Continuous bladder irrigation (CBI) is a standard process that people may undergo, especially after urological surgery. It is a relatively simple procedure but does come with a few possible complications.
CBI is a procedure that helps prevent clotting and encourages the free flow of urine after urological surgeries such as prostate surgery. It involves flushing the bladder with sterile liquid using a three-way catheter.
Keep reading to learn more about CBI, including its purpose, procedure, and recovery time.
CBI is long-standing and is a common practice after some surgical procedures, including prostatectomy and bladder surgery.
According to a 2015 article, CBI allows simultaneous infusion and drainage of the bladder with fluid, usually saline.
The procedure helps with internal bleeding or clot formation after prostate surgeries. Draining and rinsing the bladder can prevent blood and clot retention, at least until the person’s body starts flushing out fluid normally again.
Medical professionals typically perform CBI in a hospital setting over several days.
Even though CBI is common practice, some people may require an alternative procedure, particularly if they have large blood clots in the bladder that the body cannot push out on its own. They may first need manual aspiration with a large syringe and then intermittently during CBI.
Before the procedure, the person must have a bladder catheter. This is a thin tube that the medical team, usually a nurse, inserts into the urethra after applying an antimicrobial treatment. The other end of the tube remains outside the body, allowing urine and other fluids to pass.
The catheter for a continuous bladder irrigation procedure is a three-way catheter with multiple openings, including:
- An opening that connects to a sterile closed container where urine and bodily fluids can collect.
- An inflation bulb that inflates a balloon to keep the catheter in place.
- A port that connects to the irrigation solution, which will then travel into the bladder.
Once the catheter is in place, the nurse or urologist can perform CBI. The medical professional will:
- Hang two bags on a pole near the person. Both usually contain sterile saline water and any other medication according to the person’s needs and doctor’s orders. The secondary bag is a backup.
- Insert a spike of the Y-type tubing into each saline bag.
- Remove air from the tubes.
- Clean the openings of the catheter to prevent infection.
- Connect the other port to the empty bag at the person’s side to collect body fluid and urine.
- Open the flow clamps and adjust the drip rate.
Throughout the procedure, the medical professional will:
- Switch to a backup saline bag when the active one is nearly depleting.
- Replace empty saline bags with new ones.
- Check the pipes for kinks to make sure the flow is continuous.
- Measure the outflow volume to make sure it is equal to or slightly higher than the inflow.
- Control the drip and flow.
- Assess the outflow liquid for blood clots or changes in appearance.
- Report the amount of fluids and any other observations in the person’s clinical records.
CBI should not be painful. However, if a person experiences pain, they should immediately notify the healthcare professional. Pain could indicate that the position of the catheter needs adjustment or that the bladder irritant fluid is not draining, usually due to clots.
Pain from a simple procedure like CBI can also happen because of incorrect technique. A 2015 case study outlines the case of a man who had discomfort and pain from three catheter reinsertions because the medical team inserted them incorrectly.
CBI aims to flush out any potential blood clots and fluids. Clear outgoing fluid can indicate that the bladder is clean.
When this happens, the medical team continues to monitor the fluids and then disconnects the catheter from the patient.
Catheters and CBI are generally safe. Some potential risks include:
- Pain and discomfort: It is possible for someone to experience pain and discomfort, for example, if the catheter does not attach properly.
- Bladder rupture: One
2014 studymentions a case where a person undergoing CBI experienced a ruptured bladder because of incorrect administration of the procedure.
- Urinary tract infection: This can happen if the catheter ports are not sterile, transferring bacteria into the urinary system.
- Paraphimosis: This happens when the medical team leaves the foreskin retracted behind the glans of the penis. It can lead to painful glandular edema or distal penile strangulation. To avoid it, the nurse or urologist needs to reduce the foreskin back over the glans after placing the catheter on all uncircumcised patients.
Medical literature does not indicate a required recovery period after CBI.
However, people may still need to recover from any surgeries.
To avoid the potential risks, people undergoing bladder irrigation should talk with a nurse or doctor if they experience blood, pain, or the inability to urinate.
CBI is a common procedure that allows a person, usually someone staying at a hospital, to clear out their bladder of any thick blood that may cause clots.
It is typically a very safe procedure. However, complications may arise, especially in combination with intensive surgeries.
It is important for people to understand what to expect from the procedure and the risks involved.