By Priya Raghunathan, Continence Nurse Specialist Β· Category: Clinical Practice Β· Published 11 June 2026
Clean intermittent self-catheterisation is one of the most liberating interventions in continence care. It restores bladder emptying, protects the upper urinary tract and gives people back control of their day. It also carries a persistent risk of urinary tract infection β and that risk is the single biggest reason people abandon the technique.
Why UTI risk deserves a strategy, not a reflex
The instinctive response to recurrent UTI in a catheter user is antibiotics. Yet repeated courses drive resistance, disrupt the urinary and gut microbiome, and leave the underlying cause untouched. A better approach treats infection risk as something to be designed out of the routine, addressing four modifiable factors: how often the bladder is emptied, how completely it is emptied, how much trauma the catheter causes, and how easy the routine is to follow consistently.
The mechanisms that actually matter
- Residual urine. Urine left in the bladder is a culture medium. Incomplete or infrequent emptying is the most consistently reported risk factor.
- Urethral microtrauma. Friction during insertion and withdrawal creates small mucosal injuries that give bacteria a foothold and make the next catheterisation more painful.
- Bacterial introduction. Organisms carried from the periurethral area or from hands and surfaces during preparation.
- Adherence. A regimen that is painful, messy or socially impossible will not be followed β and non-adherence reintroduces every other risk at once.
Getting the fundamentals right
- Catheterise often enough. Most adults need four to six catheterisations a day. Stretching intervals to avoid an inconvenient bathroom is a common and consequential shortcut.
- Aim for complete emptying. Withdraw slowly and pause when flow stops, then withdraw a little further. A small change in technique often removes a stubborn residual volume.
- Keep volumes moderate. Bladder volumes consistently above roughly 400 to 500 millilitres are associated with higher infection risk and with detrusor overdistension.
- Hydrate steadily. Even fluid intake across the day beats large intermittent volumes.
- Wash hands properly. Soap and water before and after, every time. Where facilities are poor, a sachet of gel or a wipe kept with supplies removes the excuse.
Why catheter design changes outcomes
Friction is the variable that clinicians can influence most directly through product choice. Traditional hydrophilic catheters require water activation and a waiting period, and the slippery coating can transfer onto hands and clothing β messy, awkward in a public toilet, and a genuine barrier to catheterising as often as the bladder needs.
GentleCathβ’ with FeelClean Technologyβ’ takes a different route. The lubricant is integrated within the catheter material itself rather than applied as a surface gel, so the catheter is ready immediately, requires no water, and does not leave residue on the hands. Two consequences follow: insertion is smoother, which reduces microtrauma; and the routine becomes discreet and quick enough to complete anywhere, which supports the frequency the bladder actually needs.
- No waiting. Ready to use straight from the packaging.
- No water required. Practical at work, when travelling and in accessible toilets without a basin.
- No sticky residue. Less mess, greater dignity, better adherence.
- Discreet packaging. Fits in a pocket or bag without announcing itself.
Signs that warrant review
Encourage catheter users to make contact rather than wait if they notice cloudy or strongly smelling urine with new systemic symptoms, fever or loin pain, new incontinence between catheterisations, visible blood, increasing pain or resistance on insertion, or two or more symptomatic infections in six months. Recurrent infection is a prompt to reassess technique, frequency and product β not simply to prescribe again.
The point of all this
Reducing UTI risk is not about making catheterisation more clinical. It is about making it easier, gentler and more private, so that people do it as often as their bladder requires without rearranging their lives around it. Independence and infection prevention pull in the same direction.
Convatec Academy offers continence care education for community and specialist nurses. me+β’ supports catheter users with sample requests and practical guidance.