Foley catheter clamping post surgery for bladder retraining
Posted , 6 users are following.
As I was lying in bed last night pondering my 5 months of incontinence after TURP surgery, it occured to me that clamping a Foley catheter might help retrain the bladder. In my case, medications don't seem to have helped (oxybutenin, and now I'm on Myrbetriq).
This morning, I went on-line and searched for "Foley clamp bladder retraining" and up came a nursing site, and on that site I found that iFoley clamping to expand and train the bladder is used for some patients who have been on a catheter for awhile. So I'm going to ask my urologist if they will do that for me. Did any of you use clamping before the Foley was removed?
I really think that the acute retention episode two days after my TURP is the root cause of my woes. Any comments?
0 likes, 21 replies
cleoh glenn77
Posted
This is by user "denknee", from a different thread:
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To retrain my bladder, my urologist gave me a plug to put in the catheter line, before the urine goes into the Foley. This way my bladder got use to holding urine again and muscle voiding. When I got the urge to void I took out the plug and voided. At night time I used the Foley. This exercise went on for 30 days. Then my urologist had me self-catheter once a day in the evening, for another 30 days. At this point in time I can't "pee" like a teen, but I do have a strong stream and almost fully empty my bladder, with a few drops left. Now I'm pleased with my Turp.I hope this helps, Denis"
glenn77 cleoh
Posted
Denis,
Thank you for your reply. I'm having trouble visualizing the location of the plug. The Foley catheter is inserted through the uretha into the bladder, and then a small ball near the end inside the bladder is expanded with saline solution injected through a tiny separate channel in the Foley tubing . The ball then retains the Foley in the bladder, and also serves as a sort of gasket at the bladder mouth. So urine enters the Foley tubing inside the bladder, flows through the tubing and exits through the tube outside of the uretha. So, did your plug get inserted in the external end of the tubing where urine leaves the tube? And did this allow you to not even have an external bag for urine collection?
Thanks again.
gbhall glenn77
Posted
When I had a foley catheter for a few weeks, it came as a kit. The tubing coming out of the penis had a small push-on in-line tap six inches or so outside. The other side of the tap, more tubing, sufficient to go down to a leg-bag, or an overnight bag (larger) that could be placed on a stand beside the bed. So I assumed all foley catheters would be the same, they would all have a tap, for ease of changing daily between leg and night bags. What is this about 'clamping' ? Rather a foolish way of doing it I would have thought.
glenn77 gbhall
Posted
Scroll back to my top post for the context of this discussion (Bladder retraining.) It would be to stop urine flow and expand the bladder to normal and then empty it every 3 or 4 hours, on a regular basis. I've found through my research that this technique, is in fact, used by some urologists for bladder re training. I even found this procedure on-line from one hospital just now:
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Purpose: To retrain the bladder and strengthen muscle tone preventing urinary incontinence after removal of Foley catheter following long-term catheterization or following neurological damage Equipment: 1. Clamp 2. Physician order for Bladder Training To be performed by: RN Procedure: 1. Explain procedure to patient 2. Clamp Foley catheter for two hours 3. Unclamp catheter for five minutes and measure output 4. Clamp Foley 5. Repeat steps 2, 3, & 4 increasing length of time Foley is clamped by 30 minutes if previous time is tolerated 6. If patient becomes uncomfortable, may unclamp early and increase time as tolerated 6. If period of clamping is 4 hours, continue schedule through night; if under 4 hours, open Foley to straight drainage and resume schedule in a.m. 7. When patient is able to tolerate 4 hours or more for 24 hours, remove Foley 8. Continue bladder training by assisting to bathroom at regular intervals until patient resumes regular habits 9. Establish form of communication for schedule of clamping and unclamping foley on care plan or kardex
randy_85492 glenn77
Posted
Glenn, Can you explain the Foley Clamp procedure, riks, benefits more?...I've been on the Bag Foley for ~ 5-6 weeks....I empty the Bag ~ 5-6 times/per day/night...
glenn77 randy_85492
Posted
Randy, I only became aware of the procedure today. Then my wife, a retired RN said she was aware of it and had done clamping of Foley catheters for patents in her working years before the catheters were removed
Here's its purpose. If you've had a free flowing catheter for a long time, there is no urine collected causing the bladder to expand and to exercise the smooth deltrusor muscle of the bladder. So the idea is that by clamping the Foley tube, it causes the bladder to fill, expanding the bladder and causing the bladder muscles to work.
In my case, I haven't had any cather for over 3 months now. But the trauma of an acute retention event following my Green Laser procedure, followed by a longer catherization caused the bladder to become over active, so I've had constant leakage for months now. So the leakage has kept the bladder from filling, so that its capacity becomes less and less as time goes on. My thought and hope is that by having a Foley put back in for a few days, and clamping it to expand the bladder, and voiding on a schedule would work to retrain the bladder.
randy_85492 glenn77
Posted
I hope the urologist will let you try the foley clamping and it becomes a solution for you...My uro doc did a Cystoscopy, Flow Rate, and Bladder Scan today and has scheduled a Ultra Sound for this Friday and a Biopsy the following Friday....The Bladder Scan revealed a High Retention Amout of ~ 450ml...The Cystoscopy verified a very large TRI-LOBE Obstruction....My Flow Rate was negible due to accidental voiding just prior to the office visit.....My Uro Doc is beginning to think
the Only Treatments Appropriate to me are a TURP and TUNA...Neither he nor I want to do the TURP, because of all the horror stories..The Uro Doc states the Cleveland Clinic has performed a New & Modified TUNA several times recently that was very successful with No Complications...He's going to research that new procedure more...I've researched the PAE and determined there have been a large number of complications with it...Thus, my only viable option may be the New TUNA....What Do You and Others Think?....
dennis47445 glenn77
Posted
Glenn, I'm in the same boat as you. On July 13, 2016, I went in for a turp. The uro, was able to remove the blockage and a nice clear channel was formed. After a day in the recovery room, the catheter was removed, but I was not able to empty my bladder. They sent me home with a catheter, and 12 days later I went in to remove the catheter, and went through what they called a "voiding trial" No luck, I couldn't empty my bladder at all...not even a drop of urine. So now I'm with a catheter, and on some kind of medication that constricts the bladder. I am waiting to go and see my uro, when he comes back from his trip, which is on August 26. Hopefully then, I'll be able to go on my own without the use of a catheter. After reading the posts here, I'm kind of wondering if I will also need to retrain my bladder.
glenn77 dennis47445
Posted
I would ask his office or nurse about it. In any event, I don't see any risk to using the protocol in my earlier post (clamping for 2 hours), then increasing that by 30 minute increments until you get to 4 hours. I would clamp it right after the branch in the Foley tubing in the before it connects to the tube that runs to the collection bag.
I would measure how much is released with each 5 minute unclamping and log it.
randy_85492 dennis47445
Posted
Dennis and Glenn,
Please advise me of any success you have. My Bladder is Retaining ~ 500ml of urine if I stop using the Direct Foley Catheter....Also, per a cystoscopy performed yesterday, I have a very enlarged Tri-Lobe Obstruction which per the doctor can Only Be Treated with a TURP and TUNA..Because of possible irreversible complications report on this Blog, I'm trying to determine if a PAE is possible...Also, a Prostate Biopsy has been scheduled for next week to determine if I have prostate cancer (highly suspected by my urologist after a Digital Exam and the Cystoscopy)...
dennis47445 randy_85492
Posted
Best to have the turp done, if you can't do the holep. Sounds like the holep, is the better of the two. 500ml is a lot. My surgery was a success, except my bladder, is weak and so I can't urinate without the use of the catheter. The uro, told me that he made a nice opening for urine to pass, but because my bladder is so worn out, the urine, has a hard time flowing through the catheter. The bladder, muscles are not stroung enough to push. Hope you have better results!
bernie82609 glenn77
Posted
I had a TURP done about a month ago, still can't void so I've been on a Foley. One of my doc's isn't for clamping, the other sees no harm in trying it. There's been plenty of medical interest in the overactive bladder, but not so much in the underactive bladder Has anyone had sucess retraining their bladder using clamping?
dennis47445 bernie82609
Posted
Bernie, we are in the same boat. I can't urinate as well. In a few weeks, my uro will be back from his trip, and hopefully when they remove the catheter, I will be good to go. My surgery, was on 7/13.
bernie82609 dennis47445
Posted
I'm on my 3rd weekly cath. My uro takes it out each week to see if I can void. So far, no luck, he says it takes time. I don't mind the time, but having to get a new cath every week is getting old. Now he's thinking of a suprapubic cath and a plan to retrain my bladder. wishing you luck when your Uro gets back
glenn77 bernie82609
Posted
You can't pee, and I can't stop peeing. On average, we're just perfect.
bernie82609 glenn77
Posted