Cystoclysis
Cystoclysis is a procedure that involves a continuous infusion
of sterile solution into the bladder, usually by using a closed three-
way irrigation system.
Bladder irrigation may
Also, be used to instill
medications such as
antibiotics for treating
bladder infections
Done over a period of time
and runs continuously.
Purpose
Prevent Blood Clot Formation
Maintain IUC Patency
Drain Bladder when Acute Urinary Retention
is present
Relieve Bladder Spasm
Remove Blockage from the IUC
Indication
Urinary Tract Infection Post-Genitourinary Surgery Prostatic Hematuria
Types Irrigating System
Open/Manual Closed/Continuous
Irrigation Irrigation
Flushing a urinary catheter Continuous infusion of sterile
manually with a catheter-tipped solution into the urinary
syringe and normal saline. bladder.
Equipment Equipment
• Catheter Tipped Syringe • Irrigation Set
• 2-way Foley Catheter • 3-way Foley Catheter
Equipment/Supplies
General
• 0.9% Saline Solution
• Urine Drainage Bag (Urobag)
• Antiseptic Swab
• Non-Sterile Gloves
• Personal Protective
Equipment
• Underpad
Equipment/Supplies
Open Irrigation
• Irrigation Set
- sterile basin
- sterile syringe
- sterile protective cap
Closed Irrigation
• 3-way urinary indwelling
catheter (>fr 20)
• Irrigation tubing (Macroset)
• 0.9% Saline Solution (by box)
Open Irrigation Procedure
1. Pour Normal Saline or Sterile Irrigation Solution into
a bowl.
2. Draw the solution (usually 30 to 50 ml).
3. Disconnect the drainage bag tubing urinary from
drainage.
4. Clean the drainage port with an antiseptic swab and
insert the catheter-tipped syringe.
5. Inject the solution slowly and aspirate it
immediately
6. Remove the syringe and connect the drainage port
with the urinary drainage bag
Closed Irrigation Procedure
1. Connect the irrigation infusion tubing to the
irrigating solution and prime the tubing with the
solution, keeping the tip sterile (aseptic technique).
2. Clean the irrigation port with an antiseptic swab
and attach the irrigation tubing.
3. Open the roller clamp and regulate as ordered.
NOTE!
Failure to recognize that the fluid is not draining
can result in severe bladder injury, as large
volumes of irrigating solution are typically instilled.
FLOW RATE
Infuse irrigation solution at a higher rate
(Assess for hypovolemic Shock)
Bright
Red
Infuse irrigation solution at a moderate
Pink or rate
Tea
Coloured
Infuse irrigation solution at a moderate
rate
Clear
Sample doctor’s order:
- Bladder irrigation with normal saline @
100ml/hour for 24 hours
• After each flask is complete – empty the urine
drainage bag and record urine output on the FLUID
BALANCE CHART, prior to the commencement of
the next irrigation flask. (Ensure adequate irrigant
nearby).
• Regular catheter care is required in order to
minimize the risk of catheter-related urinary tract
infection
INFECTION
Complication:
• Documentation:
– assess patient comfort
(CAUTI)
– urine color/degree of hematuria Fever
– urine output Cloudy urine
– Also the presence of clots if any and if Foul-smelling urine
manual bladder washout is necessary Abdominal pain
Change in mental status
SAMPLE DOCTOR’S ORDER
TURP TURBT
• S/P cystoTURP under • S/P Cystoscopy under
SAB SAB
• Cystoclysis @ MFD to • Cystoclysis @ FD to
maintain pinkish to clear maintain from pinkish to
UO clear UO
• Pls do not alter the • Resume Cystoclysis but
tension traction of the at slow rate @ 150-
Foley catheter w/o FAIL! 200cc/hr
How to compute Urine Output
Volume out – Volume in = Urine Volume
Sample:
Volume In Volume Out Urine Output
1000cc 1150cc 150cc
1000cc 1050cc 50cc
1000cc 1200cc 200cc
1000cc 900 -100
FLUID BALANCE CHART
No. Date Time Volume In Volume Out Urine Output Discharge
Color
1 09/21/2023 8:00am 1000cc 1150 150 Bright red
2 09/21/2023 8:20am 1000cc 1050 50 Bright red
Nursing Responsibilities
Monitor Vital Signs
Check for kinks, loops or clots in the catheter or drainage bag tubing.
Palpate the bladder and note any patient pain or discomfort
Check the flow rate and drainage to determine if output is adequate
Monitor the intake output chart and document the appearance of the output.
