Self Catherization. An alternative to Turp, Greenlight, HoLEP...?

More on urethral (and bladder) washes than you care to know about at the CareCure Comunity SCI (spinal chord injury) forum. Just google "microcyn uti" and you will find some of the threads.

That said, not sure how scientific many of the testimonials are or if even the washes help. Actual scientific studies vary. As to bladder washes, I only did that a couple of times and decided probably not worth the bother and didn't like the potential risks, especially using anything stronger than sterile saline. 

What I had done at times is more of a urethral wash with the intent of cleaning out any bacteria that might get pushed into the bladder by the catheter during the CIC process. I have used Microcyn full strength at times, sometimes diluted with sterile saline, and sometimes just sterile saline alone. 

My technique uses a small squirt bottle which I fill with one of the above mentioned solutions. Then after prepping the meatus (and squirt bottle tip) with providone idodine swabs, I open the meatus a bit and gently squirt in the solution. Not sure how far in the fluid goes, but after a couple of squirts the fluid squirts back out. Then I cath as usual. You can probably use any number of squirt bottles but the one I ended up with was the 2 oz bottle for a product called Gly Oxide. So first I empty out the Gly Oxide, then thorougly rinsed and then put in the rinsing solution. The head of the GlyOxide bottle lifts off easily making it easy to fill up and the pointed end is not too big yet not too sharp. 

Have no idea if this really helps with uti's or colonization, but I did have one run of over six months without any colonization. That said, many urologists don't think colonization is particularly bad unless it's symptomatic and that's when it's called a uti. 

My method is top down but some of the folks at the SCI forum go "botto up" meaning they fashioned a device (part of a catheter) where the ffluid begins at the end of the canal rather than in the beginning. The idea here is that if you do it my way (squirt from the outside) you might end up pushing bacteria in. 

Jim

 

Currently, I don't do the urethral wash. I just squirt the Microcyn a couple of times onto the head of the penis and into the meatus while pulling the canal open with my thumb and forefinger of my other hand. Then I insert the catheter only holding it by the plastic funnel which means a more sterile procedure because I never touch the part of the catheter that goes in. This may take a little practice an a bit of aim! If I miss (one out of 20 times) I throw the catheter away it it hit a part of the penis that I had not squirted. 

As I mentioned before, I was able to stay uncolonized for some time using the urethral wash but eventually I got colonized. At that point, since I was colonized, I skipped the urethral wash because just spraying into the urethra seems enough to keep me from getting a uti. Frankly it's a lot easier and quicker without the urethral wash and I really don't feel any difference colonized versus not colonized. I haven't had an actual UTI in over a year. Also, the urologists I've spoken to don't seem to have any issues with colonization. That said, if you ever walk into a clinic, or a GP's office, they might try and treat you with antibiotics because of colonization. Don't let them do that unless you speak to a well versed urologist first. The general rule that if you self catherize, you don't treat colonization which is sometimes referred to as an asymptomatic UTI. 

If you scroll back an read the thread from the beginning, the different techniques I used should be covered in detail but feel free to ask any questions. 

Jim

Please remember that not everyone has found that procedure necessary.  

I use an antibacterial wipe; for me, Wet Ones are very convenient as they come in individual packets for out-of-home use, as well as in canisters for more economical at-home use.

In four years of doing CIC's, I have NEVER had a bladder or urinary tract infection with this pre-CIC cleansing process.

It's a lot more cponvenient than any urethreal wash or similar proceduyre.

Carry-on CMDR,  May I ask,what is the brand that you use? I've been using hydrogen peroxide, and I am new to this.

How would a person know if they  were colonized?

OK. I'll try to get this right, but I'll probably make a few mistakes because it's a confusing stor. 

Microcyn, Puracyn, and Vertericyn (labled for pets) used to be basically the same thing using what they called a patented Microcyn technology. Occulus,  I believe was the manufacturer of Microcyn, and the others were owned and made by other companies using the Microcyn technology which they paid a fee to use. Then there was Vertericyn VF a stronger strength of Vetericyn. 

All of the above were discussed in a very long thread in the Care Cure Community entitled Microcyn Bladder Treatment, an open letter to Dr. Young. It would probably take you a day or more to read the entire thread. They are also discussed elsewhere on the net. As of a couple of years ago, Veter

I have tried all of them at various times depending on cost and availability. Puracyn, for example can usually be found at any drug store. As of a couple of years ago, Vertericyn VF seemed to be the most popular due to price and the fact that some diluted it with sterile water to save even more money while some liked it at full strength.

Then apparently the manufacturers of Puracyn and Vetericyn didn't renew their contract with Occulus so they no longer use the patented Microcyn technology, however you can still buy them and the claims on the bottle are similar.

Now there is another product by Occulus called HydroCleanse, which is basically the old Vertericyn VF using the patented Microcyn technology. This seems to be the "go to" product now. And, if you're lucky, Occulus will still give out free samples of HydroCleanse for first time users. Occulus also still manufacturers Microcyn. 

Lately, I have been using both an older Vetericyn VF (still has the Microcyn technology) and my free samples of HydroCleanse. I probably used some Puracyn at some point that may not have had the Microcyn technology. 

Pretty straight forward huh LOL. 

As to my personal use -- like most, I use the spray bottle, not the gel, although some have tried the gel as a lubricant. I did mention earlier, that I used Microcyn as a bladder rinse, but I no longer do that for various reasons. 

Right now myself cath technique is very simple. Pull back the meatus slighly with my left hand and then spray a couple of times the tip of the penis and into the meatus with the HydroCleanse. The spray probably only penetrates an inch if that. There are two spray adjustments, I use the softest adjustment. Then I use the catheter and sometimes give an extra spray into the meatus when done. 

Previously, I used either Providone Iodine swabs, but they are very messy compared to the spray and that is basically why I switched. That, and I can probably penetrate a half inch or so into the canal. I also at one point (discussed previously) used a squirt bottle and pushed the HydroCleanse all the way up the canal. I no longer do that primarily because it takes longer and also costs less this way. Also, since I haven't had any UTI's, it seem to work. That said, I am colonized (no symptons) but that is usually the case with self catherization and just to much of a PITA to prevent that. 

Is Micocyn, Puracyn, HydroCleanse, etc, any more effective than sterile water? I don't know and a lot of people don't know. There are no published studies that I know of with self cathing and the anecdotal reports, while very positive, have to be taken cautiously, and I again wonder if some of the same results could have come from flushing out the system with sterile saline or sterile water. Again, no studies.  Also, the company, Occulus, also seems to go about things in an unorthodox way and you can do some research on them if you want. 

Still, I use HydroCleanse and probably will continue to, but if I ran out, probably might just go to the corner drugstore and buy some Puracyn. Or maybe not -- because somewhere in the back of my mind is all that Occulus promotion of their "patented technology". And I can be sucker for that kind of promotion like anyone else! Good luck.

Jim

I can't recommend or not recommend either HydroCleanse or the other products (Puracyn and Vetericyn) still on the market. I continue to use HydroCle

 

I substituted the Microcyn spray for the providone iodine. Not necessarily better but quicker and less messy. One other point. The Microcyn (hydrocleanse) bottle says "use within 30 days". That would work if you're using it as a bladder rinse (I only did that a couple of times) or if using the squirt bottle. However, if you're only just squirting into the meatus you will probably have to throw away a lot of unused Microcyn at the end of the month. It's $30 USD for the 16 oz bottle (Hydrocleanse only comes in one size). That said, I only became aware of this point recently, so depending on how fast it degrades, it's possible I've been spraying only water into the meatus a lot of the time!

As far as colonization is concerned, that's hard to avoid with self catherization. I had about a six month run of no colonization but at that point I was using the squirt bottle and probably using fluid within the 30 day period. 

There is a difference between colonization and having an UTI. First, colonization is asymptomatic. You might (or might not) notice the urine a little cloudier than usual, but that is about it. If you use a urine dipstick (good idea) you will find that the leucocytes are positive but the nitrites are negative. It is possible to have a real UTI with positive leucocytes and negative nitrities, but in most cases it's just colonization, and especially if you're asymptomatic. 

In the ideal world probably best to have no UTIs and no colonization, but most urologists don't think colonization is a big deal, and to do self catherization without colonization requires more work and a little luck. I just finally gave in and went the easy way. So right now, I have colonization but haven't had a UTI in over a year. I doubt very much if colonization would affect your PSA but you could look into it. 

Jim

FWIW I did use providone Iodine Swabs and/or the liquid and/or hand sanitizer to "sterilize" both the tip of the squirt bottle, as well as the inside rim of the squirt bottle when refilling it. I would sterilize it prior to self catherization and right after. It also comes with a protective tip (cover)  but I usually lost the little thing after about a week! As I mentioned earlier, others in the SCI forum thought it best to squirt from the end of the canal as opposed to the entrance like I did. So what they did was to fashion  a short catheter (they cut a longer one)  that they inserted just short of reaching the prostate and then they injected the Microcyn into the canal using a syringe barrel (no needle) that fit right over the catheter. I understood the logic but seemed like too much work for me plus I figured that if the Microcyn was really that good it would kill any bacteria it hit as opposed to pushing it down toward the prostate which was the concern others may have had. Also, when done correctly, the Microcyn not only squirts in, but squirts right back out so I figured I was accomplishing pretty much the same thing. Again, I decided it was a lot easier to live with colonization than to go through the additional procedure but a lot of folks on the SCI forum really go the whole 9 yards, both with using the barrel syringe as well as a full bladder irrigation where you inject (using a standard catheter and barrel syringe) 40cc or so of Microcyn right into the bladder and leave it there for a little while. I did that a few times but became concerned about the long term risks of using the bleach-ike Microcyn solution on bladder tissue. If you wanted to go this route, a sterile saline or sterile water solution seems safer and has a track record. I did that a few times as well but not on a regular basis. 

Jim

Jim 

How can a person tell if he has UTI?  Is there pain etc.?

Hi John,

Not a doctor and never had a Foley, but my guess is that it might take time to get your detrusor muscles back in motion after not using them for so long. 

When offered a TURP operation, I was given a choice between a FOLEY or self catherization (CIC) to be able to more fully empty my bladder while waiting for the operation and also to help decompress my stretched bladder so it hopefully would regain some elasticity.

I choose CIC and have continued ever since, skipping the operation. You can read more about my experiences in the thread, but in your case I see no harm, and only upside in trying CIC. For one thing it definitely empty your bladder whenever  you want to. For another it will use your detrusor muscles (should  you choose) which hopefully will bring them back to life. As a big bonus you will be free of wearing a Foley 24/7. And, if CIC agrees with you, it will offer you an alternative to surgery without any sexual side effects such as retrograde ejaculation which is common with TURP and Green Light, to name two. 

As I mentioned earlier in the thread, I had a rough time with CIC for a few weeks, but once I got the hang it became virtually painless and routine. My only advice if you do this is to make sure your medical team will agressively treat any UTI's you might develop in the beginning. My team was reluctant and I got into trouble.

Also, the right catheter can make a difference. I , like several here, like the Coloplast Speedicath with its hydrophilic coating. Goes in real easy. They generally start you with size 14French, but after some practice you may be able to drop down to 12French which is thinner and more flexible. I use the one with the coude (curved) tip which is designed to go around the prostate without snagging it. 

You may be one of the lucky ones who gets the hang of it right away, but if you're like me, be prepared for at least a couple of weeks of discomfort. At least for me, it certainly was worth putting up with it for a short period of time. 

You can always get an operation down the road -- some interesting new procedures being developed like PAE for example -- but learning CIC will give you a non surgical alternative that just might be enough. It might even rehabilitate your bladder to the extent that at some point you may be able to stop CIC altogether, or at least cut down the frequency dramatically. 

If posible, see a urologist well versed in CIC, but sometimes this is not possible. In any event, the procedure is not rocket science. Lots of advice here as well as videos on YouTube, mostly by the various manufacturers. 

Hope things work out.

Jim 

Hi Jim

Thanks for getting back to me so quickly very well appreciated, great tips you are giving me, as of now I say 3 different urologist and they all want to operate, first one is with the old TURP method which I don't want, I say a laser green light expert and a laser holep expert and after reading a lot on these 3 methods and hearing best comments for the holep method, this would be my method of choice but with the reverse ejaculation side effect it makes me hesitate a little. I'm most likely will try the CIC and hope for the best, right now the size of my catheter is 12 fr, emergency stafff had hard time inserting the 14fr which caused me some bleeding and a lot of pain, so i would most likely try the 12fr, do you suggest the standing up method or it depends on the individual, I also say in the thread that you talk about the PVR to never have more than 300ml in the bladder but how does one know, should we keep a log at everything we drink and everything we urinate before doing the CIC. How about infections, is it better to wear plastic gloves.

Thanks Jim

John,

It's somewhat counter intuitive but sometimes they actually go up in size when having difficulty navigating the prostate. Also, different catheters have different characteristics. The Coloplast Speedicath 12F, for example, is quite flexible and might kink if it meets resistance, so I'd probably go with 14F and hopefully it will go in easier because of its slippery coating. Also, the coude tip might help but you have to order them with the coude tip.

Gloves can be worn but probably not necessary. Most just wash their hands with soap and water. I do that sometimes but often just use hand sanitizer or nothing at all since with the technique I use my hands never touch the part of the catheter that goes inside. But starting out, soap and water and/or sanitizer should be OK. 

The rule of thumb is that if more than 400ml comes out when you self cath, then increase the number of times you do it a day. If less than 150ml comes out, decrease the number of intervals. Another formula is not to have more than 400 ml in your bladder at any one time although I think the first formula (how much comes out) should be fine to start out with especially since you're not doing much in the way of natural voids.

It's easy to figure out. Just aim the catheter into a plastic receptacle or measuring cup and write down how many cc comes out. I kept a pretty complete log in the beginning which included date and time, the amount of natural void if any (always try to naturally void first), then how much came out with the catheter, and any other notes I might make such as if I changed the size catheter, any issues, etc. I don't log it any more but in the beginning it can help you come up with the right schedule. Most people start with 4-6 times a day, especially if you are not naturally voided at all.  Then you can adjust based on how much comes out with the catheter.

I have only done it standing over the toilet (or a receptacle) but I've read it can be done sitting or lying down as well. 

Not sure where you're locatd, but here in the states the catheter companies are pretty good with free samples so you can try different ones. 

As to retrograde ejaculation, if you haven't experienced it, you can do a trial run by taking the drug Tamsulosin (Flomax). Tamsulosin causes retro in most people. It may not bother you at all but it does bother some people. 

Jim

Hey John  I read your post.  Did they offer you any other procedure.  I don't care for catheters but I have had them.  I had a urolift done a year ago to have my protate opened up.  It has worked great.  I also have a stricture form kidney stone surgery  They cannot put in bigger then a 14fr catheter because of it.  It wiill also take time for you bladder to get used to not having a cather in like Jim said.  Try the CIC.  Don't let any doctor cut or burn away any of your prostate.  They are not sure if you can pee after they core out your prostate.  Let it rest.  Check out some of the other procedures with less side effect.   Tell them no.  You may have to take something to relax your bladder..  Take care and good luck  Ken   

My doctor gave me that med.  Did not care for the retro.  The orgasm was not good and I felt like something was missing.  I did not feel complete.  With my stricture I have to have them use a 14 coude catheter for men with strictures.  I had bladder retenion about a month ago from my blood thinner.  It hurt like hell.  The nurse had some trouble putting in the catheter but she pull it out some and turned it and got it in.  Also had to have surgery I was still bleeding had 3 blood clogs around my prostate.  I did not know at that time way I was bleeding but I did tell the doctor that my prostate is to stay right were it was and he did not have permission to remove it for any reason.  Had him sign a paper on it before I went in..  John listen to Jim.  He has some good ideas for you.  Ken  

Hi Jim

Thanks again for great advises, I'm trying to motivate myself to do the CIC and I'm almost ready mentally to try it, I've watched youtube videos on it to become more insensative to it, my only fear is not to be able to pass the point to the entrace of the bladder and of course some pain from the cath itself and maybe some bleeding. As for retrograde ejaculation I did experienced it 6 years ago when I had a blockage and was taking Flowmax (Tamsulosin) it felt weird and scary, so I know what to expect from that, seems that a lot of people here are against operation and are saying that I might still have problems urinating so it seems that the major problem is the bladder that is not doing is job or just too stretched from all the previous retention, in any case what I find strange is that before the catheter and systoscopy I was urinating fine but not emptying but now I can't even urinate when I tried after that day of the systoscopy. You're a great insipration to me Jim

thanks

John

Hi Ken

Thanks for the message, well urologist all of them want to operate, as mentioned before, methods proposed where : TURP, green light laser or Holep laser, after many reads seems that Holep is the best of the 3, right now I'm taking Flowmax (Tamsulosin), I'm also worried that even after the operation I still won't be able to urinate, which is strange because before all that episode that started about 1 month ago, I was urinating fine but felt nauseated so I went to the ER and my creatinine level was way high at 230 because of the retention in the bladder and blood pressure was way up over 180/100 so I was giving blood pressure medication. After wearing the cath for 5 days they did a systoscopy and afterward I went home no cath but could not urinate or did not even feel like urinating even after drinking 3 water bottles so I went back to the ER and had 750 ml in my bladder so again they put the catheter that I have now for 1 month and on a waiting list for holep operation which will only be in about 2 months. I appreciate your help

thanks

John

Hi Ken

The nurse also had problems putting the catheter on so she used a 12FR and put a lot of gel first in the penis and then it went it much easier,

Good luck to you too

John

 

Hi Jim

Do you think by putting more KY gel in the penis before CIC would help more to insert the cath with less resistance

thanks much appreciated

John

More lube can help. Also trying different types of lube. For example, Surgilube comes to mind as one of the lubes I tried. What is also helpful is not only to lube the first couple of inches of the catheter as they suggest, but to keep lubing it as it goes in. Different ways to do it, but one method is to wear surgical gloves and have a glob of lube on the glove and feed the catheter through the lube on the way in. 

That said, I found the hydrophilic catheter to be better than those requiring lube. With the hydrophilic, you do not use lube because it already has a very slippery coating. My preferece is the hydrophilic Speedicath by Coloplast. 

As to your concern about not being able to urinate at all, I really think it's a temporary thing, but of course, unless you self cath to get your detrusor muscles back in action, then you're doomed to a Foley for now. 

Curious, how much retention and what kind of day to day symptons did you have before they put in the Foley?

Jim

Forgot to mention, but always a good idea to check what kind of meds you're on when you can't urinate. Due to the timing and history, it sounds like your detrusor muscles have temporarily stopped working, but another possiblity is if they gave you some pain killing drugs. I noticed, for example, that taking NSAIDs (Alleve, Advil) makes it very difficult for me to urinate, and at times imposible. Fortunately, I am versed in CIC, so no problem emptying out!

Jim

Thanks again Jim for those great tips, we'll surely keep it in mind, I was also thinking for filling in the penis with lube as they did at the hospital when inserting the catheter, don't think it's armful. I had about 750ml retention at the ER, as far as symptoms before the catheter, I was feeling  nauseated for about 2 weeks, vomited a few times and could not eat much, even the thought of food made me feel that way, I thought I was pregnant, lol, but I could urinate no problems but urinating frequently and not being able to hold it for long once I needed to go. I went to a generic doctor and she gave me pills for my stomach (not even called for blood tests), obviously these pills did not do much so I went to the ER, they did blood test and noticed that my Creatinine was way up 230 (should be between 70-120 for male), that was due to the retention going back to my kidneys, my blood pressure went to 180/100 and then 225/110 (I was freeking out, waited 8 hours in this condition before they checked me out, they thought I had kidney problems and when they did a echo scan of my bladder after I went to urinate the reading was about 750 ml, this is when they told me I had prostate problems, but since I went to the ER in a different city same province in Quebec (I was visiting my brother), the hospital sent me on my way saying we can't treat you, go back to your home town in Montreal and again go to the ER there, they only thing they gave me is blood pressure med to bring down my blood pressure but left me with the 750ml of urine in the bladder and no catheter, so I had to go back to Montreal again at the ER this is when they installed the catheter and did systoscopy, echo of the prostate,etc. they then told me my prostate is huge and needs to be operated.

So I hope I can do the CIC and start to heal and decide if I will do the surgery or not.

Thanks

John

Normally you lube the catheter, not inject the lube into the penis, but whatever works, works. 

Can't say and not qualified to dx what's going on with your kidneys from what you've said, but a standard ultrasound of the kidneys should give you and your doctor something to look at along with the blood tests.

If urine is backing up into the kidneys, as sometimes happens with retention, you might have what is called hydronephrosis, which is basically water in the kidneys where the urine reluxes backwards instead of just out. If they didn't run an ultrasound, I'm surprised, and would definitely ask for it.

In fact, the ultrasound just before I started CIC a few years back showed hydronephrosis (in both kidneys) and that is what prompted the urologist to recommend the TURP. The good news is that hydronephrosis usually clears within a week or two of fully emptying your bladder with CIC. So you really don't need an operation to protect your kidneys as I understand it, you just need to completely empty your bladder. And in fact, if you've been self cathing for a few weeks the ultrasound probably won't show it but a good test to get just to make sure. High blood pressure is also sometimes associated with retention, and again, if that is the case self cathing can take care of that a well as an operation.  

This is not to say that you shouldn't have an operation, it's really a personal choice, but just to say that self cathing is an alternative. Either a long term alternative or a short term one. Unfortunately, most docs only present self cathing as a short term process prior to surgery, but many like myself are quite happy with it a an alternative to surgery.

Jim

 

Hi John,

Read your post and wanted to say that CIC is a painless procedure, and a great solution to get your bladder voiding normally . Initially it may seem scary, but actually there is nothing difficult about it. My urologist wanted me to do it when I had a hydronephosis. He had 2 nurses train me. One said "mind over matter" to get my courage up and it turned out to be a great relief physiologically. If you can try the Coloplast  Speedicath , it is the easiest catheter in my opinion. You might want to try the one with  coude tip, oriented properly, if there is a little obstacle in passing the prostate. A foley Catheter is a much more burdensome  approach, and prone to infection.

If you do start Self Cathing, you should do it with the supervision of a doctor , as you may get a UTI , which should be treated right away. I see you haven't posted in a while so you may be doing OK. Good luck.

Hi Michael, thanks for the message and sorry for the delay, I was just a little busy lately, still waiting for news from the hospital for operation date, I appreciate your feedback on CIC, I guess I have a mental block about it and have some fears that it won't go in the bladder, who knows I might get my courage up, I'm sick of wearing this catheter, it's like being in a wheel chair sort to speak. My present Urologist was againts CIC and the 2 others I saw before him said it's not a big deal and a solution instead of wearing a permanent catheter. 

I'll keep you posted

Thanks

John

I second Michael's coments on CIC. Why is your current urologist against it? All studies show it superior than wearing a Foley in terms of UTI's, and in terms of freedom to go about your life, not even a comparision. Listen to the other two urolgists. It really isn't a big deal and frankly don't even think about it anymore other than when answering posts about it here!

Jim

Hi Jim, thanks for getting back, not sure why he said it was dangerous, in any case I'm seriously thinking about doing it because I had some bad news today when I called the commissionaire of complaints at the hospital and asked her to look into my file and see why it takes so long before an operation, after researching she told me that there is a 70 patient waiting list for operation, some are waiting since last February so she told me the wait time will be between 4 to 6 months which is insane, unfortunately here in Montreal there is only 1 hospital (2 urologist) performing HOLEP. I have an appointment on the 18th for a cath change, I was thinking of telling them to let me a few hours to see how my bladder will react and then ask them to teach me self-cath, maybe the best solution would be to call them and ask to talk to the urologist or arrange an apointment with him to discuss it. 

I just need to make myself come to term with the fear of CIC, not sure what I'm afraid of, most likely the fact that It will stuck when I try to push it in the bladder. 

I'll keep you posted

Thanks

John

John.  I don't care for catheters but it would help you. You have to do it four daughter.  It would give you the freedom you need. Summr is coming and you could take her to the beachor pool and have a good time.  She would enjoy it and so would you.    As long as the catheter has enough lube on it it should go in fine you just have to relax.  It may take a few trys to do it right but if you can do this you will not have to have the surgey.  I have a friend that has been doing it for 10 years He got use to it and it's easy for him now.  It is worth a try  They can show you how in the hospital.   You have the chose to do what you want.  Maybe the doctors would get things moving and think about there patients for a change....Next   Ken

Try and get a hydrophillic catheter. They are easier to use (no additional lubricant) and very slippery so they tend to go in more easy. One favorite here is the Coloplast Speedicath. If your prostate is enlarged, the Coude tip is often recommended. Generally people start with size 14F and then either work down or up, depending on how it goes.

Jim

Hi Ken I know you`re right about that, I just need to get my brain to accept the situation and condition myself that I can do this, I have this worry that if I start CIC I might lose my place for operation and will go againts my urologist advise. I know it`s my body and my choice but if things don`t workout for me with CIC I will have to start again procedure with another urologist plus now I have a feeling that by contacting the hospital commissionaire the urology department might make me wait even longer. 

I`ll keep you posted on my next move, much appreciated Ken

John 

 

Hi Jim, thanks for this much appreciated information I wrote it down so for me it`s a matter of deciding on it and maybe go against my urologist advise which will most likely put me down the list for operation plus the fact that I rocked the boat by calling the Hospital commissionaire. 

All I know is that I can`t spend another 4 to 6 months wearing a full time catheter. 

I`ll keep you posted

Thanks for your precious information

John

I know your having a problem with this but would it be a problem to do CIC for a while in the mean time you could find another doctor.  You should not have to wait 4 to 6 month's to have a procedure.        Maybe it would make them think about the patient.  They know that they are wrong and think it does not matter.  But If you find another you may not have to wait and you can talk over you concerns on this procedure.  Think about it.  It is your life and you are worth a doctor that care about you and not being a number  Think about it  Ken 

Hi Ken, yes I know you're right but so far I seen 3 different urologist in my city of Montreal, the one I have now is the only one doing the HOLEP method, one wanted to do the TURP but also had no date, it was  a women urologist and was leaving for maternity holidays a month after I seen her so she was supposed to refer me to another urologist from the same hospital but always under TURP, the second one is a green light specialist that also saw me and since he had a all test from the previous urologist he gave me another apointment for a systocopy which I have on the 7th of June so that my other choice and this urilogist proposed to me the CIC when I say him last month, so now I have 2 possibilities, wait for the HOLEP or go to the June 7th appointment and see what he proposes afterwards but most likely again the operation won't happen before the end of the summer so no matter where I go there is a long waiting period, don't forget in Canada we are covered under medicare from Goverment so we don't pay for health care like in the States, so my other alternative is to go private but it cost a lot and I can't afford it. 

I'm trying to call my present urologist secretary but no answer and voice mail is full, did leave her a message 3 days ago, never called me back that is just to show you how we are just a number here. 

Thanks for your help

John 

Are you talking about t one you give me his name?  Ken

Hi Ken

Yes my present Urologist I finally got a hold of the secretaries and I have an appointment tusday to change my cath but I told them that I want time without the cath to see if I can urinate. 

I'll keep you posted

Thanks

John

Hello John  Just checking on you to see how your doing.  Any luck when they took the catheter out..I hope Ken  

Hi Ken

Thanks for the heads up, actually it went terrible, I met with the urologist because I wanted to touch base and see what was going on with the operation, he replied that he's the only one doing the HOLEP operation and he has 70 other patients waiting for an operation plus he said summer holidays are coming so it won't happen for the next 6 months if I'm lucky. He proposed CIC I said ok so I went with the nurse, she brought all the equipement to the washroom, she removed my cath and I started to bleed a lot, she them began to open the catheter package and started to introduct it all of a sudden a lot of blood came out so she ran to get the urologist, I began to feel ill and within 5 sec. I passed out and fell on the concrete floor from my chair and bang my head noze and teeth really bad, I woke up on the floor alone, sat back on my chair and the nurse came back in alone and freaked to see my bleeding and all equipment on the floor, anyways she took me to a bed cleaned me up, i rested a bit, then she told me that the urologist still want you to CIC, imagine that he did not even come to see me, I was still bleeding so I told the nurse that it's not an option and even her said that I was not a good candidate for CIC so she put back the catherer, don't know what to do anymore, I have another appointment with the other urologist for green light on the 7 th of July for a cystoscopy so that's where I am now, I began searching for natural methods and found few chinese sites that have potent herbs and regimen to cure this disease by remove heat toxins from prostate and restoring blood flow and shrinking the prostate so what else can I do at this point,

Hope you're doing ok

John

Hi John,

Sorry you had such a bad experience. Not sure how much of it was the sefl cathing as opposed to the bleeding pior (if I read your post correctly) when they removed the Foley.

I will say that I almost fainted the first time I self cathed while being assisted by the PA. I also had some bleeding and pain for at least the first couple of weeks along with urgency and a sensation of needing to urinate even when my bladder was full.

I was told all these symptons are normal for some people although most here seemed to have initially tolerated self cathing a lot better than I did. 

I say hang in there and if you can get through the first three or four weeks things will get significantly better. I was in a really dark place the first few weeks of self catherization and reall thought my life was ruined for good. Very different from today when self cathing not only rehabilitated my bladder to the extent that I don't have to do it very often but when I do self cath it's about as traumatic as brushing my teeth and takes much less time. 

So try and look beyond the bad part because in most cases the body does adjust remarkably well to self cathing and once it does you will wonder what all the fuss and worry was all about.

Jim

Thanks for the message, much appreciated, I understand what you're saying, yes just like you said, I'm not sure if I passed out because of the blood or the CIC ( I know I didn't have a  good feeling looking at those 16 inches catheter maybe that's what did it or the combination with the blood pouring out of my penis). I any case I haven't given up altogether the CIC so now I have another urologist appointment on the 7th of June with a gree light expert Dr. Zorn well known in the states and Canada, he's the first urologist introducing green light in Canada, I heard it's not as good as HOLEP but in any any case I'll know more. Also came across some Chines sites about curing the BPH condition by removing the toxins and restoring good blood flow to the prostate and shrinking the prostate naturally. I also found in my own town of Montreal at Chinatown a part of the city, some herbal medicine doctors that I'll go visit and see what they have as treatments.

I'll keep you posted

Thanks for your encouragement 

John

Hey John .Been trying to send you a e-mail for 2 days problem with computer that doctor was wrong. Glad your seeing another doctor. maybe he can help you sooner. Take it easy ken

Good morning John. Don't know what time you are going today but I hope you get some good news. Ken

Hi Ken

Thanks for the message actually it was at 02:30 pm just came back, news are not so good or at least dissapointing for me. The urologist did a prostate/rectal ultrasound. I had a chance to talk briefly with him following the procedure, he told me that my prostate is 100gram and need to be operated, he says he will remove 80% of it, I also asked him about medication and he said that i would take a year to work, he also said that at first glance it doesn't seem to be any trace of cancer but that would be some analysis of tissues after the HOLEP procedure, I also have a tentative operation date of the 26 of July but no guarantee, so I seriously entertaining the thoughts of CIC but I still have this fear of inserting this 16 inches cath inside of me so I have to find a way to overcome this mental block. I had ordered from Coloplast some samples and funny enough I just received them as I arrive from the hospital . They are not lubricated and are 14fr, I find them very thin and flimsy so I sent an email to the company to ask if they could send me that model:

Speedicath hydrophilic lubricated straight tip, I ask for 16fr and 1 14fr just to see the difference, in any case not sure when or how but I have to be in front of again hospital staff to get a proper training.

So now I have another appointment tomorrow Tuesday at 09:00 am in systo dept. with the green light urologist so not sure if I want to go or if it will make any differences since I know now that my prostate is huge.

I'll keep you posted thanks

I'm surprised they are not indicating a coude (bent) tip. They are designed to go around large prostates like many of us have. Ask them. "Thin and flimsy" is OK, you don't want to ram a railroad tie up your urethra Rule of thumb is to use the smallest diameter catheter that will pass around the prostate and into the urethra. Like most people I  started with FR14 and then worked down to FR12. If FR14 won't pass around the prostate then go up a size to FR16 but only then. I think you will find the Speedicath Hydrophillic will pass the easiest of all the catheters. A lot of info in the self cath threads as to technique, etc. But ask about that coude tip given the size of your prostate cause you really don't want to stick it. Ouch!

Jim

John I just read a article on large prostates. And 100gram is large but it is a good thing. What I just read said that a large prostate most of the time does not have cancer. It's the ones under 50 that you have to worry about. I would have the doctor give me the meds and do the CIC You have nothing but time and if you can do this you will not have to have the surgery You don't know if the surgery will work or not You may end up with a catheter for the rest of your life. In december I took 1000 mg of ciprofloxacin for a month and my prostate got smaller. Please try it first He said that it would take a year but it may be sooner for you. Remember you did not have a problem until they stated mess ing around and sticking tubes in you. Ken

Ciprofloxacin is not without risk, so be careful if not really indicated.

Check out the literature on fluoroquinolone-associated Achilles tendon rupture. Cipro is a fluroqinolone. Personally, I had a bad case of achilles

tendonitis after several rounds of fluroquinolone's, including Cipro. Can't be positive it was the cause, but my doc started substituting non-fluroquinolone antibiotics moving forward. 

Jim

Hi Ken thanks for the message, hope you're doing well. Yes 100 gram is large and you're right less chance of cancer, I did ask the urologist about that and he said nothing he seen during the examination seems to point that way, yes you're right about me not having problem to urinate before they did the cytoscopy, I had another appointment with the green light urologist Tuesday and again they did a cytoscopy and also confirmed that the prostate was big but told me that bladder and everything else looks great and only the prostate is blocking my urethra. I any case they filled me up with liquid and told me to try to go pee, well bad news, I tried and I tried and I tried but nothing came out, I told them to give me time since I had a cath for 3 months. They gave me the whole afternoon about 4 hours and still not a drop came out so I was forced to put back a catheter and of course after that intervention I got another infection and back on Cypro. I also asked for the combo Tamsulosin and Avadart and they prescribed me that too.

I will post another tread today to go in details on my procedures.

I'll keep you posted

Thanks and God bless you

John

We can't be sure what caused it to get smaller but that was the only meds I was on for it. Had a kidney and prostate infection Not on any now. I did read up on it. It can cause alot of problem Thanks Ken

Sorry to hear that John. Did you stay in the office or go home. I can't pee on demand I bring my samble in when I go to my urologist Had a nurse force a catheter in me 2 years ago when I told them I don't pee on demand and I did not need to go. Just came in told my son to leave and started taking off my pants they got one leg off when I felt the catheter going in me. Never ask or told me what they were doing. I even asked what was going on. The only good thing that happen out of it was I have a good urologist. The nurse never go it in after 2 trys I have a stricture you have to use a smaller coude catheter. I will never forget what they did to me. I peed a hour later when they took me to my room. If you stayed in the office it was on your mind I have to I have to. You should have gone home and relax and forgot about it Now what are you going to do. You should have ask the nurse to help you do CIC. I am praying for you buddy Ken

Hi Ken

Thanks for the message,

I understand what you mean, I told them the samething that I need to relax a while so I went downstairs at the hospital cafeteria and had a salad, an apple juice and later a coffee. I then tried again but couldn't, I ran the water, through some on me, I tried everything and it was blocked but I could feel my bladder getting fuller.

Later I went for a walk for about 30 minutes around the hospital, tried again many other times for a total of about 4 hours. I did ask for the CIC but the lady in charge was not available until the next day and also after that cystoscopy I was sore and caught an infection so it wasn't the time to try CIC, so now back with my cath and the medication that I'm taking combo of Tamsulosin and Avodart. I will re-schedule a CIC when I feel a little better.

Thanks for your moral support, I hope you're doing ok with your procedures

I'll keep you posted

Thanks Ken

John

I'm sorry but I just know you from this post but I do worry about you.  I think if you went home you may have been able to pee.  The mind does funny things. I think of you as a friend and as a man I do feel for your pain of what your going through.  I had 6 infections in 2014 one so bad I ended up in the hospital  Had sepsis.  Was in the hospital for 6 days on IV's and went home with home with a port  Had 11 more IV treatments at home  Hate infection.  Only had 2 last year and none this year.  I want you to get better hope in 2 weeks you can do the CIC.  With the meds and that it will give your postate time to get smaller and maybe you can pee without that catheter. I will keep you in my prayers buddy  Ken