Manual bladder irrigation

For a patient with acute gross hematuria, manual bladder irrigation is performed to remove existing clots from the bladder.

(A) Place a urinary bladder catheter and confirm correct placement (typically observing return of urine). If using a three-way catheter, ensure the open side port is plugged (not shown here).

(B) Gently infuse irrigation fluid into the catheter.

(C) Withdraw the fluid to extract clots. If unable to withdraw fluid, use a push-pull technique with the syringe plunger or instill more irrigation fluid to attempt to break up the clots.