Problems getting my catheter after 4 years of CIC
Posted , 11 users are following.
It has been almost 4 years now since I started CIC due to my very large prostate (300 cc). I CIC 3 to 4 times a day and still have a good natural void in between because I do not have a median lobe or other bladder neck obstruction.
Other than a few UTIs over the years I have never had any problem doing CIC - until a few days ago. I use the Speedicath 14fr coude hydrophilic catheters and always add a little lubrication to help. No other catheter has worked as well as these.
So a few days ago I must have nicked the prostate during entry. That is the problem when we get too complacent with CIC - every time is like a new time requiring full attention.
There was some pain and a little bleeding then. But now the problem is really getting bad. The prostate side lobes seem to have swelled up from the nick just enough to block my normal voids and make getting the catheter in difficult and painful.
There is no problem getting through the upper part of the urethra but as soon as I hit the prostate it is like hitting a wall. Every time I CIC now I seem to re-injure the original injury so there is a little blood when the flow starts. It quickly clears up and when I pull out the catheter there is always a little blood in the lower part.
So I don't see how this original little nick can ever heal when I keep irritating it and cause it to bleed every 8 hours. And there is so much discomfort afterwards too for a few hours.
I do not have a UTI as the urine is clear. But I worry I am in a catch 22 because I need to give the injury time to heal but I cannot do that because I cannot do a NV do the swelling.
I've taken some NSAIDs to try and bring the swelling down and that helps a bit.
Any ideas out there from your experience would be greatly appreciated. Thanks.
0 likes, 61 replies
stome Howard31850
Posted
Why the prostate grows on a BPH Site is eating to much red meat and dairy products.
Howard31850 stome
Posted
What about eggs?
HowieF Howard31850
Edited
No, I didn't have any bleeding associated with the pushing and pulling. The only issue I had was pain. It depended on the skill of the nurse (some were not used to doing catheters, others were experts). In one case, I had a large Foley in me and the nurse was trying to remove it but it got "stuck". She did the push/pull thing over and over each time the pain was horrendous (definition: approaching the point of blacking out or seeing streaks of light) each time she tried. She said she was going to get a doctor. Meanwhile, she came back with another nurse who also tried pushing and pulling with the same pain. Finally, they got a urologist who just tweaked it and it was out. Said that it was just the balloon wasn't fully deflated. Oy! There was no special bleeding as part of that and certainly nothing with my prostate. Would have been bladder bleeding. Even after my "accident" where I got the bag caught on something and I fell down, the pain was immense but the bleeding was all bladder neck (balloon hitting it).
alan86734 HowieF
Edited
Hi, Howie and others following this thread.
Stuck catheters usually occur with hydrophilic (self-lubed) catheters but I was not aware of hydrophilic Foleys being offered. Once we're into the "heavy calibers", i.e. greater than Fr-18, the lube is usually added manually by the operator. However, I have had these stick if they have been in for too long and the lube applied was a little on the lean side. In other words, more than one factor at play simultaneously.
My remedy is a small amount of saline or air, say 5 ml or so, injected down the catheter tube -- not the balloon tube -- gently, always gently, plus a little rotation usually gets things unstuck but, I am not a doctor so you do this at your own risk.
In case you share this with Staff, which I hope you do, PLEASE DO NOT WHIP A CATHETER OUT AS FAST AS YOU CAN! Fine for a hypodermic needle and perhaps even an IV cannula, but that is all.
And, if unsure always ask; how else are we going to teach ourselves?
Have fun, and warm regards. alan86734.
HowieF alan86734
Posted
Thanks for the post. In my case, the balloon got stuck. If you look at a Foley, the balloon section is a slightly rougher material than the rest of the rubber. In the case where my Foley was stuck on the removal, it had something to do with the balloon and not with the catheter itself. The nurse actually moved the Foley out a little before it got stuck. I did have one nurse pull a Foley out very quickly just prior to a cystoscopy, but that worked OK. It's really a strange feeling though. I never had the opportunity of removing my own catheter as some people have had. It was always a case that, either a new catheter had to go in, or there would be a void test involved. Plus, I'm a big guy and have limited visual ability in the groin area. So, I was not removing my own cath. A nurse was doing it. I think he just pulled on the syringe to deflate the balloon a bit more.
alan86734 HowieF
Posted
Hi, HowieF,
You are correct and I know I wrote about it quite some time ago. So I'll repeat the post, not word for word but the same meaning.
I had to go in for surgery unrelated to urology. I think it may have been for my open heart gig or even before then. The traditional Foley was placed following the instructions then in force. "Do not inflate the retention balloon until you see a spurt of urine." That event signals that you are into the bladder and it is safe to inflate the retention balloon, which the two ICU nurses carrying out this procedure started to do. I suffered immediate and excruciating pain followed a moment later by copious blood. Clearly something had gone horribly wrong and I was later informed that the participating women were not paying attention and had been duly reprimanded.
About a year and a half forward I began to suffer from urine retention. I finally convinced the "sages" to switch me from the chemical approach to C.I.C. using red rubber Fr-8 catheters if I remember correctly.
I carefully pushed this thing in and it went, and went, and went until the funnel did its best to follow the rest of the catheter into my urethra. True, in all fairness, I had gotten a bit of an erection by then, a common occurrence for me, but all I could think of were the two nurses who had been censured; they were obviously innocent and it was I who had the anomaly in the form of an extra-long urethra!
Round about that time the insertion rules for Foley catheters were amended to read:"....insert until the catheter 'Y' is pressing firmly onto the patient's meatus." Incidentally, I took care of the stricture and scab tissue left in my prostate by passing successively larger catheters; I am now at Fr-18.
Hope this helps; Foleys can be tricky!
Warm regards, alan86734.
Howard31850 alan86734
Posted
Thanks Alan for your reply. I appreciate the time you take to write the details of your ordeal. This is the only way I can learn about the pitfalls of Foleys as I get no help from my urologist.
My visiting nurse has ordered a Coude Foley for me for Monday but wants me to put it in myself. She will then hook it up for me. I hope it goes ok and is easy as my Speedicath coudes used to be. I don't want some stranger pushing the catheter which could end up making my problems worse.
Do you have natural voids ok now?
Thanks again for helping me.
Howard
HowieF Howard31850
Posted
Actually, I've never heard of a Coude tip in a Foley until someone in one of these threads mentioned it and I had to look it up. It's one thing if you are talking about a straight catheter like the kind you use for CIC, but a Foley is like a flexible noodle and I can't imagining needing a Coude tip on one but, lo and behold, there is such a thing. I've never had a coude tip on a Foley. I would NOT try to put it in yourself. It would be like trying to thread a string up there. But, remember that these are not devices that you can "reinsert". If you mess up, you have to toss the catheter and start over with a new one. I suppose you could but I was told by a nurse that it would be unsanitary. It's not designed to be removed and reinserted. It just stays "in". And, the ease that it goes in is, from what I can tell, based on the experience of the nurse or urologist. Sometimes they seem to go in easier and, I imagine, when to stop inserting the catheter (how far into the bladder) is the utmost importance as you don't want to inflate the balloon unless it is all the way into the bladder or you can damage the urethra, prostate or neck of the bladder. I was more than happy letting the professionals do this. But, if it's OK with the nurse.... what do I know. I was only a patient. There must be a YOUTUBE for that anyway. As far as "healing" goes, imagine a cut on your arm that is kept wet (water or urine). Urine is acid so a Foley, unless you spasm around the catheter, should let the wound dry a bit, I would imagine. I'm not sure how much "healing" can happen in a week... or even two... but, if your urologist thinks its a good idea they know a lot more than I do. As for inserting a Foley, I imagine there are different levels of "stiffness" but they are really very flexible. Somewhere between a wet noodle and a gummi.
Howard31850 HowieF
Posted
Hello Howie - Thanks for your reply. I appreciate the details as it makes it much easier for me to understand it and relate it to my own problem.
My visiting nurse said she had never even heard of a coude Foley or inserted one. But she called me yesterday and said she could order me 2 for Monday but she would not put it in for me and said I should do it myself since I have done so many. I called my urologist but he is nowhere to be found.
The nurse said she would show me how to hook it up once I inserted it so your post is very helpful as well as Alan's post here.
How are you doing? What is your situation? Do you CIC?
Thanks again and all the best.
Howard
HowieF Howard31850
Posted
No, Howard. I never CIC'ed. I was on Foley for a month and then had a TURP. No catheters any more (until the next time).
hank1953 Howard31850
Posted
Hi Howard, you didn't like it when I posted a while back that Coloplast Speedicath catheters are too stiff and might cause bleeding. You were such a defender for them 😀, most likely due to your personal success, which is understandable.
I had 3 years of bleeding with the Speedicath, until I switched over to Cure brand. Cure catheters are so soft, it is much better to stop the bleeding.
You might want to try them out. If one size noodles out on you, go to the next higher size. I found out that I can go many sizes higher with Cure. It took me several days for the bleeding to stop though.
Take care.
Howard31850 hank1953
Posted
Hi Hank - Thanks so much for responding here - I have been searching for your post for days!! YES - I apologize to you now for my being so adamant about my Speedicaths. You know the saying that "prides goes before a fall".
Can you please tell me more about your catheters? My prostate is huge at 300 cc but I do not have a median lobe or bladder neck obstruction. When I first started to CIC the straight Speedicaths wanted to pierce my prostate but when I switched to the coude tips they went in easily. I could not use 12fr as they were too soft and just bunched up like spaghetti but the 14fr worked fine.
So 5000 worked great but something went wrong with 5001!!
Can you tell me about your catheters please? Do they need a coude tip to get in? Will they bunch up? What size do I need? Can I do them standing up with one hand or are they the type you have to feed in with both hands while sitting? Any other info would be most appreciated.
Thanks again for writing in here. I've learned in life to brag about good things as it jinxes them!
Also how you are doing these days - we go a long way back. Howard
hank1953 Howard31850
Posted
Hi Howard, we might have had some disagreements and misunderstandings before but I always have much respect for your great contribution here on this forum, perhaps only second to Jimjames. 😀
I am doing great now with CIC so no hoLep for now. The bleeding is long gone together with some other unexpected problems including ED, RE, and minor incontinence. I am currently using Cure catheters straight 14fr M14 with my own lube. It comes with hydrophilic with a water packet as well. I tried 16fr and 18fr sizes and they both went in easily. Yes, I always use the dive bomb technique with all of them, no problems here. Also, coude works well but not as comfortable coming in, and more expensive.
I tried many other soft catheters and they also seem to work though not as comfortable as Cure. Gentlecath and McKesson are the two names that I remember. I even copycatted Jimjames and tried a red rubber yesterday. It did go through but I couldn't dive bomb because it was way way too soft. I don't see how one can injure himself with these red rubber.
With these Cure catheters it's easier to insert too. I remember you published a book 😀 on how to insert a Speedicath. Yes, I did use the book and it did help me for a while. Now with Cures, it's much simpler. I drop the catheter in straight down for about half length. After that, at the point of resistance, I point it straight forward horizontally until it goes through. I
Hope this helps. Hank
Howard31850 hank1953
Posted
That is very helpful hank and thanks for the kind words. Us CIC guys have to stick together!
I will contact Cure on Tuesday and see if they will send me some samples. I will ask for the 14fr both straight and coude and non-hydrophilic as I add my own lube too. When I first started CIC I tried a straight and it pierced my large prostate and caused bleeding (4 years ago) but until now I never had that problem with coude. Do you think I would have the same problem with the Cure straight?
All the best to you and again thanks for answering me.
Howard
hank1953 Howard31850
Posted
I have good confidence that you'd be fine with Cure, coude or straight. They are so soft that a CIC veteran 😀 like you should not have any problems. It's just pure mechanical. When you 'hit a wall' , which catheter will more likely to cause damage if you decide to nudge it in further ? That is when the bleeding will occur, or not. A soft catheter like Cure should not 'pierce' anything. It will likely bend itself to the shape of your urethra and prostate, and move on in further.
I still try Coloplast hydrophilic occasionally and still experienced minor bleeding. I don't think that I am that different from others. Hank
Howard31850 hank1953
Posted
Thanks Hank. I look forward to trying them and will let you know. I ordered straight and coude samples. Howard