Bladder Washouts
Why do a Bladder Washout?
A bladder washout is performed to remove debris from the bladder. This is commonly required for people who have:
- had a bladder augmentation as the intestine used produces mucous and can block catheters and prevent complete emptying of the bladder and increasing risk of an infection
- an ileal conduit where the bladder remains insitu. The bladder will continue to produce mucous and this will need to be flushed out regularly.
A bladder washout is not recommended for managing recurrent catheter blocking unless advised by a Urologist or Rehabilitation Specialist. See advice for alternative management of indwelling catheter blocking.
What is a Bladder Washout?
Bladder washout is a high-volume irrigation of the bladder to “flush” the bladder with clean water to remove any residue or debris. This is achieved by attaching a syringe to the end of the catheter, injecting clean water, and then withdrawing it. The frequency that this may need to be done is based on the person’s need. Not attending to regular bladder washouts can result in increased risk for urinary tract infections or calculi development.
Equipment required
- A clean catheter pack or two kidney dishes
- Catheter with funnel tip- an intermittent catheter is suitable for use
- A 50ml catheter tip syringe
- 500ml bottled sterile water or boiled water cooled back down to room temperature
- Warm soapy water or wipes
- Personal protective equipment as required
Performing the irrigation
- Gather equipment and place on a clean table
- Place water into one of the kidney dishes
- Wash the genital area with warm soapy water and dry thoroughly
- Wash hands with soap and dry well
- Insert catheter and empty bladder as per procedure
- Rest the end of the catheter in the clean empty kidney dish
- Draw up 50ml of water, expel the air and attach to the catheter
- Inject it carefully and slowly. If unable to irrigate through the catheter, do not force it. Change the catheter and try again. If the problem persists, please seek advice.
- Remove syringe, clamp catheter with the thumb and forefinger and refill syringe with another 50ml. Inject slowly.
- Repeat procedure again, there should be 150ml in the bladder. (Volumes instilled may vary with bladder capacity).
- Gently pull back plunger of syringe and withdraw 50ml
- Take note if there is any sediment or debris.
- Clamp catheter again with fingers (leaving 100ml in the bladder), remove syringe and empty it into the second kidney dish.
- Refill the syringe and repeat the process until the fluid that is withdrawn is free of sediment.
- Remove catheter
- Empty irrigation solution into toilet and clean the equipment.
Cleaning Equipment required for kidney dishes
- Sodium hypochlorite (eg. Milton) – dilute as per instructions
- Soapy water
- Airtight container
Cleaning Process
- Prepare the sodium hypochlorite (eg. Milton) solution
- Clean kidney dishes in warm soapy water
- Rinse equipment
- Place equipment into sodium hypochlorite (eg. Milton) solution for at least 15 minutes
- Remove and place items into an airtight container
- The container that is used to store the equipment should be scalded with boiling water once a week
Possible Problems
Difficulty inserting fluid
If unable to irrigate through the catheter do not force it. Change the catheter and try again. If the problem persists, please see the local doctor, hospital or nurse.
Infection
If there are any concerns with urine being cloudy, malodorous or haematuria or a sensation of stinging or burning, please contact the local doctor, hospital or nurse.
QSCIS acknowledges the Urology Department, Princess Alexandra Hospital for assistance in updating and writing this information