Trial without
catheter (TWOC)
Exceptional healthcare, personally delivered
What will happen once the catheter has been removed?
You will be encouraged to fill your bladder slowly by drinking
sufficient fluid over 4-6 hours. This normally entails drinking a
glass or cupful of liquid approximately every 45-60 minutes. You
will be provided with a container for passing urine into and you
can measure and write down the volume(s) you pass on the back
of this leaflet.
Do I have to stay on the ward during this time?
Not necessarily although, by remaining on the ward, we can
monitor your condition closely.
What is a successful TWOC?
The trial is successful if you pass urine by 4-6 hours and have less
than 150ml urine left behind in the bladder. You can then go
home but please ensure you pass urine regularly (every 3-4 hours)
over the following week.
You may notice a small amount of blood in your urine initially and
you may experience some discomfort, if so take a simple painkiller
like paracetamol. You may feel “stinging” on passing urine. This
is normal and will stop within 48 hours. You may experience
some frequency of passing urine and urgency. This is because the
bladder has not been used to storing urine whilst the catheter has
been in. This will gradually improve. Continue to drink plenty of
fluids (at least two litres a day). Please contact Cotswold Ward if
your symptoms do not resolve within 48 hours.
What happens if I cannot pass urine or cannot empty
my bladder completely (the TWOC has failed)?
If you are unable to pass urine, or unable to empty your bladder
properly (more than 150mls left behind after voiding), either a
new catheter may be inserted or you may be taught intermittent
self-catheterisation (ISC).
2
Trial without catheter (TWOC)
What is Intermittent Self Catheterisation (ISC)?
ISC drains the urine from the bladder using a small tube (like a
straw). It also ensures your bladder has been emptied properly
even when you have passed urine normally. Keeping your bladder
empty prevents kidney problems, infections, bladder stones and
dribbling of urine.
If self-catheterisation is required, you will be provided with
everything you need and taught how to do it. You will be
supervised until you are confident and a review after 1 week will
be arranged. You can stop self-catheterising when the amount of
urine left in your bladder after you have passed urine is less than
150ml on two consecutive occasions.
In order to keep your bladder healthy you should drink at least 2
litres of fluid a day.
Table for recording urine volumes
Time urine
passed
Volume of urine
passed (ml)
Residual volume of urine
measured after catheterisation
or bladder scan (ml)
Time
measured
Volume
measured
Trial without catheter (TWOC)
3
How to contact us:
Department of Obstetrics and
Gynaecology,
Cotswold Outpatients Department,
Southmead Hospital Bristol,
BS10 5NB
Cotswold ward
24 hours
0117 414 6785
www.nbt.nhs.uk
If you or the individual you are caring for need support reading
this leaflet please ask a member of staff for advice.
© North Bristol NHS Trust. This edition published February 2015. Review due May 2017. NBT002893