Continuous bladder irrigation

For a patient with ongoing hematuria after adequate manual irrigation, continuous bladder irrigation (CBI) prevents formation of additional clots that may obstruct bladder outflow.

A urine drainage bag is attached to the large port of a triple-lumen (ie, three-way) urinary bladder catheter. The irrigation fluid tubing is attached to the smaller port (ensure this is not the balloon port) of the bladder catheter. Using the flow regulator, titrate the speed and volume of irrigation to achieve a light pink to light red color (higher volumes and speed are needed for severe bleeding). Replace irrigation fluid bags and empty drainage bag as needed.

If a patient undergoing CBI complains of pain, develops drainage around the catheter, or the urine collection bag stops filling, immediately stop the irrigation fluid and perform manual bladder irrigation. This may occur if residual or newly formed clot obstructs the bladder catheter while irrigation fluid is infusing, which can cause dangerous bladder distension and increase the risk of bladder perforation.