CYSTOCLYSIS

ALVIN H. IMPERIO, RN,MAN

CYSTOCLYSIS/BLADDER IRRIGATION

• process of flushing the

bladder with normal
saline to prevent or
treat clot formation.
 Bladder irrigation may
also be used to instill
medications such as
antibiotics for treating
bladder infections

 This is done over a

period of time, and runs
continuously.
 A special catheter is
used for the above
procedure.
 Purpose:
• To prevent blood clot
formation
• allow free flow of urine and
maintain IDC patency, by
continuously irrigating the
bladder with Normal Saline
 Purpose:
• To drain the bladder when
acute urinary retention is
present

• To relieve bladder spasm

• To free blockage in the urinary

catheter or tubing
 EXPECTED OUTCOMES

1. The urinary catheter remains patent and

urine is able to drain freely via the
indwelling catheter (IDC)

2. The patients comfort is maintained

 EXPECTED OUTCOMES

3. Clot formation within the bladder or IDC is

prevented or minimized

4. The patient’s risk of Urinary Tract Infection is

minimized, through use of aseptic technique
when connecting bladder irrigation to IDC
TYPES OF IRRIGATING CYSTOCLYSIS
1. OPEN BLADDER IRRIGATION
SYSTEM
 also called MANUAL IRRIGATION
This is used when bladder
irrigations are required less
frequently and there are no blood
clots or large mucous fragments
TYPES OF IRRIGATING CYSTOCLYSIS
2. CLOSED BLADDER
IRRIGATION SYSTEM
 involves instilling sterile
irrigation solution into the
bladder allowing the fluid to
drain out
NOTE: CONTINUOUS BLADDER IRRIGATION
should not go beyond in weeks
Failure to recognize that the fluid is not draining
can result in severe bladder injury, as large
volumes of irrigation solution are typically
instilled.

• Example:
• 100cc is irrigated + 30cc urine
output/hr=130cc is expected
 if output is less than NOTIFY THE
PHYSICIAN
MATERIALS/ EQUIPMENT NEEDED
• 3 way catheter
• 0.9% sodium chloride
irrigation bags as per facility
policy
• continuous bladder irrigation
set and closed urinary
drainage bag with anti-reflux
valve.
MATERIALS/ EQUIPMENT NEEDED

• Chlorhexidane 0.5% with 70%

alcohol wipes
• Non sterile gloves
• Personal protective equipment
• Underpad (bluey)
• IV pole
 Procedure:
• 1. Explain procedure to the
patient and ensure patient
privacy
• 2. Position the patient for
easy access to the catheter
whilst maintaining patient
comfort
 Procedure:

• 3. Ensure that the patient has

a three-way urinary catheter.
– If not, a three-way catheter
needs to be inserted
 Procedure:
• 4. Hang irrigation flasks on IV pole and prime
irrigation set maintaining asepsis of irrigation set.

• Note: Only one of the irrigation flask clamps

should be open when priming the irrigation set
otherwise the fluid can run from one flask to
another.
– After priming the irrigation set ensure that all clamps
on the irrigation set are closed.
 Procedure:

• 5. Don goggles and impervious gown , place

underpad underneath catheter connection
• 6. Attend hand wash and don non sterile
gloves
• 7. Swab IDC irrigation and catheter ports with
chlorhexidine swabs and allow drying
 Procedure:

• 8. Remove the spigot from the irrigation

lumen of the catheter using sterile gauze and
discard spigot

• 9. Connect the irrigation set to the irrigation

lumen of the catheter, maintaining clean
procedure
 Procedure:
• 10. Remove spigot or old drainage bag from
the catheter lumen using sterile gauze and
apply catheter drainage bag maintaining clean
procedure.
• Note: Do not commence Bladder Irrigation
until urine is draining freely
 Procedure:

• 11. Unclamp the irrigation flask that was

used to prime the irrigation set and set
the rate of administration by adjusting
the roller clamp

• Note: The aim of the bladder irrigation is

to keep the urine rose’ coloured and
free from clots.
Diagram/ Illustrations:
 Nursing Responsibilities:

• Saline flasks for bladder irrigation do not need

to be ordered by a Medical Officer

• Continue irrigation as necessary depending on

the degree of hematuria
– (ensure adequate supply of irrigant nearby)
 Nursing Responsibilities:

• After each flask is complete

– empty urine drainage bag and record urine
output on the FLUID BALANCE CHART, prior to
commencement of the next irrigation flask

• Regular catheter care is required in order to

minimize the risk of catheter related urinary
tract infection
 Nursing Responsibilities:

• Catheter care provided should be documented

in the progress notes

• Also the nursing care plan including:

– patient comfort
– urine colour/degree of hematuria
– urine output
– Also presence of clots if any and if manual bladder
washout was necessary
 QUIZ

• 1-3. purposes of bladder irrigation

• 4-5. indication for bladder irrigation
• 6-7 nursing responsibilities for patient with
cystoclysis
• 8. complication of bladder irrigation
• 9-10. types of bladder irrigation
 ANSWER
• 1-3. To prevent blood clot formation
• To drain the bladder when acute urinary retention is
present
• To relieve bladder spasm
• To free blockage in the urinary catheter or tubing
• 4-5.
• UTI, Post-genitourinary Surgery, Prostatic Hematuria
• 6-7 nursing responsibilities
• 8. infection , trauma to the wall of the bladder, bladder
spasm, bladder distention
• 9-10 open and closed bladder irrigation system