1. Catheter care starts with assessment of the patient. All catheter events should be clearly documented on a locally approved clinical record from the outset of treatment.

2. The Continence Promotion Service recommends that manufacturers' guidelines are referred to regarding the length of time a catheter remains in situ. Repeated blockage usually indicates that the catheter needs to be changed (Ref: BNF no 57 March 2009). Because there are occasional difficulties with removal, all-silicone catheters are not used for suprapubic use in Cornwall.

3. Catheter maintenance solutions are undertaken after individual assessment for treatment of encrustation.

4. If catheter maintenance solutions are required, always commence with the lowest strength citric acid (3.23%). Two sequential solutions are suggested to be more effective than one alone.

5. Prescriptions should be for no more than a month’s supply, as determined by the treatment plan.

6. Chlorhexidine bladder washout is NOT recommended because it may be irritant to the bladder.

7. Repeated blockages may respond to oxybutynin or another antimuscarinic if bladder spasm is thought to be contributing to the blockage.

8. Further advice is available from the Continence Promotion Service (01726 291042).