BPH several procedures NONE worked

My uro also hooked me up with a cath nurse who was invaluable in teaching me the process in my own home. Beginning with the first lesson, the process has been pain-free and much easier to adapt to than I expected. There has been zero bleeding and it feels great to completely empty my bladder each time!

Another plus is the cost is totally covered by Medicare. My supplier keeps in touch to make sure my supply is sufficient so I never have to worry about running out.

Patrick

Howard,

I have tried CIC many times and it was difficult and painful. The last time the pain was so bad I had to stop after only inserting the catheter in one inch. Yes, it was a hydrophilic 14fr catheter. My urethral lining is obviously very sensitive. So, the idea that it is "easier than brushing your teeth" doesn't work for everyone.

I had the same experience as you when I first started. Actually I fainted in front of the nurse at my first attempt and had to be picked up in a puddle of my own blood! That was when I agreed with my uro to have my prostate removed. He scheduled me for 2 weeks from that time. But when I got home I got on the internet and found this forum and jimjames. Jimjames told me about learning about the urethra and properly following its shape during insertion. I got a cartoon of the whole anatomy and put it in on my wall in the bathroom and did as he suggested. It took a while and a lot of help from jimjames but I learned his dive bomb method and other adjustments. Yes - there was bleeding at first and a lot of pain but I learned to use the pain to adjust the insertion angles and to go very very slowly when there was resistance. I also used some lube to help smooth the insertion. That was 4 years ago. My prostate is over 300 gm but I now navigate it with ease and have even recovered a good natural void too over this time. The coude tip on a fairly rigid catheter is critical. I use Speedicath 14fr coudes. No other catheter would work for my large prostate. Also the Continence nurse helped me a lot with technique. It is a steep learning curve and not for everyone but for years there has been no bleeding and I do CIC faster than flossing - just as jimjames had promised.

Howard:

I have Speedicath coude tip catheters for emergency use only. I've only ever done self-cathing twice - once to learn with the guidance of a nurse and once on my own to get a residual urine amount.

About every 6 to 9 months, I open an expiring catheter and practice the technique without actually inserting the catheter. One thing I'm not clear on is if the coude tip needs to have a particular orientation. My understanding is that come companies have a line on the catheter so that the user can orient the coude in a certain direction. To my knowledge, Speedicath does not. When you self cath, do you concern yourself with the orientation of the coude tip or does it not matter.

Here's to JimJames and my cath nurse who have made my CIC journey painless and blood-free! Having said that, I realize it is not for everyone!

Patrick

Hello rdemyan,

YES! The orientation of the coude tip is CRITICALLY important!! The curve must be facing towards you, otherwise you can seriously damage the prostate and cause bleeding.

The Speedicaths have a green ribbed cup on the top for you to grasp while inserting. There is a vertical raised ridge on the cup that is oriented with the curve of the coude tip. When you insert the catheter you must be certain your thumb is over that ridge and stays that way all the way through the insertion and withdrawl process so the catheter does not twist or turn.

I prefer the raised ridge line over a line drawn along the length of the catheter. This is because the proper orientation is based on feel rather than sight. I've actually done CIC in complete darkness when the power has gone out, without any problems.

When I was learning most of my bleeding problems were caused by not paying attention to the proper orientation. Even so if you go slowly and the curved tip is not oriented properly you will really feel it anyway and then you should just pull it out and start over.

Another tip is to keep your index finger over the cup while inserting the catheter. This helps to stabilize its flexibility until you get the catheter half way in.

It is best to just take a catheter out of its sleeve, wash it off and study its structure so you get used to it. I used to practice holding one over a small pin hole to learn how to steady the tip and control it better so I don't miss when starting it in the meatus. All these tips came from jimjames. Good luck. Howard

I should add that the raised vertical ridge on the green cup should be facing your body while you insert and withdraw with your thumb over the ridge.

Ditto - I know most men have good experiences with most of the procedures and we only tend to hear the failed results on this forum. But at least CIC has little down side and I remain in control and don't have to worry about waking up from an anesthetic with my plumbing messed up. But I still worry about what i would do if for some reason I could not CIC in the future.

Howard,

No doubt a valid concern about not being able to CIC in the future. I just turned 71 and in relatively good health...but wonder how I will cope when old and feeble. Hopefully by then I will have found a mutually-agreed upon alternative with my urologist as I don't see me continuing this for the rest of my life.

Patrick

I had the home nurse come by and review my technique. She couldn't see an issue and asked me to go right to the emergency which of course ended with yet another foley.

It is really important to determine the nature of your retention problem. There are so many possibilities and they require different types of solutions. For example, you could have a urethral stricture, you could a large median lobe blocking the bladder neck, you could have bladder stones blocking the neck, you could have a bad case of prostatitis. you could have tumors benign or otherwise. The problem might also be with the bladder and not so much with the prostate or urethra.

The best place to start is with a flexible cystoscopy and then go from there. In the meantime, see if you could a few days worth of prednisone (5mg) from your doctor. If that helps you to pee or at least CIC then that will eliminate many possible causes of your problem. Who is your urologist as I know most in Toronto?

Good luck to you. Howard

The downside is that the prostate continues to grow.

That is what I believed too. But 4 years ago mine was 280 cc according to my mri and it was the same size this past Fall according to the same mri at the same hospital read by the same radiologist. I am 71 now. I also read once that after a certain age the growth rate slows down.

That is one heck of a size but by no means a record.

I was nearing 70 when I had my GL with my 75 grm prostate in 2004. From them until 2013 it grew to 135 grms and 80grms was then removed. The surgeon then suggested that I take Avodart for life to prevent future growth. I asked if he thought it had time to grow enough to need future surgery, He glanced at my age on his screen and said perhaps not. I've no idea how much it may have grown since but it is not causing me any problems.