Cystoclysis (Continuous Bladder Irrigation or CBI )

It is the 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 procedure. It prevents urinary tract obstruction by flushing out small blood clots that form after prostate or bladder surgery. It can be either open or closed: In an open system also called manual irrigation, the bladder is drained using a 60 ml syringe. In closed system, the bladder drains directly into a urine bag. Involves instilling sterile irrigation solution into the bladder, allowing the fluid to drain out. Note: CBI SHOULD NOT GO BEYOND IN WEEKS. Failure to recognize that the fluid isnt draining can result to in severe bladder injury, as large volumes of irrigation solution are typically instilled Example: 100cc is irrigated + 30 cc urine output/min= 130 cc is expected *if output is less than, NOTIFY THE PHYSICIAN. Typically, triple lumen catheter is used. * One port, is to fill the balloon so the catheter stays in place * One is used to infuse fluid * Another is to drain fluid - if bleeding occur, infuse more that 30 cc water to apply pressure on the lining and stretch the catheter and put plaster on the thigh.
Materials/ Equipment Needed: 3 way catheter 0.9% sodium chloride irrigation bags as per facility policy continous bladder irrigation set and closed urinary drainage bag with anti-reflux valve. Chlorhexidane 0.5% with 70% alcohol wipes Non sterile gloves

Personal protective equipment Underpad (bluey) IV pole

Nursing Responsibilities: Explain procedure to the patient and ensure patient privacy Position the patient for easy access to the catheter while maintaining patient comfort Continue irrigation as necessary depending on the degree of hematuria (ensure adequate supply of irrigant nearby). 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. Catheter care provided should be documented in the progress notes. Monitor urine output.