Post Rezum - Week 3 -
Posted , 9 users are following.
Went back in today for second void effort since procedure. All was well for the first 6 hours after catheter removal. Bladder pressure started building up after that and I made it back to the Uro right before they closed. Nurse reinserted catheter. No blood no clots. She will recommend to doc that I do self cathetering until bladder can be retrained. Is there any trick to doing it yourself, or is it pretty simple?
Thanks for any advice.
0 likes, 18 replies
keith42667 james88935
Posted
Both. Its simple but there are "tricks". If money is not an issue then hydrophilic ones are easiest to use IMO. It eliminates the step of having to lubricate manually. You just open them up and use them. Depending on the brand, some come with a separate package inside that you break open prior to opening the main package with the catheter itself inside. I use the coloplast fr12 which works for me. Most people seem to like to at least start with an fr14. I can use the 14 but the 12 works as well, just a little slower but I figure the smaller the diameter the less trauma.
It took me about a week to literally get the hang of it. I do it standing up over the toiletl Hold penis almost vertical with left hand if you're right handed, and try to open up the hole enough so that you can hold the catheter above it with the other hand and "dive bomb" it slowly into the hole. After inserting it for about 6 inches, hold the penis out horizontally and insert further until you feel resistance. For the last couple of inches drop the penis downward as you insert the rest of the way. Once you get it in, you see and feel it start to drain. Depending on how much you're retaining, it takes from 20 to 30 seconds or less. Pull it out slowly at first to make sure you've got it all out. Its just like siphoning gas from a tank. You'll feel it sucking the pee out.
james88935 keith42667
Posted
Thank you Keith,
Your description is pretty graphic which makes it easy to visualize and I appreciate that. I am a bit apprehensive but after being catheterized with a 24, 14 doesn't sound too bad. They told me the 24 was for draining clots only so now I am wearing an 18 again which I hardly felt during insertion. It was very discouraging to pee decently on my own for six hours only to rush back to the doctors office in high discomfort after the flow stopped completely.
So did the self cathetering help to train your bladder too pee normally again and how long did it take? I have been on the Foley for three months now and they say the bladder muscles can forget how to respond to the urge. I am 72 years of age now and it seems like it takes me longer to heal now but maybe I've become paranoid.
Thanks for your help and advice.
keith42667 james88935
Posted
<<So did the self cathetering help to train your bladder too pee normally again and how long did it take? >>
It is helping. I've been doing cic for about 22 months. When I started I was retaining approx. 400 ml before I even got an urge. Now I start getting urges much sooner (that is, suddenly having to hold it back or go to the restroom) but I can't always get anything out or can just get out a few drips. After all these months something is changing. I understood going in that many urologists say once the bladder gets stretched the way mine was it cannot be rehabilitated. Some here have proven that wrong. At this point, I beleive that, if I live long enough, I probably have some operation in my future to open me up, but I haven't seen anything yet that is available to me locally that I would venture into. Good luck in your recovery
james88935 keith42667
Posted
Keith42667,
I was surprised to read about the 22 month time frame. Did you have a prostrate procedure prior to your bladder condition? Is there any type of surgical procedure available to correct a stretched bladder? I hope your path to improvement continues and thank you for your response.
keith42667 james88935
Posted
Both. Its simple but there are "tricks". If money is not an issue then hydrophilic ones are easiest to use IMO. It eliminates the step of having to lubricate manually. You just open them up and use them. Depending on the brand, some come with a separate package inside that you break open prior to opening the main package with the catheter itself inside. I use the coloplast fr12 which works for me. Most people seem to like to at least start with an fr14. I can use the 14 but the 12 works as well, just a little slower but I figure the smaller the diameter the less trauma.
It took me about a week to literally get the hang of it. I do it standing up over the toiletl Hold penis almost vertical with left hand if you're right handed, and try to open up the hole enough so that you can hold the catheter above it with the other hand and "dive bomb" it slowly into the hole. After inserting it for about 6 inches, hold the penis out horizontally and insert further until you feel resistance. For the last couple of inches drop the penis downward as you insert the rest of the way. Once you get it in, you see and feel it start to drain. Depending on how much you're retaining, it takes from 20 to 30 seconds or less. Pull it out slowly at first to make sure you've got it all out. Its just like siphoning gas from a tank. You'll feel it sucking the pee out.
TKM james88935
Posted
James,
When you are starting out you might use a softer more flexible catheter like the Bard Red Rubber type size 14 or 16. If you have enlarged prostate you probably want the coude (bent) tip. With the Red Rubber type you have to lubricate it your self with a water soluble jell, KY Jelly, Surgilube, or McKesson. You can wash and reuse them . I have used them up to 4 weeks with no problem.
Another good starter cath is Bard Magic 3 size 12 or 14. It is made of silicone, so it is softer and more flexible. It is a pre-lubed hydrophylic type. The hydrophylic catheters have an electrically charged surface that attracts water to it. If you can get a prescription from a doctor, most insurance will pay for the catheters. After you have used the starter caths for a week or two you can advance to Speedicath. Lofric, or other hydophylics.
I use providone iodine to wash the tip and opening of the penis. It kills germs without irratating the urethra. You can apply it with a paper towel, but a sterile gauze pad may be better. I get 2x2 inch size from Walmart $2.59 for box of 20.
Be watchful for UTI (Urinary Tarck Infection) when starting out. The urine may be cloudy and smell bad, or you may start having fever. If these things happen see a doctor ASAP for testing and possible antibiotic.
You can buy Siemens MultiStix 10SG srips from EBAY, to test for UTI, in order to get a head start on any urinary infections.
Thomas
james88935 TKM
Posted
Thank you for the advice and information. Did self cathetering help you to get back to normal peeing and how long did it take?
Thank you
TKM james88935
Posted
James,
I have been using catheters for 8 months now. In the beginning I would normaly get the urge to go at 400ml and empty 400 to 480 ml. After 3 months I would get the urge as low as 150 ml and PVR is usually 200 to 240 ml. So the bladder has definitely shrunk. I think if I had a prostate procedure, I would probably still have some retention but not bad. It seems like the bladder is similar to a stomach, where if you reduce your eating your stomach shrinks and you feel full sooner.
Before cathing I was taking double dose of Tamsulosin. Then while cathing I stopped Tamsulosin for 3 months, and was in retention except for cathing. I started back on single dose Tamsulosin so that I can postpone having to cath until I can find a suitable place.
Thomas
james88935 TKM
Posted
I had the Rezum procedure done 3 weeks ago. Went home with an 18 Foley catheter for two weeks. It was removed and I peed ok for three hours and then stopped. Rushed back to doc and they put a 24 in me and irrigated my bladder draining a large amount of clotting. Had the 24 in for one week and they removed it. No clots but I stopped peeing again after 6 hours this time. Returned to doc again for another 18. They are evaluating me for CIC next week. On flomax as well for three months now. I was wondering if it was normal for heavy blood clotting in the bladder after a prostrate procedure?
raffie james88935
Posted
James:
There are also numerous how-to self-catheterization videos out on youtube
Regards,
Raffie
arlington james88935
Posted
It's pretty simple - just takes some practice. I had a nurse teach me in 10 minutes. Be sure to try to pee naturally each time before inserting catheter (this helps reduce pressure/urge while inserting catheter). Apply gentle pressure but never force it. Gently pull penis straight (and mostly pointing up) w/ your other hand. I find that it then helps to go in easier if you lower penis once the catheter is most of the way in. Coloplact speedicath male compact catheters have worked best for me. The key is to be gentle and when in doubt - go slowly.
There is much more detailed info. from JimJames somewhere on this forum.
Best of luck!
james88935 arlington
Posted
Thank you for the information. I will continue to search. I'm only 3 weeks post Rezum and have a lot to learn. I never imagined it could get this complicated. My optimism is waning a bit, but good luck to us all.
ken19524 arlington
Posted
Arlington, I agree with your advice 100%.
I wish that Rezum urologists would recommend self-cathing after the procedure. There are far too many stories on here (and I'm sure many stories that don't get told) about having to rush back to the office or an ER to get re-Foley-ed in the first few weeks. They don't seem to recognize or appreciate how much of an issue it can be when the prostate tissue swells after the Rezum procedure.
james88935 ken19524
Posted
I also had blood clots in my bladder post Rezum blocking urine flow. I forgot to ask how clots get in the bladder from a prostrate procedure? I am not totally familiar with the anatomical plumbing involved, but i would think gravity would prevent clots from traveling upward into the bladder area?
ken19524 james88935
Posted
James, I'm afraid that I don't understand that either. The only thing that I can think of that might have caused blood clots in your bladder is possible irritation or injury from the Foley catheter since it was the only foreign object in your bladder. I agree that it's hard to visualize blood getting up and through the bladder sphincter. Now that I think about it some more, I can see where blood clots in the urethra might have been pushed back up into the bladder by the insertion of the Foley.
james88935 ken19524
Posted
Yes Ken. The catheter must have something to do with it. All I know for sure is I never expected this to happen nor was I able to anticipate being on the Foley for three months from my initial episode of AUR. I hesitate to leave town for any type of travel and have canceled vacation plans in March due to the uncertainty of my condition.