Clean Intermittent Catheterization (CIC)
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Clean intermittent catheterization (CIC) is a procedure in which a person inserts a thin, hollow tube into the bladder through the urethra to drain urine at regular intervals. It helps people with neurogenic bladder, spinal cord injuries or post-surgical retention. Emptying the bladder every four to six hours prevents urinary tract infections, bladder distension and permanent kidney damage. [1]
What the research says
CIC lowers infection risk compared with an indwelling catheter. A meta-analysis of 19 studies (1,823 patients) of urinary retention after gynecological surgery found CIC cut the risk of urinary tract infection (relative risk 0.24, 95% CI 0.20 to 0.28), improved bladder function recovery, and shortened the time a catheter was needed compared with indwelling catheterization (Wang et al., Translational Andrology and Urology, 2023) [2].
Hydrophilic (coated) catheters may reduce UTIs. A meta-analysis of 9 trials (525 people using CIC) found a lower UTI risk with hydrophilic catheters than with uncoated ones (RR 0.78, 95% CI 0.62 to 0.97), and in adults specifically (RR 0.83, 95% CI 0.74 to 0.93), but no clear difference in children or in hematuria (Plata et al., World Journal of Urology, 2023) [3].
The best technique is still uncertain. A Cochrane review of 23 trials (1,339 randomized participants) could not say with confidence whether aseptic vs. clean technique, single-use vs. multiple-use catheters, or coated vs. uncoated catheters change the risk of UTI; most trials were small and the certainty of evidence was low, so following your clinician's training matters (Prieto et al., Cochrane Database of Systematic Reviews, 2021) [4].
What is clean intermittent catheterization (CIC)?
Clean Intermittent Catheterization, also known as self-catheterization or intermittent self-catheterization (ISC), is a proactive way to manage bladder health when the body cannot empty urine effectively on its own. The procedure involves the periodic insertion of a thin, bendable tube called a catheter into the bladder. Once the urine is drained into a toilet or collection container, the tube is removed and discarded.
Common Indications for CIC
Healthcare providers typically recommend self-catheterization for patients experiencing urinary retention or incontinence due to various underlying conditions. These may include:
Category | Specific Conditions |
Neurological Disorders | Multiple sclerosis (MS), Parkinson's disease, cerebral palsy, stroke. |
Physical Injuries | Spinal cord injuries, central nervous system tumors, spina bifida. |
Urological Issues | Enlarged prostate (BPH), prostatitis, urethritis, neurogenic bladder. |
Recovery | Post-bladder surgery, complications from other pelvic surgeries. |
Figure 1: Overview of the clean intermittent catheterization process, highlighting hygiene and gentle insertion.
How do you perform clean intermittent self-catheterization?
Performing CIC safely requires adherence to strict hygiene standards to minimize the risk of infection. While the process may feel intimidating initially, most individuals find it becomes a routine part of their daily care with practice.
Preparation and Hygiene
Before beginning the procedure, it is critical to gather all necessary supplies, including a clean catheter, water-based lubricant, and antiseptic towelettes.
Hand Hygiene: Thoroughly wash hands with soap and water.
Cleaning: Wash the genital area with soap and water or an antiseptic wipe.
Lubrication: Apply a water-based lubricant to the tip and the first two inches of the catheter. Some modern catheters are pre-lubricated for convenience.
Insertion and Drainage
Positioning: Sit, stand, or squat comfortably over a toilet. A mirror may be helpful for beginners to locate the urethral opening.
Insertion: Use firm but gentle pressure to slide the catheter into the urethra until urine begins to flow.
Complete Emptying: Once the flow starts, insert the catheter another inch or two. Hold it in place until the bladder is entirely empty. Leaning forward or gently pressing the lower abdomen can help ensure all urine is drained.
Removal: Slowly and gently slide the catheter out in a downward motion.
Figure 2: Common types and sizes of catheters used for clean intermittent catheterization.
What are the benefits and risks of clean intermittent catheterization (CIC)?
The primary goal of CIC is to mimic the natural rhythm of the bladder, preventing the accumulation of stagnant urine which can lead to severe health issues.
Health Benefits
Infection Prevention: Regularly emptying the bladder reduces the risk of urinary tract infections (UTIs).
Organ Protection: Prevents bladder distension and high-pressure reflux that can cause permanent kidney damage.
Quality of Life: Reduces the fear of accidental leakage and provides independence for those with bladder control issues.
Potential Risks
While generally safe, CIC does carry some risks, primarily related to technique and hygiene:
Urinary tract or kidney infections.
Urethral scarring or tissue damage from improper insertion.
Bladder spasms or accidental perforation (rare).
Symptom | Action Required |
Fever over 101°F | Call healthcare provider immediately. |
Blood in urine | Contact doctor to check for infection or injury. |
Severe pain | Seek medical advice to adjust technique or check for issues. |
Difficulty inserting | Do not force; contact a provider for assistance. |
Figure 3: Long-term management and warning signs for individuals performing regular self-catheterization.
Conclusion
Clean Intermittent Catheterization is a vital tool for maintaining urinary health and independence. By following proper hygiene and technique, individuals can effectively manage their bladder function and prevent serious complications. If you experience persistent pain, fever, or difficulty with the procedure, consult your healthcare provider to ensure your management plan remains safe and effective.
Frequently Asked Questions
What is the primary purpose of clean intermittent catheterization?
The main goal of CIC is to empty the bladder completely at regular intervals. This prevents urine from staying in the bladder too long, which can cause infections, bladder damage, and kidney problems.
How often should I perform self-catheterization?
Most people need to perform the procedure four to six times a day, or roughly every four to six hours. Your healthcare provider will give you a specific schedule based on your bladder's needs.
Is self-catheterization painful?
While it may feel slightly uncomfortable or strange at first, it should not be painful. If you experience sharp pain, it could indicate an infection or incorrect technique, and you should contact your doctor.
Can I reuse my catheters?
Most catheters are designed for single use only, and Cleveland Clinic advises throwing them away after each use. A reused catheter can carry bacteria into the urinary tract. Trials comparing single-use and multiple-use catheters have not shown a clear difference in UTI risk, but the evidence is low certainty, so follow your healthcare provider's instructions.
Will I need to do this for the rest of my life?
The duration depends on the underlying cause. Some people only need CIC temporarily after surgery, while those with chronic neurological conditions may use it as a long-term management strategy.
What should I do if I see blood in my urine?
A small amount of spotting may occasionally occur, but persistent or significant blood in the urine (hematuria) should be reported to your healthcare provider immediately.
Do I need to use a lubricant every time?
Yes, unless you are using a pre-lubricated or hydrophilic catheter. Using a water-based lubricant is essential to prevent friction and damage to the urethral lining.
What are the signs of a UTI related to catheter use?
Common signs include fever, chills, cloudy or foul-smelling urine, pelvic pain, and an increased frequency of bladder spasms.
Can children perform self-catheterization?
Yes, many children with conditions like spina bifida are taught to perform CIC. Parents usually assist until the child is old enough and has the manual dexterity to do it themselves.
What happens if I cannot insert the catheter?
Never force the catheter if you meet resistance. Relax your muscles and try again gently. If you still cannot insert it, contact your healthcare provider or seek urgent care to prevent bladder overfilling.
How do I prepare for self-catheterization?
Start every catheterization by washing your hands with soap and water, because clean hands are the main way to avoid infection. [1] Clean your genital area with soap and water or an antiseptic towelette. [1] Take the catheter out of its package while keeping it clean, and once your hands are washed, touch only the catheter. [1] Put water-based lubricant on the tip and the top two inches of the insertion end unless your catheter comes pre-lubricated. [1] Your provider will help you choose the right catheter size and type. [1]
When should I call my doctor about self-catheterization?
Call your healthcare provider if you have trouble inserting the catheter, or if you get painful bladder spasms with leaking. [1] Unusually small amounts of urine when you empty, or pain when you pass urine, are also reasons to call. [1] Check the skin where the catheter goes in and report any rash or sores. [1] Not fully emptying your bladder can lead to infections, bladder damage and kidney problems, so don't ignore these changes. [1]
Related Reading
Urethral Dilation: Procedure, Recovery and Results explains urethral dilation.
Urinary Catheter: Types, Placement, Care and Risks explains urinary catheter types, placement and care.
References
Cleveland Clinic. Self-Catheterization (Clean Intermittent Catheterization). Cleveland Clinic. Medically reviewed; last updated March 28, 2024. https://my.clevelandclinic.org/health/procedures/15434-clean-intermittent-catheterization
Wang J, Feng M, Liao T, et al. Effects of clean intermittent catheterization and transurethral indwelling catheterization on the management of urinary retention after gynecological surgery: a systematic review and meta-analysis. Translational Andrology and Urology. 2023;12(5):744-760. PMID 37305643. https://doi.org/10.21037/tau-23-220
Plata M, Santander J, Zuluaga L, et al. Hydrophilic versus non-hydrophilic catheters for clean intermittent catheterization: a meta-analysis to determine their capacity in reducing urinary tract infections. World Journal of Urology. 2023;41(2):491-499. PMID 36547679. https://doi.org/10.1007/s00345-022-04235-5
Prieto JA, Murphy CL, Stewart F, Fader M. Intermittent catheter techniques, strategies and designs for managing long-term bladder conditions. Cochrane Database of Systematic Reviews. 2021;10(10):CD006008. PMID 34699062. https://doi.org/10.1002/14651858.CD006008.pub5
Medical disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always follow the catheterization schedule and technique taught by your healthcare provider. If you have a fever, cannot pass urine or insert the catheter, or have severe pain, seek medical care promptly.
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