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Self-Irrigation and Discharge Instructions for Patients with an Ileal Neobladder

This information explains how to irrigate your ileal neobladder.

Introduction

This fact card tells you how to irrigate your ileal neobladder. It also tells you what you should and should not do after you leave the hospital. Irrigations help prevent mucus from clogging your catheter tube and from building up on the lining of the pouch. Review the card with your doctor or nurse.

Self-Irrigation Instructions

Irrigate 3 times each day unless your doctor has told you something else.

Supplies

  • Two 60 mL (cc) syringes
  • Normal saline
  • A small container

Instructions

  1. Wash your hands.
  2. Open the bottle of saline.
  3. Remove the plunger from the outside of the syringe (casing). Recline your body at a 30- to 45-degree angle. 
  4. Disconnect your suprapubic tube from the drainage bag (see figure). 
  5. Attach the casing of the syringe to the suprapubic tube. Pour 60 mL (cc) of saline into the casing. Raise the tube straight up to promote good drainage.
  6. After the saline drains into your bladder, watch to see if it comes through the Foley® catheter into the drainage bag. You will most likely also see some mucous. This is called gravity irrigation. If the saline drains through the Foley® immediately, repeat the irrigation once. Remove the syringe and reconnect the drainage bag to the suprapubic tube. You are now finished and can go to step 12.
  7. If the saline does not flow through the suprapubic tube or through your Foley® catheter, you probably have a mucus plug. If there is still saline in the casing, empty it into a small container and discard it. Then disconnect the casing from the suprapubic tube and reconnect the drainage bag. Put the plunger back into the casing of the syringe.
  8. Pull up 30 mL (cc) of saline into the syringe. If necessary, put the syringe down on a clean surface. Disconnect the drainage bag from the suprapubic tube. Place the tip of the syringe into the suprapubic tube. Very gently push the saline into the tube. This is called flushing. If you meet resistance, do not force it and go to step 10.
  9. Pull back on the syringe. This is called aspiration. You will probably see some mucus mixed in the saline. Repeat the flushing and aspiration once. If you meet resistance during aspiration, do not force it. Remove the syringe and reconnect the suprapubic tube to the drainage bag. Get up and walk around; you will probably see the drainage mixed with mucus flow from the suprapubic tube at this time.
  10. If you cannot flush the suprapubic tube, try to flush and aspirate the Foley® catheter. Use a clean syringe. Connect it to the end of the Foley®. Follow steps 8 and 9. Do not use the same syringe for the suprapubic tube and the Foley® catheter.
  11. Return to step 5 and try gravity irrigation again. You should see better results this time.
  12. Wash your hands.

Please note: You can use the same syringe(s) again. Clean the syringe(s) after each use by pulling the plunger out of the casing and washing both with warm water and soap. Let them air dry on a clean surface.

Discharge Guidelines

  • Keep the Foley® catheter and the suprapubic tube connected to the leg bag during the day. You will need to empty these bags every two hours. At night, connect the catheter to the large drainage bag. This will allow you to sleep through the night without emptying your bags.
  • Keep your catheter or tube connected to your leg with Cath-Secures® or tape.
  • Drink eight, 8-ounce glasses of noncaffeinated liquids every day.
  • Do not drink any alcohol until your tube and catheter have been removed.
  • Exercise daily, such as walking twice a day for 30 minutes each time.
  • Shower daily. Let warm water run over the suprapubic tube. Pat the area dry; do not rub it.
  • Do not cover the suprapubic tube with a dressing unless there is drainage around the tube.
  • Clean your Foley® catheter twice each day with warm water and soap.

Call Your Doctor or Nurse If You:

  • Cannot flush the tube or catheter
  • Do not get drainage from your tube or catheter after irrigation
  • Have no urine draining from either bag. (If urine is draining from only one bag, that is acceptable.)
  • Feel pressure, pain, bloating, or distention (expansion) in your abdomen
    • (Try to irrigate first to relieve any mucus plug that could be causing these symptoms.)
  • Develop a fever over 101° F (38.3° C)
  • Notice your incision is red, hot, or leaking pus
  • Notice foul-smelling urine
  • Develop nausea with vomiting
  • Have any unexpected, unexplained problems
  • Have any questions or concerns