What is Continuous Bladder Irrigation (CBI)?
Continuous bladder irrigation is a medical process that is done mostly after bladder surgery. It is a simple procedure used in patients who have undergone surgery of the urinary tract such as prostatectomy and bladder surgery or those with urinary tract infection.
The purpose of continuous bladder irrigation is to flush out any bacteria or debris that is present in the bladder and to prevent further infections.
Continuous bladder irrigation allows the continuous drainage of the bladder with fluid, usually saline.(1) It helps in preventing internal bleeding or clot formation after surgery and flushes the bladder to prevent blood or clot retention until the body starts flushing out fluid normally on itself.
Even if Continuous bladder irrigation is a procedure that is commonly done, it may require an alternative procedure particularly if there are large clots in the bladder, which the body would not be able to put back on its own. In such a case, first manual aspiration may be needed with a large syringe, and then intermittently Continuous bladder irrigation may be needed.
How is Continuous Bladder Irrigation Done?
Continuous bladder irrigation is performed as an outpatient procedure, but some patients may need to stay in the hospital. How long the procedure would take depends on the patient’s condition and the reason for the procedure.
Before the Procedure
Before the procedure, the person may be having a bladder catheter, which is a small tube that is inserted into the urethra after applying antimicrobial treatment. The other end of the tube is present outside the body through which the urine and other fluid passes.
The catheter for continuous bladder irrigation procedure is a 3-way catheter with multiple openings, which include:
- An opening that connects to a sterile closed container where urine and body fluids are collected
- An inflation bulb to inflate a balloon that plays the role of keeping the catheter in place
- A port that connects to the irrigation solution that travels into the bladder
During the Procedure
Once the catheter is put in place, the nurse can perform the Continuous bladder irrigation procedure. Two bags are placed on a pole near the person. Both contain sterile saline water and medication according to the person’s need and doctor’s orders. The secondary bag is kept as a backup.
T-type tubing is put into a saline bag. Air is removed from the tubes. The openings of the catheter are cleaned to prevent infection. Another port is connected to the empty bag in which urine is collected.
During the procedure, the empty saline bag is replaced with a new one to make sure there is a continuous flow. Outflow volume is measured to make sure it is equal to or slightly higher than the inflow volume.
Continuous bladder irrigation flushes out potential blood clots and fluids. Clear fluid coming out may indicate that the bladder is clean. Then the catheter is disconnected.
Continuous bladder irrigation is not a painful procedure. If a person experiences pain, a doctor should be informed. The pain would indicate the position of the catheter needs adjustment. However, there may be just some discomfort as the person may have to carry the pole with saline bags on getting out of bed.(2)
Risk Associated with Continuous Bladder Irrigation
Catheters and Continuous bladder irrigation are mostly safe, but there may be some potential risks associated. These include:
- Pain and discomfort: There may be a possibility of some pain and discomfort if the catheters are not attached properly.
- Bladder rupture: A study mentioned a case in which the person undergoing Continuous bladder irrigation experienced bladder rupture.(3)
- Urinary Tract Infection: This can happen if the catheter ports are not sterilized before using.
- Paraphimosis: It is a condition in which the foreskin of the penis retracts behind the glans of the penis. It may also lead to painful glandular edema or strangulation in the distal penile region
Continuous bladder irrigation is a medical procedure in which a steady flow of fluid is passed through the catheter into the bladder and then drained out. It is commonly used in patients who have surgery on their urinary tract or those who have a urinary tract infection that is not responding to antibiotics. It is a relatively safe procedure with some associated risks. To avoid risks, people undergoing bladder irrigation need to talk to a nurse or a doctor about experiencing pain, blood, or inability to urinate.
