If your doctor or nurse has recommended clean intermittent catheterization — commonly called CIC or CISC (clean intermittent self-catheterization) — it's natural to feel apprehensive. Catheterizing yourself is a skill, and like any skill, it gets easier with practice. Most people are able to learn CIC — many in a single teaching session with a nurse — and for most it soon becomes a routine part of the day.[1]
This guide covers everything a new CIC user needs to know: what CIC is, why it's prescribed, how to do it safely, and what to consider when choosing a catheter.
What Is Clean Intermittent Catheterization?
CIC is the practice of inserting a catheter through the urethra into the bladder at regular intervals to drain urine — then removing the catheter completely. Unlike an indwelling (Foley) catheter, which stays in place continuously, an intermittent catheter is used for a few minutes several times a day and then removed. Intermittent catheters sold in Canada are generally single-use.
The word "clean" distinguishes this method from sterile catheterization (used in hospital settings). Clean technique focuses on good hand hygiene and avoiding contamination rather than a fully sterile field — making it practical and achievable at home, at work, and while travelling.
Why Is CIC Prescribed?
CIC is used when the bladder cannot empty adequately on its own. Common reasons include:
- Neurogenic bladder — caused by spinal cord injury, multiple sclerosis, spina bifida, or other neurological conditions that disrupt bladder control signals
- Urinary retention — the bladder does not empty completely, leading to overflow incontinence or recurrent infections
- Urethral strictures or BPH — obstruction prevents adequate voiding
- Post-surgical recovery — following prostate surgery, bladder surgery, or certain gynecological procedures
- Underactive bladder — the detrusor muscle does not contract strongly enough to empty the bladder
Guidelines generally favour intermittent catheterization over long-term indwelling catheters when a person (or their caregiver) is able to do it, mainly because it is associated with fewer catheter-related infections.[3] See Indwelling vs. Intermittent Catheterization for more.
How Often Should You Catheterize?
Catheterization frequency is set by your healthcare provider based on your bladder capacity and fluid intake, but a typical schedule for an adult is 4–6 times per day, spaced roughly 4–6 hours apart. The goal is to prevent the bladder from overfilling — generally keeping each catheterized volume under about 500 mL unless your health professional advises otherwise.[1] Keeping a simple diary of what you drink and drain for the first week or so helps your care team set your schedule.[1]
Most people find it helpful to catheterize at consistent times: morning, mid-morning, lunch, afternoon, evening, and before bed. Adjusting for fluid intake — catheterizing more frequently on days with high fluid consumption — becomes intuitive over time.
Regularly letting the bladder overfill can stretch the bladder wall, raise the risk of UTIs, and over time increase the risk of urine backing up toward the kidneys. Keep to your schedule even when you feel no urge. If you have a spinal cord injury at T6 or above, an overfull bladder is also the most common trigger of autonomic dysreflexia — learn the warning signs (see our UTI article).
Step-by-Step CIC Technique
The following steps describe a general CIC technique for reference. Always follow the specific instructions provided by your healthcare team, as technique may vary based on your anatomy and catheter type.
Gather your supplies
You will need your catheter, water or saline for hydrophilic activation (if applicable), a clean surface or catheter bag, and soap and water for handwashing. Some people also use a mirror for positioning assistance initially.
Wash your hands thoroughly
Use soap and water for at least 15–20 seconds, cleaning between fingers and under nails. Canadian best practice recommendations call hand hygiene the single most important practice for preventing the spread of infection.[1]
Prepare the catheter
Some hydrophilic catheters come ready to use in saline; others need to be activated with water or by breaking an included sachet. Follow the manufacturer's instructions, including any waiting time. The catheter should feel slippery along its length.
Clean the urethral area
Gently clean the urethral meatus with a moist wipe or cloth. For male users, retract the foreskin if present and clean the glans. For female users, part the labia and clean front-to-back.
Insert the catheter
Hold the catheter by its sleeve or grip area (avoid touching the insertion portion). Gently advance the catheter into the urethra. For males, hold the penis upward as you begin, as your nurse shows you. When you feel resistance at the sphincter muscle, pause for a few seconds, take a slow breath out, and continue gently.[1] Never force past significant resistance. Urine will begin to flow when the tip reaches the bladder.
Drain fully, then remove
Allow urine to drain completely. When flow stops, shifting position — or gentle pressure on the lower abdomen, if your nurse has shown you this is safe for you — can help ensure the bladder is empty. Slowly withdraw the catheter. If urine flow resumes during withdrawal, stop and allow it to complete before continuing to remove.
Dispose of the catheter
Discard the catheter after use — reusing a catheter labelled for single use goes against the manufacturer's instructions, and Canadian recommendations don't support it.[1] Wash your hands again afterward.
Choosing the Right Catheter
No single catheter is right for everyone, and it's worth seeing and trying a few before settling on one.[1] Key considerations include:
Size (French/Charrière)
Catheter size is measured in French (Fr) or Charrière (Ch) — each unit equals approximately 0.33mm in diameter. Commonly used adult sizes are around CH 12–14 for women and CH 12–16 for men, but your healthcare provider will confirm the right size for you. The catheter should be large enough to drain freely but small enough to reduce the risk of trauma.[1]
Hydrophilic vs. Non-Coated
Hydrophilic catheters have a coating that becomes slippery when wet, lubricating the full length of the catheter to reduce friction. Hydrophilic coating has been shown to reduce microscopic bleeding from the urethra.[1] Evidence on whether it reduces UTIs is mixed,[2] but Canadian recommendations advise single-use, pre-lubricated catheters, especially for people with repeated UTIs.[1]
Tip Design
Most people start with a straight (Nelaton) tip.[1] For men with urethral strictures, an enlarged prostate, or difficult catheterization, an angled Coudé/Tiemann tip or a flexible rounded tip may be options to discuss with your care team. See Straight, Coudé or Flexible Tip? Understanding Catheter Tip Designs.
Packaging and Ease of Use
If you have limited hand dexterity — common in spinal cord injury, MS, or arthritis — packaging design, grip features, and ready-to-use formats can make a real difference. Insertion aids are also available.[1] Ask your continence nurse or occupational therapist about options for one-handed or low-dexterity use.
CIC is a skill that takes practice. It is normal to find the first few attempts awkward, uncomfortable, or nerve-wracking. Many people find it gets much easier within the first couple of weeks. If you are experiencing consistent pain, resistance, or inability to insert the catheter, contact your healthcare provider — the issue may be solvable with a different catheter type or technique adjustment, not a reason to stop CIC altogether.
Managing Common Challenges
Resistance During Insertion
Some resistance — especially at the external urethral sphincter or prostatic urethra in men — is normal. Taking a slow, deep breath and relaxing the pelvic floor can help. If you consistently cannot advance the catheter, do not force it. Contact your healthcare provider; you may need a catheter with a different tip design, or there may be a stricture that needs evaluation.
Urinary Tract Infections (UTIs)
UTIs are the most common complication of CIC. Risk reduction strategies include consistent hand hygiene, a new catheter for each insertion, adequate fluid intake (your care team can give you a target that suits your health), and sticking to your catheterization schedule.[1] If you have a spinal cord injury, UTI symptoms can look different — see Preventing UTIs in Intermittent Catheter Users.
Bladder Spasms
Some people experience bladder spasms or leakage between catheterizations. This may be managed with medication, bladder training, or adjusting catheterization frequency. Discuss with your urologist or continence nurse.
Emotional and Psychological Adjustment
For many people, beginning CIC is an emotional as well as a practical adjustment. It can represent a significant change in how you relate to your body. Peer support can help — for example, through provincial spinal cord injury organizations such as Spinal Cord Injury BC — and your healthcare team can connect you with a continence specialist or counsellor if the adjustment is challenging.
About the IQ Catheter
The IQ Catheter from Manfred Sauer GmbH is a single-use intermittent catheter, available in hydrophilic and gel versions, with a soft, rounded tip on a flexible front section and a firmer guiding shaft. It is available in CH 10–18 in male and female lengths, and is exclusively distributed in Canada by IQ Catheter Canada.
Healthcare professionals can request complimentary samples on behalf of their patients for evaluation.
Healthcare professionals can request complimentary IQ Catheter samples. Submit a sample request →
This article was written by IQ Catheter Canada, which distributes the IQ Catheter in Canada. It is general information, not medical advice. Talk to your healthcare provider about your own situation.
References
- Nurses Specialized in Wound, Ostomy and Continence Canada, Canadian Nurse Continence Advisors, Urology Nurses of Canada, and Infection Prevention and Control Canada. Clean Intermittent Urethral Catheterization in Adults – Canadian Best Practice Recommendations for Nurses. 1st ed. 2020. PDF
- Campeau L, et al. Canadian Urological Association Best Practice Report: Catheter use. Can Urol Assoc J. 2020. Full text
- Hooton TM, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(5):625–663.