Have you or someone you know ever had to have surgery on your urinary tract, such as a prostate operation? After such a surgery, you may have heard doctors say that the bladder is continuously irrigated. It can be a little scary to hear that. It's normal to wonder, "What is this irrigation? Why is it being done?" So today, let's learn all about it very simply, as if we were talking to a friend.
Simply put, what is Continuous Bladder Irrigation (CBI)?
It's very simple. Think of your bladder as a small, balloon-shaped organ. It is in this bladder that we separate the waste products from the water we drink and the food we eat and store them as urine. Continuous Bladder Irrigation (CBI) is a procedure that continuously injects a sterile liquid into the bladder, especially after surgery, to cleanse it, and then flushes the liquid out with urine.
This is like washing a bottle full of muddy water, continuously pouring clean water into one side and pumping out the muddy water out the other. This process is done in a hospital for several days.
Why do you need to wash your bladder this way?
The main reason for this is surgery on the urinary tract. Especially after bladder surgery or prostate surgery (for example, transurethral resection of the prostate - TURP ), blood clots and small pieces of tissue removed during surgery can accumulate inside the bladder.
Imagine what would happen if your sink drain got clogged with dirt? The water wouldn't drain properly, right? That's how it is. These blood clots and tissue fragments can block the urethra, preventing urine from leaving the body. After surgery, urine is often drained using a catheter. So, there's a chance that these blood clots could get stuck inside the catheter.
If the urinary tract becomes blocked, it can cause severe pain, lead to infections, and even damage the kidneys.
That's why, using the CBI method, the inside of the bladder is continuously flushed to flush out these blood clots and unwanted substances. This allows the normal flow of urine to be maintained.
In addition to this main reason, doctors use this method for several other reasons.
| Other uses | Description |
|---|---|
| To provide medicines | Sometimes, when it is necessary to administer a medication directly to the bladder, the medication can be delivered to the bladder with this irrigation solution. |
| To dissolve urinary stones | This method treats certain types of small bladder stones by injecting special fluids into the bladder. |
| To relieve inflammation | This method is also used to relieve the condition if the bladder wall is inflamed due to an infection or other cause. |
How does this treatment work? Let's take a step-by-step look at it.
Knowing about this process will help reduce your fear.
What happens before treatment?
To do this CBI treatment, you first need to have a special catheter tube (three-way catheter) inserted. After surgery, you will already have this tube inserted.
This is not like a regular urethra. On the outside of this, there are three ports that serve different functions.
| Port | The work that it does |
|---|---|
| For the washing up liquid | A sterile solution is passed into the bladder through this route. |
| For urination | The urine and toilet solution mixture leaves the body and enters the urine bag through this route. |
| For the balloon | This method is used to hold the catheter in place inside the bladder, and to inflate a small balloon-like part at the end of it. |
What happens during treatment?
This treatment is usually performed by a nurse or a urologist.
You will see two bags filled with sterile saline hanging on a small stand next to your bed. One end of the catheter is connected to one of these saline bags. The other end is connected to a bag that collects the urine that comes out.
Throughout this process, the medical staff will be watching closely for these things:
- Urine color: At first, the urine may be very red and may contain blood clots. Over time, it should turn pink and eventually clear.
- The speed of the irrigation fluid: Depending on the amount of blood flowing, the speed of the irrigation fluid going into the bladder is increased or decreased.
- Urine output: This measures how much urine and fluid comes out.
- Emptying the urine bag: The urine bag is emptied each time it fills up.
- Changing saline bags: When one saline bag runs out, the other is connected.
You may feel some discomfort from the catheter at this time. You may feel like your bladder is full, or you may feel like you need to urinate more often. Never try to pull out the catheter tube at this time. If you feel any pain or see any fluid leaking from the tube, let the nurse know right away.
What happens after treatment?
Once your urine becomes clear or slightly pink for a day or two, your doctor will decide to stop the CBI treatment. He will then remove the saline bag and urine bag, and carefully remove the catheter tube.
The most important thing is that you will need time to recover from the CBI treatment, not from the surgery you had initially. Therefore, you should follow your doctor's instructions carefully.
Are there any risks to this? (Risks and Complications)
CBI is generally a very safe procedure. However, as with any medical procedure, there are some rare complications that can occur.
- Catheter blockage: The catheter can become blocked by something like a blood clot. If this happens, a nurse or doctor will clean it or insert a new catheter.
- Urinary tract infection (UTI): No matter how clean you are, sometimes there is a small chance that germs can enter and cause an infection.
- Paraphimosis: A condition in which the foreskin of an uncircumcised male is pulled back and cannot be pulled forward again. This is a very rare condition.
- Bladder perforation: This is a very rare event. The bladder wall can be damaged during catheter insertion or during treatment.
Remember that the chances of these things happening are very low. The medical staff is always on the lookout for this.
What time should I see a doctor?
After you go home from the hospital, it is very important to keep an eye out for certain symptoms. If you experience any of the following symptoms, call your doctor immediately or go to the nearest hospital's Emergency Department (ETU).
| Symptoms to watch out for |
|---|
| Blood in the urine. |
| Burning or extreme pain when urinating. |
| Urinary incontinence, even though you need to urinate. |
| Severe pain in the lower abdomen. |
Take-Home Message
- Continuous Bladder Irrigation (CBI) is nothing to be afraid of. It is a very effective and safe treatment to prevent dangerous blood clots after surgery.
- Although you may feel some discomfort during this treatment, it is temporary. This is very important for your speedy recovery.
- It is normal for the color of the urine to start out red and gradually become clear during this process.
- After you go home from the hospital, be aware of any abnormalities when urinating. If you have any problems, let your doctor know immediately.
- If you have any questions about this, never be afraid to ask your doctor or nurse.
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