URINE AND BOWEL MANAGEMENT
Methods for the limp bladder
If the person’s bladder is limp (flaccid), it never empties by reflex. The bladder will
constantly have urine sitting in it unless an effective emptying method is used.
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Boys:
1. Put in a regular catheter every 4 to 6 hours to empty the bladder. Between
catheter use, the boy can put on a condom to catch any leaking urine, as described on
page 208.
2. A Foley catheter can be used, but may lead to problems (see p. 207).
3. Other alternatives include a surgical operation, which allows the urine to come
out through a small opening on the belly into a bag. Or a special catheter is put into
the bladder through a small hole in the lower belly.
Girls:
1. They can use a Foley catheter. This is often the simplest method, but can lead to
urinary infections.
2. Or try an ‘intermittent’ (in and out) program, using a regular catheter every 4-6
hours. If there is leaking in between catheter times, use diapers, rags, or a thick sanitary
pad to catch the urine. Change them often and wash often to protect the skin and
prevent sores.
3. The surgical procedures mentioned for boys can also be done in girls.
OTHER SUGGESTIONS FOR THE LIMP BLADDER—BOTH SEXES
• The push method:
Push down over
the bladder
with the hands.
Or strain to push
urine out by
tightening the
stomach muscles.
Or put a fist
over the lower
belly and gently
press it by
bending forward.
This method is recommended by many professionals, but it can cause problems. If
the muscles do not relax to let the urine out, pushing on the bladder can force urine
back into the kidneys—causing kidney infection and damage. Therefore, the push
method should only be used if the urine comes out easily with gentle pressure—or
if there is no other way possible.
• With boys with a limp bladder, the condom method can be used. But it is best to
also use a regular catheter at least 3 times a day. This is because the bladder does not
empty completely, which makes infection more likely.
disabled village children