Intermittent catheterisation in children September 2016 and who catheterise via the urethra. This is due to the mucous produced by the patch of bowel inserted into the bladder. It is important therefore that mucous is regularly removed to minimize the risk of stone formation. Washing out the bladder with a saline solution which can be either readymade or cooled boiled water with salt added. If mucous is particularly problematic acetylcysteine or chondroitin sulphate instillations may be used to help break down the mucous. Acelylcysteine is also available in an oral tablet formulation. Catheters with wider openings or additional eyes (for example four eyes rather than the usual two) are also practical recommendations to assist the effective drainage of urine and mucous. For patients with ileocystoplasty the use of size 14 Fr catheters, or larger, is generally effective to evacuate all the mucus. For patients with residual urine after catheterization siphoning of the bladder twice a day with a longer tube into a lower positioned receptacle prevents stone formation. Recommendations LE GR In case of mucus the bladder can be washed out with a saline solution or acetylcysteine, or chondroitin sulphate can be instilled. Catheters with wider openings can also be used 4 C
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