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Equipment

Q: What if I forgot the code to unlock the settings?

A: Contact Wellspect HealthCare, see contact information.

 

Usage

Q: How often should I perform TAI?

A: At the start it is common to irrigate once every day for the first 10-14 days. Later on the frequency may possibly be reduced to once every other day or every third day. The frequency should be decided in consultation with a healthcare professional.

Q: Can I stop using stool modifying medicine when I start using Navina?

A: TAI is usually part of a bowel management program. It is possible that you may be able to reduce the amount of laxative you are using eventually but you may have to continue using some to ensure that the stools have the right consistency to ensure easy evacuation. It is best to continue with your current laxative regimen until you are getting regular results from TAI. Consult a healthcare professional before changing your personal regimen.

 

Instillation

Q: How much water should I instill?

ADULTS:
A: A healthcare professional will advise you how much water should be used. For adults it is common to start around 500 ml. A maximum of 200 ml may be added to the container for activating the catheter's hydrophilic surface and to expel air from the System.

CHILDREN:
A: A healthcare professional will advise you as a caregiver how much water should be used. For children it is common to calculate 20 ml/kg body weight. A maximum of 200 ml may be added to the container for activating the catheter´s hydrophilic surface and to expel air from the System.

Q: Can I add salt to the water?

A: Navina Smart System can be used with a saline solution but the product needs to be rinsed thoroughly with clean water directly after use.

Q: Is the water temperature important?

A: Always use lukewarm water (36-38 °C). Water that is too cold can be unpleasant and you may experience cramps. Water that is too hot may irritate the delicate lining of the rectum and colon.

Q: Can I use gel on the catheter?

A: No, the catheter is hydrophilic and will become slippery when immersed in water. There is no need to add gel.

Q: What water quality should I use?

A: Only use clean tap or bottled water. 

Q: What water flow rate should I use?

A: A healthcare professional will advise you what water flow rate you should use. The water should be instilled at a rate fast enough to provide stimulation to the bowel wall but not too fast as it can cause abdominal cramps, pain or strong reflex contractions.

Q: What if I cannot get to the instillation mode when I press the  button?

A: Make sure that the water container is filled with water, that the lid is closed and that  has been pressed long enough so that water runs through the catheter and the catheter balloon deflation symbol is shown at the bottom of the screen.

Q: What if the water flow is too low?

A: Please check the flow rate selected in the settings.

Make sure that:

  • The lid of the water container is completely closed.
  • The tubes are connected at the right place.
  • The tubes are connected tightly so the air does not leak. Make sure the tubes are not blocked or kinked.
  • You are not impacted and that the rectum is emptied. 

Try placing the water container higher. The pressure in the System might have reached the maximum and the safety valve may be opened. Deflate the catheter and try to empty the bowel. If you do not feel completely empty, make sure you are not constipated and that the rectum is empty and repeat the irrigation procedure.

Q: What if the water instilled on the display and the scale on the water container do not indicate the same amount of water instilled?

A: The display and the scale on the water container have an accuracy of +/- 50 ml so due to rounding effect the two scales could show 100 ml (0.1 l) difference. Note that the amount of water is shown in l (litres) on the display. The water container has double scaling for improved readability.

Q: What if debris from the catheter flow back in the tube?

A: Do not turn off the Navina Smart control unit the tubes have been disconnected from the control unit. If there's an experience that debris from the catheter is flowing back in the tube, clean the tube by pumping water through it. New tubes can also be ordered separately if needed.

Q: What if there is leakage of water around the catheter?

A: Ensure that the catheter is properly positioned. Check water temperature. Increase balloon inflation up to the personal maximum setting. Instill water more slowly.

Q: What if the catheter gets expelled before  I have deflated the balloon?

A: Minimize inflation to avoid triggering reflexes. Instill the water more slowly. Contact a healthcare professional who will assess and treat any rectal impaction that may be causing the rectal expulsion.

 

 

Balloon

Q: Navina catheter regular:
Why can't I inflate the balloon more than to step 5?

A: The maximum size of balloon inflation was selected after consultation with healthcare professional experts, to meet the anatomical needs, prevent over inflation of the balloon and the risk of balloon burst.

Q: Navina catheter small:
Why shouldn’t I inflate the balloon more than to step 3?

A: The maximum size of balloon inflation was selected after consultation with healthcare professional experts, to meet the anatomical needs, safety in children, prevent over-inflation of the balloon and risk of balloon burst. 

Q: Can the balloon burst and, if so, is it dangerous?

A: Yes, there is a risk of the balloon bursting and this is why the Navina Smart control unit has a maximum inflation size of the balloon already set. If the balloon bursts despite the safety stop, this may certainly be discomforting although generally not dangerous. There are however 
a few reported cases of patients that have had bowel perforations due to balloon burst. The risk for bowel perforation is 1 out of 500,000 irrigations or 0.0002%.1 
1. Christensen P, Krogh K, Perrouin-Verbe B, et al. Global audit on bowel perforations related to transanal irrigation. Tech Coloproctol. Feb 2016;20(2):109-115. 

It is also possible to change the maximum balloon inflation size to a smaller size if recommended by a healthcare professional. This is done simply by entering the setting mode and changing the maximum balloon inflation size setting. This minimizes both the risk of over inflation and of balloon bursting.

Q: What balloon size is recommended?

A: A healthcare professional will advise you of the appropriate balloon size. It should be just big enough to hold the catheter in place and seal the anal opening to minimize leakage during irrigation.

Q: Can the size of the balloon be adjusted?

A: The balloon can be deflated by pressing .

Q: What if the balloon does not inflate when I press the button?

A: Make sure the Navina Smart control unit is on and that it is in the instillation mode. This is the only mode where the balloon can be inflated. Make sure the tubes are connected at the right place. Make sure the tubes are connected tightly so the air does not leak. Make sure the tubes are not blocked or kinked. Make sure the catheter has not been used before. The Navina Smart control unit automatically rejects used catheters with a 3 hour time limit, for hygiene and balloon safety reasons.

Q: Why does the inflation sometimes stop before the balloon has reached its set size?

A: Navina Smart is equipped with an automatic stop that is activated when the pressure in the rectum is considered high. As a consequence, inflation may stop before the balloon is inflated to the set size. This will be clearly visible on the display.

Q: What if I cannot fill the catheter balloon more when i press the balloon inflation button?

A: It may have reached the maximum balloon size selected in the settings. If there is a “<” sign beside the balloon size on the display, it means you have deflated the balloon but not completely and then tried to reinflate it. For safety purposes only a limited amount of air can be reinflated. Deflate the balloon completely until the ‘<’ sign besides the balloon disappears and then it will be possible to inflate it again up to the maximum setting.

Q: What if no water is flowing when pressing the water buttons?

A: Make sure the Navina Smart control unit is on and that it is in the activation or installation mode. Make sure there is water in the container. Make sure the lid of the water container is closed. Make sure the tubes are connected at the right places. Make sure the tubes are connected tightly so the air does not leak. Make sure the tubes are not blocked or kinked.

 

Aborting Procedure

Q: Can the instillation be stopped?

A: Stop the instillation of water at any time by releasing the button  / . 

Q: Can inflation be stopped?

A: Stop the inflation of the balloon at any time by releasing the button .

Evacuation

Q: What if the bowel does not empty?

A: Try to lean forward, cough or perform abdominal massage. If water and the bowel content still do not come out, you may be severely constipated and a manual clean-out of the rectum might be necessary. You might also be dehydrated, so remember to drink a lot of water and repeat the TAI procedure the day after. If you have been successfully using TAI for a while it might be that the colon is clear of faeces and this could be a first indication that the TAI frequency could be reduced.

Disassembling

Q: Can I reuse the catheters?

A: No, the rectal catheter is for single-use only. Dispose of it after use in the normal household waste. If reused, Wellspect HealthCare cannot guarantee the functionality nor the safety of the product. Reuse may lead to infection. For your safety and hygiene, Navina Smart rejects balloons that have been inflated >3 hours earlier.

Q: How should I store my Navina system?

A: After the components are cleaned and dried, store your Navina System in the Navina case and keep it out of direct sunlight. Also ensure that the tubes are not kinked and that the System is kept away from sharp objects. Keep away from children.

Q: Can I wipe the Navina Smart unit with alcohol?

A: No, only use mild soap and water as the alcohol may negatively affect the display and reduce visibility of the information on the display.

Documentation for users

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Documentation for healthcare professionals

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