Water for Bladder Irrigation

Just wondering why a Doc would take such care in steril procedures when catheterizing only to bring tap water through it to fill up the bladder? Why bother using a sterile catheter if an unsterilized substance is coming through it? This perplexes me.

Hmmm, good question, and I'm not quite sure myself, but could it have something to do with natural salt/water balance in your cells? There's a similar discussion in this board about wheather or not it's a good idea to use distilled water for an enema and I think that this has a similar basis if you wanted to check it out.

Saline or distilled water into the bladder makes no difference since the body does not absorb fluid from the bladder the way that it does from the intestines. The key item here is that both need to be sterile-- no ifs, ands, or buts!!!

Well I think the colon is much different in having bacteria. I don't think bacteria should be introduced directly into the bladder as it's a sterile enviroment even though it doesn't absorb any of it, right? If the bladder fills up full enough with it can't it get backed up into the kidneys? How much is a safe volume to fill a bladder? This just doesn't seem safe to me. My kidneys are more important to me than a playdoc's amusement.

You are completely correct that the intestines are not sterile, but the bladder is. That is the entire point of my previous post. Saline or distilled water that is put into the bladder must be sterile. This also means that the tubing or syringe used must also be sterile. Gloves used to insert the catheter should also be sterile.

Regarding the volume that can be safely used, a "normal" bladder volume can be approximately 300-500ml, but some can be less and some can be more. Nothing will back up into the kidneys as long as these volumes are respected and no pain or discomfort is felt. There are small "valves" in the bladder to prevent urine from backing up into the kidneys (unless there is abnormal anatomy). A UTI is a much more common occurrence caused by improper technique.

Do not introduce tap water into the bladder.

It is not sterile. It is chlorinated and fluoridated.

A bad idea any way you look at it.

It wasn't something I had chosen or even was aware of until I had my wits about me afterwards. When I questioned the playdoc about it he said there has never been a problem before. I knew damn well all the pomp and circumstance he talked about that he always used sterile technique and never reused catheters didn't follow any comon sense running the tube into an elevated bucket full of tap water to fill up the bladder until there was pain. It wasn't until after play (more like torture) I realized where he got the water from because it was almost hot. No pun intended, but I'm pissed. :'(

Yeah, I would not go back to him. If he didn't feel the need to tell you until afterwards, and then he doesn't even realize that it isn't safe, this guy should not be playing with this kind of stuff.

You really have to be careful when playing in this area. There is so much misinformation out there, including many people that post on this board. Even some of the legitimate medical videos that you find on the web display techniques that I would rate as awful and I would remove anyone that performed like that in the hospital from duty until properly reeducated.

I'm getting conflicting opinions that tap water is safe inside the bladder. That it is used to debride wounds by medical personal etc. That it is just a safe as sterile saline. I don't buy it. If tap water is so sterile. Tap water travels through a lot of pipes right? God knows what it picks up on the way to an actual faucet. I think the medical person that told me tap water through the catheter and into the bladder is safe is full of crap. Perhaps he is in need of an enema? lol

Most municipal water supplies include enough residual chlorine to keep the water safe for potable use until it reaches the end user. Most water systems in the United States leak over 20% of their production into the ground. This is because we have had cheap water policies for so long that it has not been economical to repair these leaks. Each leak is a potential source of contamination.

Sterile water is probably not necessary for bladder irrigation (and that is really what we are talking about here). It is highly desirable. Using a new, sealed bottle of distilled water for this is the minimum level of clean play that I would consider for this sort of activity.

Speed

Speed, I'm sorry to say that your information is uninformed, incorrect, and dangerous. Anyone who irrigates the bladder with any water that is not sterile is asking for trouble. There is no guarantee that non-sterile water will cause a UTI, but on the other hand, the risk is significant AND the possibility exists of not only a bladder infection, but possibly a kidney infection or septicemia (a blood infection). A bottle of distilled water from a supermarket is not appropriate.

Good Job being skeptical. Your concerns are well founded. Tap water fresh from the tap cannot be guaranteed sterile so it should never be introduced urethrally. I once had a patient who had a congenital birth defect that caused her various bladder problems. Eventually she had a urostomy. She enjoyed urethral play and periodic bladder irrigation was actually therapudic for her. She came to her appointment fully prepared with her own bottle of distilled water. That was per her Doctor's recommendation.

I couldn't see any doctor recommending a urological patient under chronic care to use "distilled water" for self-irrigation. Anyone who is in a long-term care situation would have regular access to proper urological supplies. There is nothing difficult to finding sterile irrigation or pour solution as either water or saline, if you look for it. Check your Yellow Pages and find a store who sells home medical care supplies, usually listed under "Urology Colostomy Supplies". If you need an excuse why you are buying it, they are perfect for your fully equipped First Aid kit to debride wounds.

The quality of tap water varies a lot between different countries.

Nothing, and I mean Nothing which is not sterile should have anything to do with your bladder. Period.

Yes tap water will work. And most likely you will not get an infection. Most times. But it only takes once. Trust me - I've done it to myself. You do NOT want to go there. It's just asking for trouble. I played with this before I knew about sterility and the dangers of this (LONG before I cam across this site). And for the first month, everything was fine...but then one day...

For those of you who love Russian Roulette...sure - slam yourselves with random tap water. For those of you who wish to be safe and have a long, healthy career in play, well, don't fool around with this stuff.

Bladder irrigation should be done with sterile water or saline (in this case it doesn't matter I don't believe). The balloon on a foley catheter should be inflated with sterile saline or water. Sterile procedure should be used during insertion, removal, or interaction with the catheter. Period. It's not optional.

Ye, tap water is not safe. especailly where i live

hey, here is a fun fact...did u know, in south australi, where i live, they add fluoride to the water to combat the other stuff in the water?

100% true!

As I and a few others on this board have noted, sterile water or saline for bladder irrigation must be sterile (distilled is not sterile). While I completely agree that the quality of tap water varies greatly from state to state (here in the US) and country to country, it doesn't matter where you are, you should never introduce any tap water into the bladder.

In a previous post someone made mention of using tap water for wound debridement. I can't imagine any situation in a medical facility of any kind where sterile water or saline should not be used.

Finally someone else mentioned filling the balloon of a foley catheter with water or saline. For short term play, it probably does not make a difference, but for longer periods where the foley remains indwelling, saline should NOT be used. Saline may crystallize causing an inability to deflate the balloon. This is not just my opinion, this is well documented in medical literature.

Maddie fluoride is added to water to strengthen teeth.

- rat

Yes drt...i know that, BUt it is specially added to south aussie water cos our water has soemthing wrong with it..being in a drought etc. something else besides our teeth. i dont know what.

If I were you, I'd find this playdoc and kick him in the nads for the risk he put you in. It has been said here many times and I cannot reiterate it enough...STERILE water or STERILE saline only although my hospital's best practices say the sterile water. It varies by institution. In fact, this playdoc needs to have their name published on boards like this so that we can put them out of business.

The hippocratic oath stating "I WILL FOLLOW that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous" should be sworn to by all playdocs as well.

I would not use anything but sterile saline for bladder irrigation. Distilled water does not equal sterile. Also the catheter, syringes, lube, etc. should also all be sealed, sterile, single use items.

Tap water varies from city to city!!

CurveyFemme, Maddie, and others, please do not take this the wrong way. I and others have made it very clear on this particular question that sterile water or sterile saline is the ONLY acceptable irrigant for the bladder. Please it doesn't matter whether you live in the heartland of America, New Zealand, or Botswana, tap water should never, ever be used. Please everyone, please read this entire string of posted messages and take the information seriously, unless of course you want an infection that at best will be extremely unpleasant, and at worst, life threatening. 😜

I would say buy some distilled water. or saline.

Distilled water just means that it does not have dissolved solids or any other substances (e.g. chlorine) and that it is nothing but pure H2O water. It means absolutely nothing about its sterility. You will know if you have sterile water or sterile saline because it will clearly state on the label that it is STERILE. Also, once you open it, it should be used immediately and not saved for another day, because that will likely result in it no longer being sterile. You also need to ensure that whatever tubing or syringe you are using is sterile. Again the package that these items will come in will say STERILE if they are.

Be safe, healthy, and very happy! 😁

I use only single-use syringes and sterile water marked 'for injection'. I agree with the other posters who are adamant that nothing but STERILE items (including gloves, caths, lube) go anywhere near the bladder. I also use only sterile water injection vials to inflate a Foley, because you never know when the baloon might pop or leak.

100% agree with Deke and other similar responses. Sterile or nothing! There is always a risk of infection when inserting a catheter but do not increase the odds by using anything that is not sterile.Bladder infections are not pleasant and can be dangerous with fewer and fewer antibiotics effective against them.

Only sterile water for bladder. UTIs can be a bitch

PlayDocWithMe - You are right about tap water. Tap water contains chemicals (i.e. stannous fluoride, chlorine, etc.), microbes, solid particulates and who knows what else? I am not prone to UTI's but I would NEVER allow anyone to put something into my urethra/bladder that isn't sterile. My play doc (a real life male nurse) uses pure medical grade sterile water or normal saline to irrigate my bladder.