flip flow valve. new to it. problem with urine leaking through penis!

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Husband new to flip flow. Is catheterised for life. Today we started using the valve, so currently no leg bag but we noticed his pants are wet. Urine dripping from penis even though he is opening the valve every one and half /two hours. Any suggestions would be grateful. I will be calling nurse on Monday but in the meantime I'd like to be enlightened. Anyone else have this problem Thanks.

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12 Replies

  • Posted

    Hi, Doloroso,

    That is exactly so! My remedy was to continue using the plugs that I used before trying the valves. Not good and, quite frankly as a former manufacturing engineer, I can speak with a degree of authority on the matter.

    Perhaps, if we all raise our voices in unison, the manufacturer will come to realize that there is such a thing as Quality that cannot be ignored.

    Warm regards, alan86734.

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  • Posted

    My husband has had a permanent urethral catheter for 5 years now and uses a flip flow all the time to maintain the health of his bladder. Can I just check that before he had the valve he had a leg bag connected directly to the catheter and there was no sign of leaking? Can I also just check that the catheter is in via his penis and not supra pubic?

    If I've got the right idea with regard to these two things I would say that by shutting off the flip-flow urine is collecting in the bladder (as it should) but under pressure is then somehow by-passing the catheter and leaking out around it. This would indicate that your husband's urethral sphincter isn't closing around the catheter properly. It should normally be shut tight unless the brain has signalled it to open for urination so I don't know why this would happen.

    Without knowing more details such as why he had to be catheterised in the first place it's not possible to say what has happened to cause a leak. You are right to use a flip flow as the filling, storing and emptying process keeps the bladder doing what it's made for and keeps it healthy.

    My husband has the opposite problem and his sphincter was clamped tight shut permanently (he has MS). His nerves stopped responding to the signal to urinate so he couldn't leak even if he wanted to - hence the catheter.

    Which country are you in? Some catheters are better than others.

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  • Posted

    Doloroso,

    What size is the catheter ? Maybe it is leaking around the catheter and he needs to go to a larger size. If it is the valve leaking he may have to replace the valve or whole catheter. Other wise he can try a plug in the catheter or a clamp temporarily.

    Why doesn't he use intermittent catheters ? I think intermittent catheters are a better solution if he can do it. There are some good discussions on this site about the use of intermittent catheters CIC (Clean Intermittent Catheterization), started by jimjames. There have been posts by some people who have been doing CIC for 10 years or longer.

    Thomas

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    • Posted

      Thomas 37368 Hi Thomas. Intermittent catheterisation is not possible as my husband has problems with his hands. He only has leakage when I attach the flip flow valve. Thanks for your kind response. Keep well x

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  • Posted

    I can't comment on the leakage as I have a suprapubic catheter, rather than a unrethral one.

    However with regard to valves, most of them are a disaster, having been designed for use with a bag and suffering from drip problems if used without a bag. Fluid goes around the perimeter of a tube and it's very difficult to get rid of the last of the urine in the outflow tubing. Additionally, the handle of the Flip-Flo and similar valves is easily caught in clothing and can open the valve slightly without the user being aware of it.

    The Manfred Sauer valve is free from the second of these problems but not the first.

    The only valve I've come across which is really designed for use without a bag is the Stäubli valve which is streets ahead of any of the others.

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  • Posted

    Hi, Doloroso,

    In my last post I should have mentioned that one of the first things I checked was bypass flow and found this was not the problem. Not surprising since at that time I was still using Fr-18 catheters on a regular basis. Now I have undergone a bladder irrigation for which the nurse used a Fr-22 and a flow rate of approximately 3 ml/sec saline which is consistent with my last urodynamic evaluation.

    This was a first-time event and might well occur again at any time. I did not suffer pain but was aware of quite a strong pressure sensation throughout the procedure which completely obliterated my normal cathing feedback. As a result I was unable to provide any useful navigational help to the nurse. With this in mind perhaps I should do some more urethral stretching?

    All the best, alan86734.

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  • Posted

    Hi

    My hospital put me on a long term indwelling catheter for months without any options and I had a little leakage but I believe this can be overcome with a larger catheter that might seal better.

    I remember how much better the flip valve was than the bag which I discovered while on the internet. It was great but even better was CIC or self catheterisation whenever needed. If that is possible give it a try. However I understand you need to have the ability to carry this out. Come back if you need more advice.

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  • Posted

    Hi All,

    Thanks so very much for your responses. I have not responded until now as hub was so disenchanted with the the flip flow valve that he gave up even though I tried to encourage him to continue using it. Today, I have insisted that we start afresh and try to get through this hiccup of the urine bypassing. He has been so disheartened. I need to go back to read your responses again and will answer the questions each of you have put to me.

    Miriam65408 - Ok. So here goes, In August 2018 my husband was diagnosed with chronic kidney disease. He will be 85 in June and has Type 2 Diabetes. His prostate is enlarged. 9 years ago he had a successful op on his prostate (to make it smaller - not the correct lingo but am sure you understand)! and the consultant did tell us that hubby would have at least 10 good years before he would start to have problems again. The consultant was right. Urodynamics showed that sadly hubby retains urine. His whole urinary tract does not work properly with his bladder terribly stretched and as his blood results were pretty bad he was catheterised in A&E, We have had ongoing visits to Urology and Nephrology and all is really under control. Being catheterised his Kidney profile is good as are creatinine and other levels now. They were dangerously high and they prepared him for admission. Luckily, that never happened. When using the leg bag all is really fine (except of course that fastidious bag strapped to your leg). Urine does NOT overflow. Does NOT bypass, As we are due to go to Italy in the Summer to visit family, hub would like to be able to go on the beach. Having success with the flip flow is our ultimate aim Miriam. "urethral sphincter isn't closing around the catheter properly. " means nothing to me Miriam. Our assigned clinical nurse has told us to insist, that it will take a while for the body (his bladder) to adjust to the valve. I have a darling cousin who is a specialist nurse in lady problems and knows all about the catheterisation and flip flow valves and she too says we must insist! We are in the Uk Miriam. The catheter used is a good one! I insisted we be prescribed with that one when I spoke to our GP. It was fitted after the Urodynamics at the hospital. I do hope your husband is well and you too. Hope you had a good Easter. Once again, thanks so much for your response. Any other suggests would be so welcomed xxx Oh yes the catheter has been inserted through the penis. As I have stated, only when we attach the flip flow valve we have a problem x

    Thomas 37368 Hi Thomas. Intermittent catheterisation is not possible as my husband has problems with his hands. He only has leakage when I attach the flip flow valve. Thanks for your kind response. Keep well x

    Coigach. Thanks for that information. Look after yourself. xx

    alan86734. Thanks for that information. Take care xx

    gregg73359 Thanks so much . Take care xxx

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    • Posted

      Hi Doloroso,

      I've only just seen this. From what you are describing it sounds like when the bladder is free draining into the leg bag there is no pressure build up and so nothing leaks. I do apologise that my sentence about leaking befuddled you. The sphincter is the valve we all have to keep our urine in our bladders until we're ready to go to the loo. It sends a message to the brain to say it's feeling pressure and these messages get more urgent (I've got one now but I'll just finish this!). The brain will tell the sphincter when we're in position and then it opens to let out the urine.

      If the messages to and from the brain are blocked in some way (as in my husband's case) the sphincter won't behave as it should. Also, age or other deterioration is a big factor affecting how well it works. It sounds like your husband's sphincter isn't closing very tightly around the catheter which is gine when there's no pressure. Using the Flip-Flo prevents urine from leaving the bladder so pressure starts to build up and then he gets the leaks.

      Can I ask if the bypassing starts almost immediately or is if after an hour or so? If it's ok for say an hour then you can perhaps get over this hump by turning on the Flip-Flo and emptying the bladder by the clock. This will at least help keep the bladder toned a little and give you both an hour or so free of leg-bags. You might be able to gradually build the time up. If, however, it starts immediately (although it shouldn't as there's no pressure) then you may have to look at a larger size catheter (if he's using a 14 go up to 16 or 18) to find a better fit.

      The sphincter valve is like an elastic band and should have a point where it makes a good seal - unless the elastic has totally gone. If this has happened (age or whatever can do this) you may have to look at crop trousers instead of shorts on the beach. I do hope you get something sorted before your holiday, I know we have had summers where the thought of a leg-bag poking out at the ankle has taken a lot of the fun out of life.

      Finally, speak to a continence nurse or the manufactures to find out what options there are in length and size of leg bag etc.

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