Quick Post Urethrotomy Question Regarding Self-Cath Procedure

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I just had a urethrotomy performed seven days ago. Following the surgery, I had a Foley catheter in for five days. I have now begun to self-catheterize using a 16Fr LoFric for the last two days as per my doctor's instructions. However, each time that I have done this self-catheterization so far, a small but visible amount of blood/tissue has been captured inside of the tip of the catheter (where the eyes are located) after it is removed (and some slight pain is felt during the process). My question is primarily whether this is normal and to be expected for the first few days/weeks following the surgery, and, whether I should simply continue to use the same catheter size and procedure. I certainly do not want to cause further damage to the urethra at the exact same time that I would like it to heal. I am waiting to hear back from my doctor regarding this question, but I thought I would post in this forum in case someone could reassure me that this small amount of post procedure blood/tissue is normal. Thanks in advance (and please refrain from letting me know that urethrotomy is inferior to urethroplasty, etc...  there is nothing that I can do about that at this time and I am trying to be optimistic that as long as I stick to a self dilation regime, I might be successful).

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  • Posted

    Hi Vansos,

    I'd say it was quite normal so soon after an op. It certainly happened to me, and has happened since on an occasion when I had picked up a particularly nasty infection. A change to a smaller catheter might help, I think. I moved down from 14 to 12 qjuite early on in my self-catheterisation, and have been on 12s ever since, about 11 months now.

    I self-catheterise about four times a day - my bladder has packed up and it's the only way i can pee at all now. That frequency of self-dilation has certainly kept the tubes clear - I had a meatal stricture opened up by dilation under general anaesthetic about ten seven months ago now, and it has not recurred at all. Are you self-cathterising purely to dilate, or also to urinate? How often has your doctor instructed you to self-cathetrise?

    I am pretty sure the blood is nothing to worry about. The urethrotomy will heal in time and it's important to keep dilating while it does so, to discourage the stricutre from narrowing the tube again. But keep us posted on how you get on and what your doctor says. By sharing our experiences here we all get to understand our own situations better!

    Best wishes,

    Colin

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    • Posted

      PS Apologies for spelling errors! It's 2315 here!
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    • Posted

      Thanks Colin.  Appreciate the feedback and the late hour at which you wrote it!
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    • Posted

      Self-cath purely to dilate and keep the "pipes" as open as possible following the urethrotomy (not for urination purposes). One week post procedure, I'm peeing like a racehorse which is certainly a nice change. This is actually my second procedure. My first urethrotomy was about 15 years ago and all was fine until this past year when things started closing up again and I was getting recurring UTIs. With my first procedure, I wasn't really good with the self dilation and stopped completely after three months or so. This time, I plan on adhering to a strict self-cath program as I would like to avoid another urethrotomy or urethroplasty if at all possible. I know the odds are not great, but I also know there are many people out there who do not require additional procedures as long as they stick to a dilation regimen. My doc has suggested a 16Fr. cath once/day for the first 90 days and then we have a follow up check-in to decide if I can perform the process less frequently. I'm just anxious and want to make sure that I get a good start here which is why I asked the question. I will definitely post another response once I hear back from my urologist. He did say that I could go to a 14Fr, but to try the 16 Fr initially. We'll see.
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  • Posted

    Hi, Vansos. I'm not a doctor, but I do have experience in plastics of various kinds. When I was evaluating my selection of catheters -- my Catheter Lady had very kindly sent me armfulls of different types of catheter rather than flowers, bless her --  I soon discovered that the bending radius of all the hydrophyllics I had was quite substantial. Even if I took the precaution of moving my penis down between the legs to facilitate insertion through the external and internal sphincters, this was still of concern to me.

    Then it dawned on me, I was testing them at room temperature. As soon as I warmed them up to body tempreture the bend tightened significantly. So, try inserting the catheter slowly allowing it plenty of time to warm up.

    I should point out that when I started self-cathing this time around it was more than 70 years after the first time. I used an 18Fr SpeediCath which proved to be too generous. Moving from an 18-year old urethra to a 70 + urethra exhibited some significant changes. When I withdrew the catheter the first two or three times, always with the funnel blocked, I had about 3 inches of blood trapped withing the lumen. However, this soon changed to spotting and now I have not seen blood for more than a year. I also reduced the catheter size down to 16Fr, just like yours, and I settled on straight Red Rubber caths. This is not to say that I thought the hydrophyllic devices inadequate; on the contrary they were extremely slick. In any event, share this info with your own Doctor.

    Good luck, Vanos, and I hope everything heals up well and your cathing experiences become bearable, or even pleasureable as in my case.

     

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    • Posted

      Thanks for your reply Alan!  Much appreciated. One follow up question to make sure I understood you. You wrote that "As soon as I warmed them up to body tempreture the bend tightened significantly".  Did you mean that the warmer the hydrophyllic cath, the more flexible it becomes (as I would expect)? Or did you mean something else?  Also, may I ask what type of lubrication you use with the red rubber caths? Just basic surgical lube, or, do you use a type that has the numbing slightly analgesic feature?  THanks again.
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  • Posted

    Hi, Vansos. That is exactly so. The warmer the material, the easier it is to bend around a tight radius.

    Your second question, I spent quite some time trying different lubricants. I needed a product that did not have any analgesics mixed in (Lidocane, etc) and an antibacterial that I tolerated. I had been suffereing from urethral irritation and was blaming myself for some time before I realized that the trouble was in the lubricant. I finally settled for Aplicare lubricating jelly which is readily availble on the US retail market.

    If you have other questions please feel free to get back to me.

    Warm regards. Alan

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