I am concerned about bleeding when trying to find the right catheter

Posted , 8 users are following.

Hello All,

I am scheduled to have my urologist's NP show me how to self cath next week. Aside from the experience itself, I am very concerned about the number of people on this forum that have spoken about the bleeding they experienced in experimenting with finding the right catheter for themselves.

I am and have been a heart patient for more than 35 years. I had open heart surgery in 2005 and over the past 6 or 7 years have had 6 stents placed in various arteries. These procedures demand that I stay on blood thinners to keep the stents open. I was planning to have a TURP (which was supposed to happen tomorrow) and decided to postpone it in favor of trying CIC. The TURP required that I stop the blood thinner a week before the TURP.

I am and will remain on the blood thinner for the foreseeable future, hence my concern about injuring the urethra and causing it to bleed. My question is how much bleeding occurs if damage is done? Is it a consequential amount or just a few drops?

I understand that everyone is different, but would really appreciate hearing from those who have bled a bit about their experiences in these regards.

Thanks in advance for any information that is offered.

0 likes, 12 replies

Report / Delete

12 Replies

  • Posted

    Barry, if you are on blood thinner, forget about self cathing, unless there are no alternatives because bleeding is possible. I was conditioned to think that bleeding is unavoidable for beginners, but I have changed my mind since I discovered soft catheters.

    About how much bleeding, it all depends on how much you injured yourself. I started and stayed for years with some very stiff catheters and I had blood gushing out of my penis at times, luckily it stopped. Most other times, I only bled a teaspoon or so. Sometimes only traces, probably from scraping over old wounds.

    The problem with bleeding is "bleeding begets bleeding". Once you injured yourself in there, you cannot apply a bandage and the injury does not have a chance to heal before your next cath, and you will likely scrape of the scabs and opened up the old wound again. Once you get serious injury, changing to a softer catheter may not be enough. I was lucky that changing to softer catheters solved my problem, after few days, the bleeding stopped for good

    Talking about blood thinners, during my 3 years of bleeding self cathing, I often felt fortunate that I wasn't on any of them. Actually, I often had to take vit K which has the opposite effect, which is clotting, to minimize my bleeding . I don't think that it's a good idea in your case.

    Why are you having TURP ? Look into bipolar TURP. Why are you even considering self cathing ?

    Hope this helps.

    Report / Delete Reply
    • Posted

      Wow!

      A most sobering assessment that is more than enough to put me on alert

      My urologist did not even mention bleeding. I am in the process of finding another Doc and I think I'll defer doing anything with CIC until I have a conversation with him/her.

      Thanks Hank

      Report / Delete Reply
    • Posted

      Barry,

      My uro once recommended I learn self cath. I tried it and the first time failed - a terrible experience. I asked him if he had ever tried to self cath, and he admitted he hadn't. I thought, shouldn't he at least try it so he knows what he is telling his patients to do? For some it's an easy process, and for others, like me, it's almost impossible without pain and difficulty. Almost all agree it takes time to learn and becomes easier over time. Each time it is done there is always a slight chance of injury and bleeding and the possibility of a UTI, the that means antibiotics. So, there are tradeoffs.

      Tom

      Report / Delete Reply
  • Posted

    Just recently, Frank who has been self cathing for 3 years and always had bleeding problem, had blood gushing out that would not stop and had to go to emergency room. I don't know if he was on blood thinners or not.

    Report / Delete Reply
  • Posted

    Barry, I think you are better served by discussing it with your urologist. I take a baby aspirin daily. I did have issues the first two times I tried, but I attribute that to a lack of good instruction and use of stiffer coude tip catheters. I subsequently switched uros in the same practice. I have not had a problem since in over two years of self cathing using straight tip latex and soft plastic catheters. Discuss the various catheter and lube options with the nurse. Make sure the nurse observes you inserting the catheter. You will probably be tense at first, but take your time and try to relax. It's second nature now for me.

    Report / Delete Reply
  • Posted

    Barry,

    I was scheduled to have a bipolar TURP last December, but, like you, I postponed it after reading so many negative posts here. I tried to self cath - had a bad experience with a lot of pain. Was unable to get the catheter in more than in inch before I stopped. My urethra was very irritated for many hours after. Five years ago I did self cath a few times, and again it wasn't easy. So, I rescheduled my TURP. By the time I got to the hospital I was almost in total retention. Couldn't wait to get the operation over. All of my concerns about the operation were for nothing. It was very easy, no pain, home 4.5 hours after I checked into the hospital. I had a Foley catheter for 3 days - the only discomfort of the entire experience. Urine slightly pink in the leg bag while the Foley was in. Began to exercise again a week after the surgery and after a month was almost back to where I was before surgery. Flow was stronger by about 50%. I am now tapering off my Flomax and will be completely off this med soon. Sleep is finally improving. Frequency/urgency much better. Only minor incontinence, but I have had this issue for years, so no different now than before. I should have gone ahead with the surgery in December. Postponing it only caused me four months of retention. Make sure of what type of TURP you are getting - has to be the newer bipolar or Plasma Button TURP. The older style monopolar TURP causes more issues.

    Tom

    Report / Delete Reply
  • Posted

    Hi Barry,

    That's an excellent question and don't think I'm qualified to answer completely, but here are some thoughts.

    Some people bleed in the beginning when they start to self cath. It's not necessarily which catheter you use, but in most cases it's your system getting used to a foreign object, ie the catheter.

    In my case, I bleed a lot for several weeks using a very soft red rubber catheter. After about four or five weeks, the bleeding stopped except for maybe a couple of times when I had a UTI. That said, some people don't bleed in the beginning. You probably won't know where you fit in until you start.

    Did you ever bleed from a UTI while you were on thinners? And if so, how did you handle it?

    If it were me, I would thoroughly discuss your situation not only with your urologist, but with your cardiologist, and come up with a contingency plan in case you do bleed. Maybe the first time you try it should be under medical supervision?

    Are you on one of the modern thinners or are you on the older coumadin? I know warafin has a reversal agent, not sure about with the newer thinners.

    FWIW I am also on thinners from time to time (Xerelto) but never had any bleeding issues with

    CIC during the time I was on them. I did cut my finger once and went to the local doc in the box for caution's sake where they gave me some sort of topical enzyme to stop the bleeding. Your

    case sounds more complex and again, you really probably want your doctors involved.

    Hope this helps some.

    Jim

    Report / Delete Reply
  • Posted

    thank you Jim

    i need to rethink and regroup with another urologist and think getting my cardiologist into the conversation is the way to go

    I appreciate your thoughts and kindness

    time, gravity and friction sure have a way of wearing a guy down

    Report / Delete Reply
  • Posted

    Sometimes bleeding is very difficult to stop outside where you can apply pressure to it but inside how would you do it? The prostate is a mass of blood vessels. A couple of times I had blood for about three days from a burst blood vessel but ones damaged by a catheter would be much worse. When on warfarin I had what looked a fairly minor cut on the joint of a finger from the sharp rim of a tin can. No matter how much pressure I applied to it just started to bleed again as soon as I let go. After eight hours it was still bleeding and I felt foolish having to go to A&E to get it dressed.

    Report / Delete Reply
  • Posted

    I've had that bleeding issue as well. It looks like a lot but I think it's very little. I've been told by docs that just a few drops can turn urine completely red. You'll learn to back off and not force it as soon as you feel the slightest bit of cutting. Make sure that you try to pee completely (even though, for me at least, nothing comes out) just before starting the self cath process. This really makes a difference by decreasing the pressure/resistance when you do insert the catheter.

    The best catheters I found were the coloplast speedicath male compact; however, at some point I just wasn't able to pass them through (the first 6 inches are 12FR, non-coude tip) and had to go back to the more cumbersome speedicath tieman 12 and 14 w/ coude tip.

    Best of luck!

    Report / Delete Reply
  • Posted

    Just 2000mg omega 3 and low dose aspirin.

    Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up