Review of Intermittent Catheterization and Current Best Practices

Diane K. Newman, MSN, ANP-BC, CRNP, FAAN, BCIA-PMDB; Margaret M. Willson, MSN, RN CWOCN


Urol Nurs. 2011;31(1) 

In This Article

Bladder Physiology

During voiding, the bladder contracts, and internal and external sphincters and pelvic floor muscles relax to allow urine to pass through the urethra. Normally, after the bladder empties, a small amount of urine (less than 75 ml), called the post-void residual (PVR), may remain in the bladder. If a person cannot urinate or empty the bladder completely, the PVR increases and can contribute to urinary tract infections (UTIs), overflow urinary incontinence (UI), and permanent damage to the bladder and kidneys. Incomplete bladder emptying or urinary retention may lead to the development of a neurogenic bladder, a general term referring to bladder or voiding dysfunction resulting from interrupted innervation from a lesion or disease in the central or peripheral nervous system (Newman & Wein, 2009). Neurogenic bladder can be caused by 1) upper motor neuron disease (for example, central nervous system lesions, including stroke, Parkinson's disease, and multiple sclerosis [MS]); 2) spinal cord injury, including MS of the cord, and cervical and thoracic disc disease; and 3) lower motor neuron disease (for example, pelvic nerve injury, peripheral neuropathy, diabetes mellitus). Neurogenic bladder represents one of the most common problems in individuals with a variety of neurological impairments. Table 1 lists common lower urinary tract diagnoses seen in patients with neurogenic bladder.