Catheter recommendation

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BHP has become a big issue in my life. I'm taking .8 mg of Tamsolosin a day plus an anti-inflammatory. As I've read in other threads, there are good days and bad days. On the bad days I fear that I may have to go to the ER to be catheterized but so far, I've gotten by. There's usually 1-2 bad days a week. The other days are fine. I have a long planned 10-day trip coming up in about 10 days and thinking it would be a good idea to have some catheters on hand. I tried to call my Doc but he's out for 2 weeks and they said to go to the ER if it's an emergency.

I'm looking on some of the med-supply sites and instruction videos. I would have no problem with self-catheterization. My daughter is an RN and she just talked to me about hygiene and I'll be fine with the htdrated, no-touch caths.

I'm going to place an order for the trip. I don't know anything about size and tip except that 14F, straight tip is the most common. I'm average size, in every way.

Will I be OK with the  Coloplast SpeediCath Male Hydrophilic Catheter 14 F, straight tip, for an back-up on the trip? Or, is there something else for a first-timer?

 

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  • Posted

    Hi Joseph,

    You didn't mention whether you have a prescription for the catheters. You will need one. If you have an obstructive prostate, you may need a coude tip. Medical supply houses will usually send samples, so get some of both tips and see what you like. 14 French should be fine. Good luck,

    Fred

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    • Posted

      Thank you. No, I don't have a prescription since I can't reach my doctor. The prostate isn't obstructive as I'm able to void, although slowly, on most days. It's just my fear of being away from my city, having a really bad day, and no backup plan. I would be much more comfortable with enough catheters to at least get through a bad day and it sounds like the Coloplast SpeediCath Male Hydrophilic Catheter 14F would be OK.

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    • Posted

      Joseph, I would urge you to get a selection of brands and both kinds of tips, because everyone is different and what works for one is not necessarily good for another. Then try it out and practice before you travel. You don't want be under that kind pressure while on the trip.

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  • Posted

    Hi Joseph, Been self cathing (CIC) for four years now and maybe I can share some of my experiences.

    First of all, being on a trip and away from home is not the ideal time and place to learn CIC. I would say the majority of folks take to it fairly easily, but a sizeable minority (including myself) had difficulties the first few weeks.

    So here are your choices:

    1. Listen to your doctor, forget the caths, and head to an ER in the unlikely event you have acute retention. 

    2. Practice CIC well in advance of your trip, like several weeks. That way, should you get a UTI early on, you will have time to recover prior to the trip.

    3. Go ahead with your plan without practicing as an ER alternative. If you are going to go this route, definitely look at some videos and not a bad idea to bring some prophalaxis antibiotics along such as Macrobid. With your doctor's blessing, I would take one Macrobid the first time you self cath, and maybe one or two the next day depending on how much difficulty you have.

    I agree the Speedicath FR14 is the best to start with, but if you have an enlarged prostate, you should start with the Coude model which is designed to go around large prostates. Note the coude tip needs proper orientation unlike the straight. But even if you want to start with the straight, which I do not advise, you want to pack Coude tip models as well in case the straight doesn't work.

    I would also look at some of the self cath threads for technique tips but as a first timer, bring some surgical non powdered gloves with you that will give you a better grip on the Speedicath which can be slippery.

    Jim

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    • Posted

      Jim, that's excellent input. Thank you! The one thing I didn't say in the first post is the trip is out of the country, which complicates the ER option. I will follow both your option #2 and #3 by ordering the straight tip and Coude Speedicath FR14, practicing before we leave, use gloves, and having antibiotics available.

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    • Posted

      Again, try and leave yourself a buffer between practice and leaving, because if things go south with CIC, and they sometimes do in the beginning, I'd hate to see you have to leave the country with a UTI, or worse yet, have to cancel the trip if it's a bad one. And given you wil be out of the country, having a full course of antibiotics available is not a bad idea. Belt and suspenders would be a full course of Macrobid (first defense) and then a full course of something very broad spectrum like Cipro should the Macrobid not work. You could also scout out urologists and hospitals in advance, so if push came to shove, you wouldn't have to be scurrying around on your trip looking for someone.

      Hopefully, none of this will come to pass but you don't want to spoil your trip, and that's why your doc probably just told you to go the ER if you go into retention, which is the simplest solution. That said, CIC is a really great DIY emergency room alternative, either for now or down the road.

      Jim

      Jim

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  • Posted

    Hi, Joseph,

    Light1 has given you good advice. Can I ask you which country are you in? If it is the U.S.A. then the need for a Dr.s prescription will be required by any reputable catheter supplier, and it may also be a legal requirement. Stick to these to be certain that the catheters you get are manufactured to strict medical standards, and not from recycled tractor tires, or the like. The Coloplast one you mentioned would probably be an excellent choice.

    Now, the "no touch" insertion technique can be a challenge. If your daughter is a RN then she is fully qualified to coach you through the prep and insertion, but manipulating the catheter while holding it by the funnel demands a degree of skill. So, to help you avoid the "wet noodle" syndrome, I'll describe how I cath myself (3 times a day) for the past 18 months.

    I do the whole procedure while standing. Holding my penis with my non-dominant hand (left, because I'm right-handed). I move my penis to as near vertical position as possible. Using thumb and index finger of non-dominant hand I open the meatus (the hole where urine comes out and soon the catheter will go in) by gently spreading the glans. Now lower the catheter into the opened meatus, Gently stretch the penis vertically while lowering the catheter a few more inches. Somewhere along here there should be slight resistance opposing further catheter passage. This would be the external sphincter, the first of two. To help the catheter I bear down as though to urinate. Alternatively  wait a few seconds while pushing on the catheter, but never force it. The catheter, once through,should travel another two inches, or so, to come up against the inner sphincter, the second one of the two. The bladder is on the other side so line up with the toilet, or get ready with a container because once through this one, urine will flow, so don't be caught off guard. Again, I bear down as though to urinate while pushing firmly on the catheter, but do not force it through. Once the urine stops move it out a fraction of an inch and rotate the catheter a quarter of a turn to get every last drop. When there is no more flow place a finger firmly on the funnel opening and withdraw the catheter. Finally, with the catheter aimed into the toilet or container, take your finger off the funnel to allow the catheter to drain any urine retained within it.

    If your daughter has been watching all this she'll probably wonder who the heck trained this guy! Please disregard.

    All the best. alan86734.

     

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    • Posted

      Alan, thank you and I'm very touched that you would take the time to completely detail the procedure. Incredible information! It does make me give second thought to the backup plan, but I really don't see an option.  I can't, in good conscience cancel or reschedule the trip. BHP and void problems are relatively new to me, 7-8 months, and this is the first trip. 

      I'm in the U.S. I'll try to get a prescription from my general practitioner, a good doctor who knows me well. Yes, my daughter really is an RN and she has verbally talked about hygiene and can couch me through the prep, but I, and I think she, wouldn't be comfortable with more. 

      Again, your technique is very valuable information. Hopefully, I won't need it.

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    • Posted

      Hi, Joseph,

      Thank you for your kind words. That is what is so unique about this forum. Others taught me. I applied the knowledge gained. Once I was comfortable with what I had learnt, I pass it on to others, like you..

      I hope your trip is enjoyable!

      Warm regards.  alan86734.

       

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    • Posted

      You can get a prescription for catheters from urgent care, Minute Clinic, Walgreens walk in, ect. Don't wait, get it today, have the provider rush the catheters to you. I agree with Jimjames - start with the speedicath 14 coude. With your sister helping you, you should have no problems with a few days practice. And also (per JJ) have whoever ends up prescribing your catheters also set you up with an antibiotic to take proactively and one to take if you end up with a full blown infection. 

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    • Posted

      Thanks, I didn't think about the urgent care clinics,  I'm waiting for a call from mt PCP and if it doesn't come today, I'll go tomorrow. The trip is still a couple weeks away so there's time for a delivery.

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  • Posted

    Joseph, I use a 14fr coude tip.  I think you will be OK with the straight tip, but perhaps the coude tip, would be an improvement.  My opinion, best to get off the medication and just do CIC.  I've been doing CIC for close to two years, and it helps to keep the bladder empty.  I used to have bladder stones, and reason for it, according to the Urologist, was that I had stale urine in the bladder.  By using a catheter, the bladder empties completely, and so no stale urine. Have a great trip!

     

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    • Posted

      Thank you, Dennis. From what I'm seeing and reading, a straight tip would probably be OK, but, as you say, the coude tip would be a safer choice. Yes, I know my bladder isn't completely empty and that it can cause complications.

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  • Posted

    I think it would be wise if you empty the bladder as much as possible.  I had to have surgery to laser the bladder stones that had formed because of my stale urine.  Easy surgery, but can be avoided by emptying the bladder completely.
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  • Posted

    Without being too repetitive, I would first do a risk/reward analysis of the situation. What do you think the chance is you will have to go to the ER during your trip because of acute urinary retention. If we're talking very low risk, then the risk of developing a UTI and possibly ruining your trip is greater. In that scenario, I would advise against practicing at home within two weeks of your trip. While not ideal, you could still bring the catheters along and try them in an emergency with the ER as a back up. The ideal scenario is to learn how to CIC at home without having additional stressors like traveling on the short horizon.

    Jim

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    • Posted

      Jim, that'a is a good point. Most days, the daytime hours are OK.  Flow is start/stop and slow, but I do void. Some nights are more difficult, to different degrees. In the past 30 days, I've thought I may be going to the ER for a catheter on 3 nights but did not. The past 8 days have been OK. So, the chances of an ER situation are low.  Yes, I'll scout-out urologists a 24-hour facility and I'll take several caths as back-up. I think this is the best plan.

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    • Posted

      Just watch your fluid intake on your trip and anything else that could run you into trouble. Assuming your trip goes well, when you get home would be the optimal time to learn CIC. Depending on your overall situation and residuals,  you might want to use it more often than just for emergencies.

      Jim

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    • Posted

      Hi Joseph,

      Air travel will increase your risk of retention due to the air pressure changes as well as the stress of traveling, and dietary changes. My visit to the ER came right after returning from a trans continental flight.

      Good luck,

      Fred

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    • Posted

      Fred, thanks. There is much more to self-catheterization that I realized. But, this is good to know. I have no choice but to travel by air but now I know the flying might be a catalyst for retention.  
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