Clean Intermittent Catheterization (CIC): Why It Is Needed, and How It Is Done

Ultimo aggiornamento: Agosto 30, 2026

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Clean intermittent catheterization (CIC) is a routine part of urological care in Western countries but is still used relatively little in this region. It is what we turn to when the bladder can no longer empty itself properly — so it helps to start with what the bladder is supposed to do.

The bladder’s job is to store urine and then squeeze it out completely. With age, or with any condition that damages the bladder muscle or its nerve supply, that squeeze becomes incomplete and urine is left behind after voiding — the residual urine volume. Urine that sits in the bladder becomes a reservoir where bacteria can settle and multiply. This is why these patients come to me with urinary tract infections that keep returning, and with the impression that the antibiotics are not working, when the real problem is that the bladder never empties. For an vescica non attiva, the most effective answer is CIC.

Important — please read first. The instructions below are a reference for patients who have already been assessed by a urologist, had CIC prescribed, and been taught the technique in person by a doctor or nurse. Catheterisation is easy to describe and less easy to do well; passing a catheter without training can injure the urethra, and the underlying cause of incomplete emptying needs diagnosing before anyone starts. Please do not attempt this from a written guide alone. Read this to understand what you have been taught, or to prepare for a training session — not instead of one.

Why clean rather than sterile

Catheterisation in hospital is done with full sterile technique: trained staff, a sterile field, and single-use disposable equipment. That is appropriate in a clinical setting, but it is neither affordable nor practical for someone who needs to catheterise every single day, indefinitely.

CIC deliberately relaxes the requirement from sterility to cleanliness, which is what makes it something a patient or family member can do at home at a manageable cost. The obvious worry is infection — and the reassuring finding from the letteratura is that infection rates with the clean technique are comparable to the sterile technique. That single piece of evidence is what makes long-term home catheterisation possible.

The CIC technique, step by step

For patients who have been trained in this technique. If your urologist or nurse gave you different instructions, follow theirs.

1. Pass urine normally first, as far as you are able.
2. Lavarsi le mani con acqua e sapone liquido.
3. Wash the genital area with an over-the-counter antiseptic soap.
4. Take the catheter out of its container carefully, keeping it clean and avoiding contact with anything else.
5. Apply water-based lubricating jelly generously to the tip of the catheter. Use plenty — under-lubricating is the commonest cause of discomfort and of urethral trauma.
6. Get into position — sitting on the toilet works for most people, lying down for others — and have a container ready if you are not draining directly into the toilet.
7. Pass the lubricated catheter gently into the urethra. It should slide; if it does not, stop and do not force it.
8. Continue until urine begins to flow — that tells you the tip has reached the bladder.
9. Advance it a little further so the tip sits properly inside the bladder rather than at its neck.
10. Hold the catheter in place and let the bladder drain completely.
11. Withdraw the catheter slowly and return it to its container of antiseptic solution.
12. Wash the genital area again, and wash your hands.

Looking after the equipment

• Change the antiseptic solution in the container every day, so the catheter is stored in fresh solution rather than yesterday’s.
• Replace the catheter set after about 3 settimane. Beyond that the infection risk rises, and the material degrades to the point where it can injure the urethra.

Cloudy urine is not the same as an infection

This is worth understanding early, because it decides how many courses of antibiotics you end up taking over the years. Almost everyone who catheterises regularly will grow bacteria in their urine. That is colonisation, not infection, and in a person who feels well it does not need antibiotics and does not need a urine sample sent. International infection guidance is explicit that the look and smell of the urine should not be used to decide whether infection is present.

What decides it is how you feel: fever or shaking chills, new pain in the flank or lower abdomen, blood appearing in the urine, unexplained tiredness or feeling generally unwell. Those are worth contacting your doctor about. Cloudy or strong-smelling urine on its own, in someone who feels normal, usually is not — and treating it repeatedly causes antibiotic resistance without making anything better. Drinking normally through the day and keeping to your catheterisation schedule does more than any antibiotic here.

When to be seen the same day

Go to an emergency department the same day — in Thailand you can call 1669:

• You cannot pass the catheter at all and your bladder is full. Do not keep trying, and do not force it — repeated attempts injure the urethra and make the next attempt harder for whoever has to do it.
• Fever or shaking chills, particularly with flank pain or feeling systemically unwell.
• Heavy bleeding, rather than the occasional trace that can follow a slightly difficult passage.
• If you have a spinal cord injury or another neurological condition: a sudden pounding headache, sweating or flushing above the level of your injury, blotchy skin, a blocked nose, or a feeling of impending doom — especially if your bladder is full or the catheter is not draining. This is a recognised emergency in people with spinal injuries at higher levels, blood pressure can rise dangerously fast, and draining the bladder is often the thing that fixes it. Sit upright, catheterise if you safely can, and get help immediately. Tell the emergency team you have a spinal cord injury and that this may be autonomic dysreflexia — many staff outside spinal units will not think of it, and saying the words changes what happens next.

Book a review, rather than an emergency visit, if catheterisation becomes newly painful or difficult when it had been easy, if you are seeing blood more than occasionally, if leakage between catheterisations is getting worse, or if you find you are needing to catheterise more often than the schedule you were given. Any of those suggests something has changed and is worth checking rather than working around.

CIC sounds daunting when it is first suggested, and most patients are apprehensive. In practice it becomes routine within a few weeks, and for people who have spent years on repeated antibiotic courses, the drop in infections is usually what convinces them it was worth learning.

Se soffri di vescica iperattiva, svuotamento incompleto o infezioni ricorrenti delle vie urinarie e desideri una valutazione specialistica e un addestramento al cateterismo intermittente (CIC), la Dottoressa Soarawee Weerasopone offre consulenze specialistiche presso la sede centrale dell'Ospedale di Bangkok. Prenota una consulenza. È possibile fissare un appuntamento presso l'Ospedale Samitivej Sriracha chiamando il reparto di urologia al numero 088-022-1445. Questions about the cost of consultation, training or equipment should go to the hospital directly — for Bangkok Hospital, by email to bhquro@bdms.co.th.

Bangkok Hospital also runs a Telemedicine service, arranged in advance by email to the Urology department at bhquro@bdms.co.th. It is useful for reviewing how CIC is going, troubleshooting problems, and discussing whether the schedule still suits you. The initial assessment and the hands-on training must be done in person, and so must any problem you are having with the technique itself — that is something to be watched rather than described. Samitivej Sriracha is in-person only.

Domande Frequenti sulla Cateterizzazione Intermittente Pulita (CIP)

Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. The instructions above are a reference for patients who have been assessed and trained in this technique, and are not a guide to attempting catheterisation without training. No medical advice, diagnosis or prescription is provided through personal messaging channels or social media. Always consult a qualified healthcare professional before starting any medical treatment. In an emergency, attend the nearest emergency department — in Thailand the emergency number is 1669.