7.4.4 Bladder instillations and urological surgery

Dimethyl sulfoxide
  • 50% irrigation

Notes

  1. For use in South Devon and Torbay Hospital
Glucose
  • 5% irrigation solution, 3 litre
Glycine
  • 1.5% irrigation solution, 1 litre, 3 litre
iAluRil®
  • Pre-filled syringe containing sodium hyaluronate 800mg and sodium chondroitin sulfate 1g in 50ml
Instillamed®
  • Pre-filled syringe containing sodium hyaluronate 800mg and sodium chondroitin sulfate 1g in 50ml
  • For use in Torbay and South Devon NHS Foundation Trust only
Potash Alum
  • 10% bladder wash (unlicensed preparation)
Sodium chloride
  • 0.9% irrigation solution, 1 litre, 3 litre
Sodium hyaluronate
  • 40mg/50ml
Water (sterile distilled)
  • Irrigation 1 litre, 3 litre

Catheter maintenance solutions

Sodium chloride
  • Sachets 0.9% (£7.92 = 100ml)
Solution G

(Citric acid 3.23%, magnesium oxide 0.38%, sodium bicarbonate 0.7%, disodium edetate 0.01%)

  • Sachets (£3.66 = 50ml)
Solution R

(Citric acid 6%, gluconolactone 0.6%, magnesium carbonate 2.8%, disodium edetate 0.01%)

  • Sachets (£3.66 = 50ml)
with Antimicrobial
Farco-fill® Protect (CliniMed Ltd)

(Triclosan 0.3%)

  • Catheter inflation solution (£4.93 = 10ml)

Maintenance of indwelling urinary catheters

Catheter care starts with assessment of the patient and a clear Care Plan developed from the outset of treatment, including a catheter risk assessment and regular reassessment. Urinary pH should be checked regularly and all catheter events should be clearly documented. Repeated blockages require catheter reassessment and if there is bladder spasm, consider an anticholinergic.

Prescriptions should be for no more than a month's supply, as determined by the treatment plan.

The deposition, which occurs in catheterised patients, is usually chiefly composed of phosphate. Latex catheters are not recommended due to allergies. Biocath and 100% silicone catheters are used and are changed routinely every 12 weeks. Repeated blockages need reassessment and a change of maintenance plan. 100% silicone catheters are not recommended for supra pubic use, as cuffing occurs on deflation of the balloon.

Solution G should be used first line for encrustations and Solution R only used as a last resort. The frequency of use is dependent on the patient's individual treatment plan.

Chlorhexidine catheter irrigation solution is not recommended because it may be an irritant to the bladder.

Last updated: 07-11-2019

 

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