed to further analyze the situation.

 

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