Questions To All The Intermittent Self Catheter Veterans

Any particular lubricant you could recommend? I do not want to irritate let alone cause any trauma to my already damaged urethra.

Passion is the brand name. I buy it from amazon. Hank

Hamza, K-Y lube is a good one. I use Walmart's brand, Equate, it's the lowest cost.

I used HR pharma lubricating jelly 5 gram foil packets and it worked quite well.

Do you guys apply the jelly all over the catheter or just at the tip? Should I apply a bit of jelly to my urethral opening and wait for it to come to effect before I insert the catheter? What size catheter do you guys use? I am getting the LoFric 12Fr catheter. Since I got stricture, I am scared even 12FR might not go through my urethra.

I apply the lube to almost all the catheter, except for the funnel and 1

or 2 inches next to it. You don't need to wait for the lube to work. 12fr is a good starting point. With a stricture, you might need to go lower. Hank

Hamza, The Urologist who showed me how to use catheters squeezed some lube on a paper towel or gauze pad and twirled the end of the catheter (about 3 inches) in it. I still do the same although sometimes I lube almost the whole catheter. I used to lay them out on a paper towel to dry after cleaning. Later I made a hanger to hang them after cleaning.

When I began doing CIC, I didn't read the instructions for each brand of catheter which meant I didn't wait long enough/waited too long after breaking the water satchel in the package. Even after rehydrating the catheter properly, I found that sometimes first 2" or so of my urethra would lose lubrication and the catheter would "bind" during the last inch or so of insertion. I'd add a packet of lube (carefully) to the 2nd half of the length and it was fine albeit a little messy with extra lube dripping off. That's ok, I'd rather have comfort over irritation. I used 16Fr (16" long, coude tip) and didn't have trouble pushing it through an enlarged prostate.

I got used to cathing into a plastic measuring vessel that was in the sink. By relaxing and just gently pushing the cath towards the bladder, breathing calmly, I didn't have much problems.

What scares me is UTI, I don't want UTI at all. That will further aggravate my problems. Did you ever have catheter-induced UTI? How did you deal with it?

I am using Nelaton tip catheter. My prostrate is just 19 ml which is probably normal considering my age, but I have really small bladder opening. I wonder how I can get it past the bladder neck. Also, did you ever have catheter-induced UTI? How did you deal with it?

I found that for a Foley catheter being inserted at the hospital or with a catheter installed at home, it was important to relax and the catheter went into the bladder without much effort, sometimes I had to rotate the coude tip a bit to get it through the IUS/bladder neck. Yes, I had a really bad UTI during my time doing CIC as I found myself cathing 6-7 times a day. I had a lab test done to prove the UTI and was given antibiotics which resolved the issue. I was trying to be very careful not to introduce bacteria up into the bladder by keeping everything clean. This is common from what I've read.

I never had a UTI during my 5 years of cic. Just use common sense and don't let any dirty bacteria from getting into your urethra via the catheter. When I suspected something dirty got on the catheter I either discarded it or disinfected it with some alcohol. The easy way to do it is rubbing your fingers with some alcohol before you do the cic. Hank

I am going to ask you some questions. I hope you won't mind answering. 😅

What size catheter are you using? What brand is that catheter? How long do you reuse each catheter? Nelaton or coude tip? Thank you for your time. 😃

I am now using mostly Coloplast speedicath size 12 coude tip, one time useable hydrophilic. Up until a month ago I was also using Lofric Primo size 12 coude tip, also a one time usable hydrophilic.

The last time I used a reusable catheter was about 4 months ago, it was a Cure M12C made with natural latex. I prefer it for a reusable catheter. It is very smooth and stiffer than the red rubber catheters. When it is lubed with a water soluble lubrication it can be inserted all the way without touching it, which is more sanitary. It also has a blue line down the length of it, which helps with the alignment of the coude tip. Medicare and my Medicare supplement insurance cover the cost of my catheters.

Thomas

Hi Hank and all

Just started getting notifications again, so I wasn't here for a long time.

I think that the position at which I hold my penis and insert the catheter is important. I hurt myself once. The catheter seemed a little sharp on the end but I think I didn't lower my penis sufficiently to a more horizontal position while pushing it in. I use Cure hydrophilic catheters fr14. They seem about right for me. I tried samples from the suppliers until I found the right ones that worked best for me.

I start with my penis pointed straight up with my left hand and then spread the metus with that same hand then drop the end of the catheter in. I didn't use the little glue thing on the back of the packages on each catheter to hang it up first, if there is something to stick it to. My wooden cabinet door works fine. Then I can hold myself in position with my left hand (I'm right handed) then reach the pre-opened catheter, pull it out and drop it in. But I have to lower the penis when I am get it about 1/4 of the way in. It goes in much easier if it's pointing about 90 degrees away from you.. straight out or slightly down. I don't worry too much about taking it out. I go kinda slow but not as carefully as when I put it in.

Welcome back Keith. 😀 You are right. How to position the character on the way in is very important. I dropped it in exactly like you did and usually about halfway through when I feel resistance I lower it either horizontally or even pointing it downward.

I no longer use hydrophilic catheters from Cure. They seem to be sticking inside the urethra at times. Instead, I use Cure non hydrophilic catheters with external liquid lube. The liquid lube seems to more slick and works better for me that way. I do not use gel lube because it is usually to thick and causes the catheter to stick to the urethra. Hank

Perhaps you got an old box of Cure catheters. I've had some that seemed to stick as you say, but for the most part they don't do that. But I know what you are talking about.

I'm getting to the point, I think, I'm going to have to do something different. My PSA level keeps going up. I get an annual medicare physical. Last year it was @7.5 and this year it's up to 8.5. They ordered another visit to urologist and I know he is going to want to do a biopsy and a TURP. I've been doing intermittant catheterization now for about 4 yrs. I'd like to continue a watch and wait strategy; its working fine for me. If it just wasn't because of the damn PSA blood test thing, I could probably do indefinitely. I'll turn 70 the end of this year. I understand that average PSA level for someone my age is @6.5. I think one time it was even higher than 8.5 but went down one year to 6 or something I also understand that cathing or sex or anything that irritates the prostate can cause that blood level psa to spike.

At the same time, I have to say that the cathing is not improving anything much. I definitely have more feeling in my bladder and notifications when it's time to pee (I used to have to go by the clock because I had no feeling). So except for that improvement, my BPH is not getting any better. I had some hope that strengthening my bladder might rehab it. I definitely have a blockage and have to get at least 300 ml in my bladder before I can naturally pee, and then it's just a dribble. At least if I do that, I feel I don't have to use an alcohol wipe or something cause I drop it right in. The doctor says my prostate is "not that big" and the urologist, doing his own digital exam, says it feels smooth and not bumpy. So I guess that is good. What do you think Hank, in you unprofessional opinion. Should I let this one sort of iffy blood test lead me into doing a TURP and/or a biopsy? It sounds like quite the ordeal

​Hi Keith, I would not worry about an increase from 7.5 to 8.5 and would keep retesting it every few months instead. Percentage wise it's a small increase, and I've read you should worry if it doubles in 6 months.

Yeah, I must have had a bad box, because I don't remember the sticking before this box.

My self cathing is not improving my retention either. I don't think it's supposed to help, other than keep your bladder and kidney healthy.

Hank

Keith,

Your story is very similar to mine. I have been self catheterizing for 3 years now. I noticed an increase in my PSA when I started using catheters. It went from about 3 to 5. After a couple more years it went to 7.5. My doctor wanted to do a biopsy. I went to a local MRI center where they said I could get Medicare and insurance to pay for it if they checked the appropriate codes and I would get my doctor to sign it, which he did. I had a prostate MRI specialist at Stanford Health Care look at it and he did not find evidence of cancer lesions. After 6 months I had the PSA checked and it was 5.5. We checked it again in another 6 months and it was 6.2, The doctor was not concerned and recommended to check it in a year. By the way TRUS measured the prostate at 75 cm and the MRI measured it at 100 cm.

A better measurement to use than PSA is PSA density, which takes into account the size of the prostate. Even for a PSA of 7.5 my PSA density was 7.5/100 = 0.075. PSA density less than 0.1 is considered OK.

I suggest you find out the size of your prostate by TRUS or more accurately by MRI then calculate PSA density. If you get a 3T MRI it can also be used to look for cancer instead of biopsy, if there is evidence of a cancer lesion you can have a targeted biopsy that uses only one needle instead of 12 or 16, and is more accurate.

Thomas

do you mind me asking hiw you got your stricture. was it from cic?