Living with a urinary catheter

Bladder washouts

A bladder washout is a technique used to flush out the catheter and bladder by introducing a catheter maintenance solution into the bladder through the catheter.
A bladder washout might be needed if:
  • there is a lot of sediment in the urine
  • the catheter is not draining correctly
  • the catheter has blocked and is not being replaced
Advantages of a bladder washout:
  • it offers an alternative to those who cannot drink large amounts of fluids to treat a urinary tract infection or heavy sediment
  • if the catheter repeatedly blocks and someone is unwilling or unable to do frequent catheter changes
  • stretching the bladder frequently can help avoid shrinkage
Disadvantages of a bladder washout:
  • every time the catheter is disconnected from the drainage bag, an entry point for infection is created
  • it introduces foreign fluid into the bladder
  • the procedure takes time
  • it can cause bleeding and blood clots if not done carefully
  • it risks damaging the epithelial lining of the bladder
  • studies have shown it has little or no effect on most infections
  • bladder washouts can induce autonomic dysreflexia in some people with spinal cord injury
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There is little research available to suggest whether there is a difference between the various solutions to treat encrustation and blockage*. For persistent encrustation, a catheter maintenance solution may be tried before the leg bag or catheter valve is changed after all other measures have been tried. e.g. more frequent catheter changes.
Some people we interviewed had never had a bladder washout. Several others had, though how often they had one varied. Ian, who’d had an indwelling catheter for over 20 years, said he had many blockages until he started using bladder washouts to try and prevent them. Michelle said bladder washouts never worked for her – they give her headaches because her bladder is so small. Whenever her catheter becomes blocked, she always has to have it changed.
Peter did fortnightly bladder washouts and, since he started these, has gone back to 12-weekly catheter changes. Sara has bladder washouts twice a week and described what this involved. She uses Suby G and Solution R, acidic catheter maintenance solutions which dissolve the minerals that have been deposited'
Alex said that sometimes the district nurse gave her a bladder washout when the catheter became blocked but, at other times, the catheter would be changed. Some people did their own bladder washouts at home. Several people had a professional carer do the washout and a few people had their partner do it.

*Shepherd  AJ, Mackay  WG, Hagen  S. Washout policies in long‐term indwelling urinary catheterisation in adults. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No.: CD004012. DOI: 10.1002/14651858.CD004012.pub5.
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Last reviewed October 2018.


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