New Speedicath FLEX being replaced by Speedicath FLEX Pro

I have tried the Speedicath Flex Pro Coude three tmes and it gets easier to use after you have used it a few times.  They fit it in a small package by rolling it in a circle and plugging the funnel end into the tip end with a twist lock.  Because of the coil in a circle and the plastic material it is made from it tends to keep some of the the circle shape after being released from the packaging.  The problem with that is it wants to flip sometimes while inserting it and can easily flip 180 degrees because the hydrophilic coating is very slippery.  When that happens the coude tip is upside down and may cause irritation.  I found with practice the flipping situation can be controlled so it will not happen.  

Overall it has a very good hydrophilic coating , and is a little more flexable than the Speedicath, so goes in easily.  The packaging is small and very easy to conceal so very good for cathing away from home.  The catheter can be put back in the packaging bag and re-sealed for disposal.  Finally the plastic sheath keeps it clean in dirty environments and helps to advance it.  I think it is the best catheter to use away from home but not the best to use in the home.  If you use it be sure to watch the instruction video first.

Thomas

I agree the Flex are best for traveling. I kinda liked the tip on the old ones didn't have to worry about insertion. I still have about half a box of the old style flex so I think I'll use them up before switching to the new style....

Thanks for the review Thomas and it appears that you have made the Flex Pro work for you which is the important thing. My irritations tend to quickly turn into UTIs so I have much less tolerance for getting used to a new catheter therefore I stick with what has always worked well which is the Speedicath. The only issue I have with the Speedicath is that it's not the greatest for traveling since it doesn't roll well.

Jim

When I travel I carry a mailing tube with all my supplies. I've gotten pretty good at cathing in public places like public bathrooms etc. I would never switch from the straight Speedicaths. Like you if I get an irritation in the urethra it can quickly escalate so I stick with what works for CIC and find work arounds when I travel which is irritation-free!

Hi Howard, I don't travel a lot, nor do I have to cath much in public places, but when I do, I also use a mailing tube that I stick in my back pack. If lazy, I just stick the catheters in the back pack and hope they don't get too crunched. With the supplies I also carry some paper towel squares in zip lock bags that I can use to create a clean surface to work on.

Jim

Hi Jim

I just passed the 2500 mark with my Speedicath Coude 14fr straight - all thanks to you. I just had a kidney check up and all hydronephrosis is gone even with a 240gm prostate! I continue CIC 4 times daily with minimal effort. I reduce my nighttime CIC volumes from 800cc to 350cc with a pinch of salt before bed.

Can you give us an update on your own situation?

Take care

Howard

Hi Howard,

If I'm counting right, the "2500 mark" is about two years? In any event, congrads all is going well with you and the hydronephrosis is a thing of the past. Without a doubt, CIC will protect your bladder and kidneys as well, if not better, than any surgery. All else is just bonus.

On my end, don't know how many catheters I've used but I must be around four years and counting, although for the past year or so I don't cath every day and still empty well. Sometimes it' been weeks without needing to cath, sometimes days, and lately due to some arrhythmia issues, a little more because certain arrhythmias can unload the kidneys very fast plus my activity level has dropped a bit.

So for me at least, CIC has not only protected my bladder and kidneys but has rehabbed my bladder to the point where it functions normally most of the time with an IPSS score now of "mild" when before CIC it used to be "severe". But again, the rehab part is the bonus along with the benefits of not having to subject myself to a surgery with uncertain outcomes and side effects.

Jim

Hi All,

Also anyone see problem with using two different caths. Olive tip is cheaper than Speedicath so i use each twice a day. Maybe eventually all Speedicath but I do feel get more out with olive tip but using that in AM when bladder can have 600 to 725 as I am not waking up in the night.

THX

Hi Brad, I've been CIC ing for over 2 years now, 4 times a day. I have used many different brands but settled on the Speedicath 16fr coude tip a year ago and am happy with it even though it is a straight catheter. I noticed that all the catheters drain at different rates even though they are 16fr. I think it is a function of the slit sizes and geometry and not something to worry about as long as you are draining your bladder ok.

Are you able to natural void at all? What are your residuals during the daytime as you do not want them to get much above 400 ml. Take care. Howard

Hello there, I've been using the speedicath 6 x a day for 4 years. so I'm up into the 8k range. I got some speedicath flex coude to try out and found them to not be as easy to feed in. However the very ingenious omnidirectional flex tip that functions as a coude (which they called coude), made the instability of orientation during insertion a non issue.I found them to be much more transportable. a very worthwhile improvement.

Apparently somebody at medicare judged this flexible tip to not be a true coude, (or maybe some american manufacturer was able to lobby medicare with that concern, to protect their market share)(I am just trying to understand how such an ignorant position could come about)

anyway, I did have one experience early on with confusion about coude orientation which was painful. (the ony pain I have ever experienced in my CIC career), and so I totally agree that I would not want to use a flex pro, with a coude that could get oriented the wrong way, because of the flip floppy ness of the insertion process.

Carrying around a bunch of speedicaths can be a little challenge . I have a small backpack that I take on hikes etc, and I put them in a cloth sheath in my pack.. for going out to a restaurant, I fold them in half, take 2 if necessary. When I go hiking, I take some sandwich bags and put the used ones in a baggie which I bring home. Stopping at gas stations I have gotten quite nonchalant about leaving them in the trash.

Hi Howard,

When you reference coude tip and straight catheter I assume you mean just a regular catheter as the coude is bent, correct?

I only get small voids in the AM when bladder is holding I'm guessing over 700ml.

And thats not every AM.

Every so often maybe once every few months I'll get up in AM and have a good natural void standing with good stream. I don't keep a diary but last time i tracked for a week my volumes ranged as low as 225 ml to 525ml. I try and keep my fluid intake around 2 litres. I have a distended bladder and large diverticulum which was discovered looking for something else. I didn't realize I was having any retention issues as was healthy and voiding okay. I just had a urodynamics test done this week and they put 800 ml and i didn't go. Only good thing is they said there is still pressure in bladder so its not totally shot. Preliminary is its the prostrate is obstructing. Unless prostate has grown (2016 measured 36cc with ultrasound) its not a large but a tight prostate which Uro said was a possiblity before test. Now where to go from here. As much as I'm okay with doing actual CIC I hate the somewhat restrictions or inconvience when travelling. I turn 59 this year.

Brad

Hello,

I still have not gotten comfortable with doing CIC in public but have done a few times.

I put cath back in package, roll up and then tape so can dispose of.

Have you had any signs of improvement with voiding on your own?

Do you have any other options?

THX

Hi Brad - Yes I use the straight Speedicath catheter with a coude tip which is essential to get the catheter past my very large (300cc) prostate. For public use I carry everything in a gym bag so it looks like I am going to the gym.

I think if your prostate is so small and you are still having voiding problems it is important to know for sure if your voiding problems are due to the prostate or a neurogenic bladder. Sometimes men get their prostate size reduced by various procedures only to find that they still cannot void properly because the problem was their weak bladder muscle.

With small prostates often the problem is a median lobe that is obstructing the bladder neck and/or a urethral stricture. These can be determined by a flexible cystoscopy which is easy and quick. If you do have a weak bladder muscle then CIC can strengthen it over time if you try to keep your total void volumes under 400cc. I've done this and it has increased my natural voids from a trickle to about 200cc. The idea is that if your total voids are greater than 400cc you need to increase your number of CICs until it is less than 400cc. You need to keep a daily log for this. Good luck. Howard

Brad79016,

Doing CIC in public is not a problem for me because I go in a toilet stall, and close the door.

Voiding on my own: I have bladder diverticula

which make my bladder pressure weak. I haven't attempted trying to void on my own for a while.

I had a PAE wit Dr Bagla, which didn't do anything. I plan to get another urodynamic test and see if there is potential for another PAE.

There are other procedures emerging.. (steam?) but for me the pressure issue is the first thing to determine.

I have not found the mild restriction to be a big deal while travelling.

Of course you need to plan ahead , and if travelling ,be prepared for lost baggage etc. I go skiing etc. no problem.

Hello,

You sound similar to me. I have a distended bladder and a large diverticulum.

There is some pressure still in bladder but don't know what numbers are or what they are as a comparrison to normal. I've been 4x/day since April 2018. Started at 2x went to 3x. I guess its forcing yourself to get use to these changes and life's bumps in the road. I'm just not great at dealing with some of these things. Hard when all friends around are okay. You seem to be dealing with it great. I had uro dynamics test done last week and couldn't void with 800 in bladder but don't know how much went to diverticulum . I'll find out pressure results shortly. Is your bladder okay?

Have you looked into having diverticulum removed?

Hi Howard,

In the AM and night I use olive tip and add lub. During the day i have been trying the speedicath straight tip. In Ontario coude tip is crazy money. I think using two different caths is okay. More of a cost thing. Since i hold cath few inches below funnel and need to squeeze more on speedicath to keep grid due to prelub if that is causing odd flow from cath. Today urine came out but was really like a spray and made a bit of a mess. Thoughts?

THX

Hi Brad - May I suggest that you contact CCAC( Community Care Access Center) for your region in Ontario and speak to someone there about arranging a home visit with a continence nurse. You do not need your doctor's permission to do this - you can just set it up yourself. You can check online for the phone number in your region. Their home nurses are really good at self-cathing and they carry a lot of supplies for free and can help you get coude catheters at low prices. Also the home visit is free.

Regarding the technique, I also use Speedicaths with the green funnel on top. I keep my fingers on the green funnel and never ever touch the plastic portion for fear of contamination. I use jimjames "dive bomb method" for getting the catheter started. This just means I lean way back and open the meatus with my thumb and index finger on my left hand and then drop the catheter straight into the opening holding the green cup. It takes a little practice but once you do it is easy. Make sure you first clean the tip of the penis with a good cleaner.

Once the catheter tip is in a few inches I straighten up and then gradually lower the catheter while gently inserting it until it is horrizontal. By then it should be 2/3 of the way in. Then I lower the catheter all the way down and push it UP the rest of the way until the pee flows. This way you follow the geometry of the urethra.

Also while initially inserting the catheter I keep my right hand index finger over the cup to help stabilize it while inserting. This keeps it from flopping around.

Good luck. Howard

Hi Howard,

Thank-you for the information and time. Do you think there is any problem using two different types of caths? The olive tip that is not lub'd is really easy. Just not great if away from home. I have not tried Speedicath with coude tip yet. Online straight tip is $ 116 and coude is $ 210. Right now I'm covered by insurance but if retire coverage will be gone. Thats why i was hoping straight tip would work.

Don't have any problem getting straight tip Speedicath in, just noticed the spray thing and sometimes abdomen feels a little sore after but wonder if thats tension or just something else as there is no discomfort inserting. Are CCAC nurses better than nurse, that work in hospital urology? I must admit when i was taught a year ago I think i got more info reading the net.

THX, Brad

Hi Brad - Yes the CCAC nurse is better than a hospital nurse if you ask for a continence nurse since this is their specialty. Often they were hospital nurses that retired where they specialized in urinary issues so they are very good. I had one help me early on and it is all free. they are great at helping you with supplies and insurance issues in Ontario.

I don't see a problem with using 2 different catheters each day. When I travel I put my straight catheters in a mailing tube and then put the tube in a gym bag along with the other supplies I need like cleaning swabs and paper towels and a plastic bag for the waste which I bring back home with me.

The coude tip is important if you have a large prostate like I do (300 cc) or if you have urethral constrictions where the catheter tip could get caught. Initially I used a straight tip but it would pierce my prostate and cause a lot of pain and bleeding. With the coude tip it navigates the urethra easily as long as I go slowly and never force it. Have you had a flexible cystoscopy to check for any constrictions in the urethra and the bladder neck (like a large median lobe)? Also I take D-Mannose every day to help with any UTIs.

Good luck. Howard

my urologist mentioned that would probably be necessary, i have 2.diverticula. and then he thought i would need a prostatectomy, instead of another PAE.

first i need to get a urodynamic flow test. im not excited about the surgery, so i have been stalling.

he is an advocate of CIC , and I'm happy i stumbled on to him. i haven't had an infection for over a year. but i know what you mean, it would be great to not have to use .catheters. i have to say withe speedicath there is never any pain, so its not so bad.

Hi Howard,

Thx for the advise. I have had two cystoscopies and both times there was no visual obstruction. However two uro's explained that they cannot always see an obstruction but need to do the uro dynamics test to tell if there is an obstruction.

Local Uro is waiting for test results to see what pressure if any my bladder has. We know its distended and there is the diverticulum. Did/do you have distended

bladder ? You say you have gradually started to get more natural voids? I get concerned i'm past point of no return. I guess 2 and 3 times a day probably didn't do much to rehab bladder and maybe only started when i moved to 4x a day in April so really not a year yet. Was hoping to see more positives.

Brad