Catheter Insertion Tips From Clinicians

It can be challenging to learn how to insert an intermittent catheter. Get tips from nurses that can help make catheter insertion easy and trouble-free. 

Learn what experienced health care professionals know about catheter insertion.

One of the most challenging aspects of intermittent self-catheterization (ISC) is learning the correct insertion technique. Your healthcare team likely provided some initial instruction, coaching, and guidance. It’s important for you to follow their recommendations since everyone’s challenges and comfort levels with self-catheterization are different. 

Yet, even with expert instruction, the thought of inserting a catheter on your own can be scary. In this article, we’ll give you some additional hints and tips from two experienced continence care clinicians – Corey Knott and Gina Powley. 

 Corey Knott, CNS, NCA  
Corey is a Clinical Nurse Specialist and Nurse Continence Advisor at Richmond Hospital in Vancouver, Canada who helps patients overcome their anxiety around intermittent catheter insertion. She dedicates herself to teaching good technique to her patients from the beginning, to lay a foundation for trouble-free self-catheterization and improved quality of life. Based on her years of experience, she has developed a list of tips for those learning to insert their own catheters. 

Corey’s general tips for performing ISC: 
  1. Catheterize when your bladder is not at its fullest
  2. Give yourself plenty time to find a toilet and get ready to catheterize
  3. If you don’t have sensation, set an alarm to do ISC on a regular schedule
  4. Wear accessible clothing to catheterize more easily
  5. Have everything ready and laid out before you start the ISC process
  6. Be sure to wash your hands thoroughly
  7. Take up a comfortable position that works for you – sitting in your wheelchair, on a toilet or commode, or standing up
  8. Breathe deeply and keep calm
  9. Make sure you always have enough product with you and at home 
Corey also believes that trouble-free insertion over the long term may mean switching to a different catheter. “Bodies change as we age, and products do too,” she says. “As a person’s condition develops, it could be worth trying a different catheter, maybe to deal with a stricture, a decline in hand dexterity, or more limited mobility.” 

Corey’s gender-specific ISC tips 

Corey also has some ISC tips specific to women and men and their respective anatomy. “Some women worry about inserting the catheter into their vagina by mistake, so sometimes it helps to put a tampon or some toilet paper into the vaginal opening and block it,” she says. “Then, they can then feel where the catheter is meant to go and it finds its way to the urethra by default.” 

For male patients, Corey recommends a technique to help them relax. “If a man can imagine letting urine go while they’re inserting the catheter, it will help the pelvic floor relax and the internal sphincter will open a little,” she says. “It also helps everything relax if they wiggle their toes as if they’re on a beach and their feet are covered in sand.” She also provides additional guidance for once the catheter is inserted. “Once urine flows and they feel relief, I advise them to push in a further inch to make sure they’re right in the bladder, and not just in its neck,” she says. “Then, as the flow begins to slow, they remove the catheter slightly – and if the flow begins again they should wait for it all to drain; bearing down slightly as the urine slows ensures that it all comes out.” 

 Gina Powley, MSN, ANP-BC, CURN, FAUNA  

Gina is a Hollister Clinical Resource Manager with over a decade of clinical practice experience as a nurse practitioner. She also has deep expertise in instructing beginner intermittent catheter users on how to achieve seamless insertions. 

Gina’s thoughts on ISC anxiety 

Gina has seen first-hand the apprehension that new patients feel about self-catheterization. “They are so stressed because they don't know the process and they’re scared to put a tube someplace in their body that they feel is not meant for inserting anything,” she says. “I’ve seen the anxiety across all genders and age groups – from young men to elderly women.” 

Gina offers insights for learning to overcome this fear and relax. “It’s important to understand, as someone new to self-catheterization, that your anxiety is so high is because it's something that’s unknown,” she says. “But once you are properly trained in ISC and do it a few times, your stress level will start to go down and the process will eventually become routine.” 

Gina’s ISC tips for women and men 

“If you’re a female and new to catheterization, you’re likely to be instructed to use a mirror, which can be helpful at first in locating where you need to insert the catheter,” Gina says. “But I think it’s important to learn to insert by feel so that you don’t always have to use a mirror; inserting by feel helps ease the anxiety of having to do self-catheterization in a public bathroom or in any situation when you don’t have a mirror or your usual setup.” 

Like Corey, Gina encourages her patients to breathe deeply and stay calm, and to add wiggling their toes to their catheter insertion routine. “It’s a method that is particularly useful for men who have an enlarged prostate that results in a more challenging insertion,” says Gina. “But it can actually be helpful to anyone who is new to self-catheterizing.” 

Hollister is here to help 

If you would like more information about ISC, be sure to read these additional articles in our Continence Care Learning Center.