Continuous Bladder Irrigation

Continuous bladder irrigation (CBI) keeps a three-way urinary catheter draining when gross hematuria and clots threaten its patency, often after a transurethral procedure. Sterile fluid enters the irrigation lumen and leaves through the drainage lumen with urine, blood and debris. Its purpose is unobstructed drainage while the bleeding source is assessed and treated. A rapidly filling collection bag is not proof of adequate kidney output or controlled hemorrhage. Routine postoperative CBI uses the prescribed sterile irrigation solution, delivered by gravity with an individualized prescription and the facility procedure. Alberta Health Services describes positioning the bottom of the irrigation bag 60–90 cm above the bladder. A bag height of 60 cm is within that range. This is a postoperative bedside recommendation, not a universal intraoperative pressure limit. Titrate to catheter patency, clot burden and the ordered drainage-colour target; a fixed rate cannot replace reassessment. [1,2] The first safety question is whether outflow is keeping pace with inflow. New suprapubic pain, bladder distension, leakage around the catheter or unexpectedly poor return requires immediate assessment. Stop inflow if obstruction is suspected, inspect the...