Intermittent catheterisation: challenges when children move to adult services

Intermittent catheterisation has long been cited as the gold standard approach to assisted bladder drainage with the least risk of infection compared to indwelling catheters. It is defined as the aspiration or drainage of the bladder or urinary reservoir using a hollow tube/catheter with subsequent removal of the catheter (Abrams et al, 2003; Vahr et al, 2013). As the intermittent catheter has no retention balloon and is removed within minutes of insertion, the risk of biofilm formation is eliminated. Commonly, the intermittent catheter is inserted by the patient themselves—intermittent self-catheterisation (ISC)—although on occasions it is necessary for someone else to assist, or take over this task for them.

Intermittent catheterisation procedures are not dependent on age or culture, and the technique can be adapted to suit many situations or scenarios. In paediatric practice it is common for parents/guardians to take on the initial catheterisation responsibility, with the child achieving competence and independence with the skill over time.