What is bladder washout?

If your child’s bladder has been enlarged, or replaced completely using part of the bowel they will produce mucus in their urine.

Mucus is normally secreted by the gastro intestinal tract and helps break down and digest food.

The mucus may clump together and form a plug, which can block the catheter and prevent urine from draining out of the bladder. Retention of urine and/or mucus in the bladder may lead to infection. Mucus retention has also been associated with stone formation. Regular bladder washouts will help prevent mucus plugs and retention.

Washout solution and volume:

Generally, we recommend normal saline (salt water) for the bladder washout.

The amount of solution you require will depend on how big your child’s bladder is and how much mucus there is. The Clinical Nurse Specialist will recommend the appropriate volume.

How to do a bladder washout:

Collect the equipment you need before you begin:

1. The catheter
2. Washout solution and container
3. Bladder syringe
4. Container for collecting catheter drainage

The Procedure:

• Wash and rinse your hands thoroughly.
• Fill the bladder syringe with ……. mls of saline (ask your Consultant).
• If using an indwelling catheter, clamp the catheter tubing between your fingers thereby preventing urine drainage.
• Disconnect the drainage bag or spigot and ensure your child’s bladder is empty.

Alternatively if you do clean intermittent catheterisation, catheterise as normal ensuring that the bladder is empty.

• Gently push the saline into the bladder. Use only enough pressure when pushing the solution in to dislodge any blockage. Excessive force is unnecessary and may cause injury
• Withdraw/ aspirate the saline gently using the syringe
• Inspect the aspirated solution for mucus
• Repeat as necessary until the aspirate solution is clear
• When the aspirated solution is clear, either clean the end of the indwelling catheter and reconnect to drainage bag/spigot. Or remove the intermittent catheter as usual
• Wash your hands and the equipment, rinse thoroughly and dry. Change equipment weekly

Advice:

If you experience resistance when drawing back the fluid DO NOT exert force or panic as there are several things you can do:

• Make sure the catheter is not kinked or twisted
• Change the position of the catheter
• Disconnect the syringe from the catheter and allow the fluid to flow freely over the next 10-15mins. If this does not happen syringe a further …….mls of saline, once only as this may dislodge any blockage
• If the fluid is still retained contact your Clinical Nurse Specialist/Consultant for advice

Contact us:

If you have any questions or problems either before or after the surgery, please do not hesitate to contact Clinical Nurse Specialist, on 020 7580 4400, 10838 (09:00 – 17:00 Monday to Friday) or email at: [email protected]

For Out of hours: Contact our Paediatric Site Practitioner via the switchboard on: 02075804400 ex 10843