Anyone Self Cathing? I still am after over 10 years.

Hi John, That's what Coude tips are for, going around corners -- and in our case that corner is our enlarged prostate! Just make sure you have the curve going the right way, because it's not exactly intuitive. The tip should actually curve toward you, not away. I posted a good diagram of that, but not sure where it is now.

Surgery won't solve overproduction of urine at night, so don't even think about another surgery for that! The bladder can only hold so much, even if it empties completely. But if you're not getting it emptied completely naturally, cathing before bed, or once in the middle of the night, might help to some extent.

Let me know how the Coude works out.

Jim

John,

I found that if I pull down and stretch my penis, while inserting the catheter, it goes in much easier.

Thank you, Ted. I will try this.

Thank you, Jim. I will update soon .

I personally don't know anyone who opted to have surgery after doing CIC for years, but I see no reason why one couldn't should they change their mind for various reasons.

Jim

The first couple of months, I was more than depressed with the prospect of having to self cath for life, I felt my life as I knew it had come to an end. Flash forward a few more months and it did be come routine like brushing my teeth, except a little quicker 😃

When you say your voids are in the 350-450ml range, are these voids CIC only, or are they preceded by a natural void? I found a good rule of thumb for a healthy bladder is to keep total bladder capacity (TBC) down to 400ml or lower. TBC would be what your bladder is holding at any one time, which would be the sum of any natural void plus your CIC void. Anything more than that has the tendency to keep your bladder stretched. In fact, as part of my bladder rehab program, I periodically tried to keep my TBC below 300, even 200 for a week at a time, which involved cathing up to 10 times a day. I called this a "bladder vacation" which gave it time to rest and get stronger.

You asked how do you check to see if your bladder has gotten some of its elasticity back. One way is to keep track of natural voids (NV) and post void residual (PVR) volumes. If no NV's, then hard to know, but you might try some of my bladder rehab techniques, including the bladder vacation, in some of my earlier threads.

When I first started CIC nine years ago, I was almost at the point of complete urinary retention and could only void small amounts like 50-100ml by pressing my hand hard against my bladder. I had already developed hydronephrosis from all the back pressure. I was told I needed a TURP or I could CIC for the rest of my life, but I would never be able to have a natural void again. "When pigs fly" was what my uro said, if I asked if my bladder damage could be reversed.

This morning, I had a natural void of 400ml. I still cath a couple of times a day, not because I have to, but because I like to do a full empty twice a day so that my rehabilitated bladder stays rehabilitated. PIgs don't always fly, but in my case they did 😃

JIm

I rarely do any natural voids prior to self cathing. The only time this might happen is if I have drunk a ton of fluids and i am over my baseline threshold my bladder can take and it is basically surplus. If not, it is merely a dribble, probably less than 50ml.

Generally speaking, my voids are anywhere between 400 -500 when i cath, I am trying to keep under 400 but it is dependent on how much fluid i taken consumed. I am heavily into fitness, so i like to remain hydrated, so consume anywhere between 2.5 / 3.5 litres a day.

To be honest, I don't feel like I am anywhere near being able to void those sorts of volumes (~400ml) going forwards, it feels like my bladder is a lost cause. It is quite depressing the thought of it. Even in the night I am waking up once or twice in the night whilst cathing.

My fear is that my bladder won't repair and this is me for life. Also, my other concern is that could i ever be in a position where self cathing won't work?? I'm not entirely convinced that are self cathing my bladder is fully empty, is there anyway of knowing? For example, after pulling the cath out slowly, there is still urine in the cath, so to stop it going back into the uretha, I keep my finger over the end of the cath and pull it out and empty the excess amount into the toilet. It is very rare that I have seen the cath clear (as in empty) when I have pulled it out.

It should be empty unless you have a bladder irregularity such as a diverticulum (pouch). One way to know would be to cath at your doctor's and have him scan your bladder right after. Or, buy yourself a bladder scan, which I did. The used ones are reasonable but require hunting around and exchanging parts. The new ones can be pricey. I cobbled together parts from some used ones and got a workable unit. I have a thread on it if you want to do a search. Portascan Plus was the name of the unit and the manf was Mediwatch.

As to your bladder repairing, no guarantees and I was told mine never would, however in my case they were wrong. I can stop cathing completely if I want and might try that next while checking PVR's occasionally with my scanner to keep things honest.

Waking up at night doesn't mean your bladder isn't empty. It will only hold so much, before it wakes you up. As we get older, we tend to go more at night for reasons other than the prostate.

Hi Jim. My catheter always has pee in it when I finish with it pointing straight down to the toilet bowl. I attribute that to capillary forces holding the pee in the catheter tube after the pressure in the bladder is depleted. I hold my finger over the cup as I rotate upwards while withdrawing the catheter so atmospheric pressure won't drain the pee back into the bladder. Still I don't believe I fully drain the bladder because I cannot get in fully with the length limitations.

What do you think of Hank and Ted using Betadine? It is quite corrosive and I think over time may eat away at the urethra tissue which is very delicate.

I agree that it's mechanically trapped in the catheter and has nothing to do with how empty or full the bladder is. Holding your finger over the cup also avoids a bit of a mess 😃 I used to use BZK pads but they always seemed to have too many dry pads in the box. Lately, I've been using Betadine pads, because less messy than the solution. Not sure how corrosive it is or isn't. Doesn't sting like for example alcohol which some people use. I also spray some Microcyn or one of it's vetenarian formulations into the urethra first, but not confident that it does much, however the SCI community swears by it. I still get more uti's than I want. Thinking now of stopping CIC altogether for several months and see if I have less UTI's which are now 3-4x a year. It may just be from stale urine in my diverticulum which I can't do anything about, we will see. Just dusted off my bladder scanner so I can keep things honest regarding PVR's when I stop CIC. Still haven't figured out exactly why I'm able to stop completely, but it may be from the pelvic floor excercises I've been doing. Intellectually, quite curious, but not going to look a gift horse in the mouth.

Jim

Hi Jim - I've been using Dynarex obstetrical towelettes all these years and have only had 2 dry ones in all the thousands I used. Also I've only had 2 confirmed uti's in almost 7 years which I attribute to these gentle wipes. These were your suggestions early on and like all your suggestions have worked great for me!

When I use my lube I hang the catheter on the wall and just open it 1/4 of the way and squeeze in a small amount of lube and then pull the catheter out slowly while twisting it. It gets nicely coated and works fine for insertion. I just wish Speedicath did not use up the last 2 inches with that rough grip - ouch!

My problem has always been my nocturia. Last night was a typical example. Before bed at 11 pm I CICd. First my NV was 200 cc and then my cath void was 200 cc. So 400 cc total in keeping with your rule.

But then at 2 am I was awakened with my nightly "fire drill" and took out 1000 cc!! Then at 6 am when I awoke I took out another 700 cc! This is a typical night where I generate about 60% of my daily urine production to qualify as nocturia.

I've tried all your ideas to reduce this problem but none have worked. My uro gave me desmopressin but I won't take it as it is a potent hormone drug.

This is the main reason I do not get a procedure done because at night I would not be able to control the peeing and would dump all this fluid in the bed or a diaper - no way.

I use Betadine as an antiseptic throat gargle. It is very strong and discolors the sink and my mouth. I cannot imagine putting it in my urethra!

Anyway, please keep us informed about your own ongoing experiments. I watched the lovely lady in the pelvic floor video and am now trying them so maybe I will get results like yours.

All the best

Howard

Hi Howard, How can you sleep with 1000cc Of urine in your bladder? Are you taking any medications for sleep? I sure like to try them. 😀 My bladder usually wakes me up at around 400, 500cc levels. It's when I get up and do CIC. However, I always have so much problems going back to sleep after that. Hank

Hi Hank. It is very difficult at night. I CIC just before bed and usually have a good NV of 200 cc and a cath volume of 200 cc for a total of 400 cc. I always hope I will sleep through the night. But after a few hours of sleep I start to have terrible nightmares which is caused by my bladder discomfort. Finally I awake and conduct my "fire drill" to the bathroom and CIC. The volume is always between 800 cc and 1200 cc! And just after a few hours sleep. If I have my fire drill before 3am I can usually get back to sleep but after 3 am I cannot sleep and just tinker around. I don't take any sleep aids at all. When I do get to sleep and sleep for a few more hours till morning I have to CIC again for about 600 cc.

This week I will have a kidney U/S to check on things. My creatinine level has been going up over the past year and my uro wants to check for hydronephrosis. I hope I am ok as I do manage ok for 74 with 3 CICs over 24 hours. Take care.

Howard

Hi Howard. If I take antihistamine before bedtime, I would have a better chance of falling back to sleep after a CIC. However, I just stopped taking it because I found out that it would raise my risk for dementia. Tonight I am going to try mirtapazine. It is a an antidepressant but at low dosage it acts as an antihistamine and sleep aid. Hank

Actually it is spelled mirtazapine. Hank

Hi Hank,

Antihistamines relax the bladder muscles and make BPH worse. They make it harder to pee in general. I stopped taking them many years ago. Check it out on the internet and you will see that there are warnings about them if you have trouble peeing.

Last night I tried staying up later, till midnight and then did a CIC before bed. I had my usual "fire drill" at 4 am and never got back to sleep. I get used to it. It is better than having my prostate out and being incontinent at night and dumping all that pee from my nocturia in the bed or a diaper. I am trying jimjames video on kuegel exercises but that is only good when we are awake.

Howard

Hi Howard, I know that antihistamines cause problems to the bladder and urine retention but I did not think it matters much since I am doing CIC anyway. Risk of dementia is another matter.

I took mirtazapine last night and I was able to fall back to sleep after CIC. Very encouraging! I hope that it will continue to work.. Otherwise, I may have to go back to antihistamine. Antihistamines raise risk of dementia but long-term lack of sleep will do the same, maybe worse. Hank

Hi Hank - For those of us still with a small natural void the antihistamines will shut it down. My uro gave me desmopressin for my nocturia but I never tried it because of all the side effects as a hormone drug. I guess I could give it a try if it helps me not to pee at night and then I could sleep through the night. Maybe it would work for you if you have nocturia and then you could sleep through the night? Howard

Hi Howard, Are you talking about mirtazapine? I don't think it will help you from not peeing at night. It might help you to fall back to sleep after you get up and pee.

If you want to sleep through the night and not getting up to pee, you might want to cut down on your total liquid consumption. I should do the same. Hank

Hank,

You may consider CBD. There are various forms, including ones that focus on sleep. I think that's safer than taking any pharmaceutical.

Hi Ted, I am interested but clueless about where to start with CBD. Are you using it currently? Do you have any suggestions for sleep? Hank

Hi Hank. I follow jimjames guidelines which include no food or drink after 6 pm but it doesn't help. The drug my uro gave me for nocturia polyuria is called desmopressin. It is a hormone drug that slows the kidneys at night. It is really meant for children who wet their beds. I guess I've gone full circle! But I haven't taken it yet to see if it lets me sleep through the night. Howard

Hank,

I do use it occasionally. When I get up in the middle of the night, I fall back asleep almost instantly when I have taken it. Delta8 CBD is the one for sleep. You can research it online. Depending on your weight, you can take 10-15mg.

Hi Ted, can you give me more information on the exact product that you are using and how? I looked it up and it's very confusing for a beginner. Again, my philosophy is to use the exact product that someone you know already used to increase your chances of success. Thanks Hank.

I just received the Dynarex obstetrical towelettes which after sampling a few, are moist like you say. Thanks! The ones I have been using that dry up are the Dynarex BZK wipe. They look the same and the only difference is the addition of some alcohol with the the obsterical wipes, which is probably what keeps them moist. Fortunately, not enough alcohol to cause any stinging.

Unfortunately -- or rather fortunately -- maybe a little too late, because I am no longer self cathing these days as discussed earlier. I just did my own bladder study with my bladder scanner and everything looks good and intact, with reasonable PVRs, so I will probably continue not to CIC and see if that helps with the UTI's or not.

Jim

Hello Hank, believe or not, the label on my bottle had come off and now I don't even know what brand I had bought! There are a lot of CBD stores. If you have one near you, I would go in and talk to them. They are very knowledgable about that.

Thanks Ted anyway. I guess I'm on my own this time. Hank

Thanks, I will check out Portascan Plus.

Oh gosh, I didn't even know about a diverticulum (pouch) until now.. surely the Uro would have made me aware of that if i had one??

From a cathing perspective though, I noticed I can go and then need to go another hour or two later. I always though once you emptied, that was you until another 3/4 hours.

Do you think it is still ok to go out and socialize (beers etc) with friends even though I have to cath and i have said issue? I usually take around 8 caths out with me if I am out on the p!ss with mates. I don't do it regularly, probably once every 6 weeks.

That is a LOT of water held. What time is your cut off for consuming water? Where is this watre coming from through the night if you have already cath'd 400ml prior to bed?

What do people take for their hayfever if they can't take antihistamines?? I swear this might be one of the reasons i struggle because i have taken these for years!

If you've ever had a bladder ultrasound done in the hospital, you would know if you had a diverticulum. Also, many of the office bladder scanners will show a real ultrasound image although some just have a digital readout without the image. Don't see why you can't go out and enjoy those beers, just bring the catheters along!

Jim

Hi Graham,

I don't know where all the pee comes from. At night when asleep it seems I have a hormone problem that produces tons of pee. Nocturia polyuria is well understood as a hormone problem. That is what causes little boys to wet their beds. Just as an example last night before bed I did a cath and took out 200 cc after a good NV of 200 cc. Then just 2 hours later I awoke and ran to the bathroom and took out 1000cc. Then this morning at 6 am I took out another 600 cc. At 9 am I took out another 600 cc and then at noon I took out 700 cc!!! Since then I have good NVs and been ok. I don't understand this at all. But if I had my prostate out I am so worried I will be incontinent with all that pee production!

I never drink or eat after 6 pm but it doesn't seem to matter.

I also suffer from hay fever as I live in the country. I just tough it out and use those nasal band aids that you place across the bridge of your nose and open up the nostrils. That really helps a lot and gets me through hay season. Good luck. Howard

Oh gosh, that is a serious amount of urine you are holding in there! At least you can NV some of it I suppose. I can hardly NV anything unless i am over my bladder tolerance (which has caused it to initially stretch) and then any excess comes out but it doesn't empty my bladder at all, which is what has been happening for years until I found self cathing.

I don't wee out excess amounts at night probably 3/400ml but without fail I will need to go through the night, at least once. I never ever sleep right through, which is not good and i fear i'll never be able to either, which in itself is a killer!

I usually have a cut off of around 8pm but like you say, even then I will still need to go!

I have used the nasal strips also cleaning the nose first with alcohol to help them stick. I also use the 8 oz Neil Med squeeze bottles every night for nasal cleansing, with distilled water and Neil Med salt packet. Between these two things I have also cured a severe sleep apnea problem.