New to Self Cath

Posted , 12 users are following.

I went into acute retention 2 days ago. In a month I will have my PAE and was hoping to make it. My prostate is 300 gm but no median lobe or bladder neck obstruction - just constriction of the urethra.

My lesson was so humiliating and painful though the nurse was very kind. There was some blood and lots of burning. Fisrt she tried a 16 but would not go in. The 14 did go in and the pee came out through the catheter and around it. I have not tried it again but will need to tonight. Can anyone offer tips to reduce the discomfort? Don't I just irritate the urethra even more and make retention even worse so I will never be able to pee on my own? And I so worry about getting an infection. Thanks

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  • Edited

    I've been self cathing for a while and have decided that, for now, it is my best option.  Speedi-cath compact male seem to be the best ones for me.  The first half that goes in to the bladder and pushes past the prostate is 12FR size.  The second half which stays below that area is 18FR. 

    You really do get much better with practice.  I've also had it come out around the catheter when I had not inserted it far enough, had not emptied copmpletely before withdrawing it or let the urgency build up too much before catheterizing. 

    With regard to not being able to pee on your own, presumably you're having that problem to some extent now.  I just try to pee naturally as much as possible but do not let it build up past the point where the catheter volume is greater than 400-450cc's.  My urologist said if it's more than that it's straining the bladder too much and if it's less than about 200cc's, then you're not giving the bladder the chance to perform it's natural function.  So the catheter volume should be between 200 and 400cc's.

    I had the PAE without much success; however, you are a much better candidate than I was because, although my prostate was only in the 50's, I have bladder neck obstruction from an enlarged median lobe.  It appears from this forum that the PAE is much more successful w/ larger prostates than with not so large ones with enlarged median lobe.

    PS  stay away from the Foley - i did that for  2 1/2 months and really regretted not learning to self cath sooner.  CIC is much more natural w/ less chance of infection.

    Best of luck!

    • Edited

      Thanks for your words just started CIC this morning and your advice really helped. Good to know there is help and reassurance on this forum. I have underactive bladder stemming from the prostate issues and urinary retention.

  • Edited

    What brand of catheters ?  If rubber, burn them and get something sensible like coloplast speedicath. If you have to activate them by squeezing a packet of water, allow at least 60 seconds, during which you should invert the catheter a few times. If self-lubricated, well they should be ok.

    After acute retension, your whole bladder and urethra and prostate may be inflamed, which is why it is hard to pass the catheter. This will ease over a couple of days or so. Also however slippery the caths are, your urethra will possiblly resent having anything stretching it, but will soon get used to it.  Just hang in there !!

    • Posted

      Additionally, little danger of infection if you take care to (1) always wipe the head of your penis first (2) never ever touch the part of the catheter that enters.

      If after a while, fr14 still cause any discomfort, swicth to fr12 size. It is best not to start at fr12 because they are so thin and flexible you need to have already mastered the knack of feeding them in.

      You also may find it easy to pass, but always hard to get past the obstruction of the prostate. The solution to that is tiemann (or coude in some countries) catheter, which has a failry pointed tip which leans to one side. Provided you put them in facing the right way (with the pointed tip leaning towards your body) they can get past obstructions easily.

    • Posted

      I'm not clear what you mean by "towaRd your body ".

      Neal

    • Posted

      Imagine the tiemann cath held ready to insert as if it was your arm and hand hanging there with forefinger extended. Now bend your finger to point towards yourself.

      That is what the catheter should look like.

    • Posted

      I'm sorry if I'm being dense, but is the tip of the curve of the catheter rotated so that it points toward your belly button, or toward your rectum. This is important to those doing it.

      Neal

    • Posted

      Thanks Neal and gbhall. I had a terrible time last night with the Coloplast speedi cath (14). It went in ok up to the prostate but was too slippery to push past. I am 300gm with no bladder neck obstructions but the urethra is really squeezed down at the prostate. I then tried the Magic 14 and with much effort got it through but I was dripping blood all night - oh my! Should I go to 12s ? Or should I Coloplast 14 Coude or Magic 14 Coude? Thanks guys.
    • Posted

      As I said, 12 is too small and flexible (spaghetti someone said), for learners. But you definitly seem to need the tiemann tip, which was developed especially for this purpose. However it is not generally prescribed because it needs tobe inserted the right way round, otherwise it is possible to cause some damage.
    • Posted

      Let's try again. Imagine the cath is a long, thin letter J hanging directly in front of you. Then the bend at the bottom of the J must point straight towards your body.

      Can you imagine the route your urethra takes ? It goes down, then bends backwards and bends again to come upwards again before passing through the prostate. Now it should be obvious that the tip of the catheter should stay on the INSIDE of the bends.

  • Posted

    Post TURP surgery, I ended up in the ER for the same reason.  Doctor's gave me no help in instruction or even an order for the cathethers.  On YouTube, I found a helpful video.  Then I cajoled a local medical supply place to give me the supplies I needed.  It was fortunate I had them as I have several more blockages due to swelling.

    This site doesn't allow links, but:

    go to www (dot) youtube (dot) com (slash) watch?v=3rwpNNjXxj0

    to see a video that was helpful to me.

    The important thing is to use the catheter before you get into severe pain.

    Goo luck.

  • Posted

    Hello everyone - I just want to thank those that have responded to me so far from the bottom of my heart. I will have to cath tonight by myself and you give me some courage. The catheters the nurse used were lubricated where a little bag was first burst but she did not shake it afterwards. But when I left the doctor's office they give ne a box of Coloplast catheters which are already lubricated (size 14 ). i will try that one tonight. Does anyone take any pills to reduce the burning or pain from the catheters? Thanks again - you are a wonderful support group.

    Neil

    • Posted

      No problem.

      I don't take any pills but it does get easier as you practice.  Sometimes it needs to be gently prodded to find its way - but should never be forced. About 1 in a hundred times I just feel like its not happening and I through that catheter away and start over.

      I do wash my hands thoroughly before and after and put an antibiotic ointment on and around the opening after to help prevent infection.

    • Posted

      Thanks arlington. A couple more questions: Is there any danger of damaging the internal/external sphincter muscles with the catheter? Also do you ever get blader spasms from the catheter? Thanks.
    • Posted

      Neil,

      When I started self cathing, my uro had me take AZO (Phenazopyridine Hydrochloride). The medicine will turn your urine bright orange. It's supposed to help with pain and burning.

      I had a difficult time getting started self cathing (CIC), and found a lot of useful help on a thread on this site: patient.info/forums/discuss/self-catherization-an-alternative-to-turp-greenlight-holep--336874In the beginning I also had urine leak around the catheter while doing CIC. My uro's nurse thought it was due to a bladder spasm while cathing. I always try to void naturally before I CIC.

      As some have mentioned before, be gentle when you're CICing. Hang in there, and you'll be able to do it, too. It took me several weeks before I started to master it. I still sometimes have questions about CIC, but this forum has been most helpful.

      Stebrunner

    • Posted

      Thanks stebrunner for your response. The link is great and very helpful and  educational. Good luck to you.
    • Posted

      not that i'm aware of

      better to back off if too much resistance rather than forcing it

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