Self Catherization. An alternative to Turp, Greenlight, HoLEP...?
Posted , 82 users are following.
Since I posted a thread about self-catherization -- more formally called Clean Intermittent Catherization (CIC) -- there have been a few different discussions on the topic in various threads. I thought it might make sense to bring those discussions over to a dedicated thread. With that in mind, I will summarize and/or copy and paste some of what was said before into this thread for better continuity.
My story in a nutshell. 68 years old with BPH probably since my late 20’s. Watch n’Wait strategy with on-and-off trials of Tamsulosin (Flomax) with poor results. Symptoms were the normal retention issues resulting in frequent urination with incomplete emptying, urgency, and having to go to the bathroom at night in increasing frequencies. Near the end, two or three uti’s per year often accompanied by gross hematuria (bleeding).
Two years ago things got significantly worse and I couldn’t urinate on my own without physically pushing against my bladder (Crede Maneuver). That led to another trip to the urologist where ultrasound showed significant retention and hydronephrosis (water in the kidneys). I was told I needed an operation (this facility primarily did Turps) but first I had to rehabilitate my bladder because at the time it was too flaccid (stretched) for a good surgical outcome. I was given the choice of wearing a Foley Catheter for six weeks, or a program of self-catherization (CIC) in order to decompress the bladder. I chose CIC so I didn’t have to wear a Foley 24/7, and also because I felt it put me more in control.
Six weeks later my bladder was rehabilitated to the extent they could do a Turp, and the hydronephrosis was gone. After doing some research and a lot of thinking I decided to put off the Turp due to the potential of irreversible side effects, primarily retrograde ejaculation. Two years later, I am still doing CIC while waiting for newer procedures with better outcomes and fewer side effects.
I will detail my experiences with CIC in following posts -- but to summarize, once mastered, it’s a painless five minute procedure that allows you to empty your bladder completely any time you want. With CIC, I therefore have no retention issues, no urgency, and in most cases sleep 6-8 hours through the night without having to get up and go to the bathroom. No UTI’s in over 18 months. And because my bladder has been partially rehabilitated, I can urinate normally about 50% of the time without using the Crede maneuver. My IPSS Score (International Prostate Symptom Score) would be Zero (the best), albeit with a little mechanical assist. 
As of now, nothing that I have read about the various current procedures has tempted me to have an operation. That could, or could not change, in the future, but the nice thing about CIC is that you can stop it any time you want with no repercussions. The caveat is that CIC should be done under the supervision of a doctor who will monitor your BPH as required. Similar to seeing a doctor on a regular basis during a Watch n’ Wait BPH strategy.
I know many of you here have already had operations like Turp, and in most cases people seem pleased with the outcomes. CIC certainly isn’t’ for everyone, and I can understand why someone does not want to carry around a urinary “tool box” with them. On the other hand, with practice, it’s not the traumatic and scary procedure some think. I can honestly say right now that for me it’s about as traumatic as brushing my teeth.
I’m offering my experiences and thoughts on CIC for any of those who haven’t yet made up their mind on an operation. It even can make sense for those of you who don’t need an operation yet, but want to increase their IPSS quality of life score. In fact, wish I had done CIC earlier while on Watchful Waiting. Didn’t realize how much BPH had been affecting me for most of my adult life until I was able to empty my bladder completely.
CIC doesn’t have to be a permanent solution, it could just part of a waiting strategy like I’m on, until better surgical operations are developed with better outcomes and fewer permanent side effects.
For any number of reasons, the majority of urologists don’t seem to offer CIC as an alternative to surgery. My current urologist doesn’t as far as I know, but he’s OK with what I’m doing because it works for me. So, either you have to find a urologist you can convince to go along, or go to some of the major teaching hospitals where CIC is probably more in use and better understood. That is where I was taught, albeit not very well, but that is another story.
Jim
19 likes, 2092 replies
jimjames
Posted
Just a heads up that Coloplast has a new catheter and you can contact them or your distributor for free samples. It's the Coloplast Speedicath Flex Coude. I believe it is also offered in a non coude version, but not sure.
Haven't tried it yet, but looks similar to the IQ cath in that it appears quite flexible. They call it a "coude" but it's more of a bulbous end than a bend tip so no specific orientation is required. Comes in a small carry packet that fits into your pocket.
The rep says it's more flexible than the regular Speedicath, so probably makes sense to try a sample both in whatever french size you now use, and one size up.
If you try it, let us know. I've ordered some samples but I don't need to cath that often these days so it may be a while till I test it.
Jim
hank1953 jimjames
Posted
Thanks Jim, I've just ordered some coude samples. I did not see any info on the non-coude version though.
Hank
jimjames hank1953
Posted
Think of these as non-coude coude's, if that helps a little
Did you order samples in your french size and then one size up? They may be too flexible to use in your regular size.
hank1953 jimjames
Posted
111Alex111 hank1953
Posted
The thinner ones are too flexible.
The compact/portable one is too short if you have a bit of an errection
Using them is very easy, when you
get used to it.
hank1953 111Alex111
Posted
jimjames 111Alex111
Posted
jimjames hank1953
Posted
Hank,
They are for sale in the U.S. Just tell them you want "Speedicath Hydrophillic FR12 with Coude tip (unless you don't want Coude). Also if you haven't tried the 12's yet, definitely try some FR14's as well. Some people find the 12's too flexible, espeically in the beginning.
Jim
hank1953 jimjames
Posted
jimjames hank1953
Posted
That's a European number for what appears to be what I recommend but all I could see was the outside of the box. If you're trying new cath's, I would first recommend trying Coloplast's Speedicath Hydrophillics in 12 and 14 F to see what works better. I would get them with coude tips and non coude tips but try the coude tips first. Also, get samples of their new flex catheter. I wrote a separate post about those earlier.
alan86734 jimjames
Posted
Hi Jim,
Thanks for the Coloplast heads up. I'm very interested so contacted Coloplast USA. Their first question was, "How did I hear about this when it hasn't been released yet?"
Yes, it is to be released here in the US early next month (April) and they are currently putting together sample packages for user evaluation. I signed up right away, even though i'm a regular SpeediCath user.
I did get some questions in but these relate to my own concerns.
Nonetheless, they could still be of intrerest to a wider audience.
Insertable length: 16 inches.
Catheter tip: More flexible than the remainder of the catheter.
Coude: Small ball or sphere eliminates need for alignment.
Sizes: Usual French sizes. (She could not be specific)..
Regards, Alan.
jimjames alan86734
Posted
I asked to be notified several months ago after I saw their press release. I got the email notification today. I called my distributor up and they already have them. I should get samples later this week. Unfortunately -- rather fortunately -- I probably won't be able to test them for awhile since I don't have to cath very often these days.
BTW the 16 inches is the entire length including the funnel. Insertable length is 13" which is one inch short of the regular Speedicath but longer than the Compact.
alan86734 jimjames
Posted
When I spoke to their Customer Rep she gave me the overall length as 17 plus inches. However, I got the impression that she was reading off her screen so there could be discrepancies here.
I picked up on this because I have an extra long uretha which came to light when I began some serious self-cathing using Red Rubbers. Just as the tip passed through the inner sphincter into my bladder, the funnel was doing its best to disappear down my meatus!
No big deal for normal self-cathing, but a serious risk if anyone tries to place a standard Foley indwelling device and inflates the retention balloon while it is still in the prostate.
Thanks for your support,and the heads up; much appreciated.
Alan86734
jimjames alan86734
Posted
The overall length may be 17" but that includes the handle, etc. The only number that effects you is the length of the catheter tube that actually enters your urethra. With the regular Speedicath that is 14". With the new flex, around 13". The Compact is around 11" which I find too short but workable. I suppose you can play around with positions and angles to get a little more length, just don't lose the handle in the meatus! FYI There are longer catheters out there than 14" and I believe I sent you a link to one a few months back.
Jim
zdzislaw alan86734
Posted
that are my first choice too! ZD
zdzislaw jimjames
Posted
jimjames zdzislaw
Posted
Hi JD,
There is only one model of the Speedicath Flex. It is usually referred to as the "flex coude" and sometimes as just the "flex". Exact same catheter. Exact same tip. Reason for the two names have to do with insurance and copyright issues, not medical.
Jim
frank74205 jimjames
Posted
Hi Jim, My Urologist said he didn't know why i have this frequency. I then asked him if he could refer me to a voiding specialist? He said as urologists we are voiding specialists.Does this make sense?
Thanks Jim ,looking forward to your response.
frank,
jimjames frank74205
Posted
Frank,
Remind me again the frequency issue you are referring to. "Yes", they all consider themselves "voiding specialists" just like they probably all consider themselves excellent urologists
Anyway, some docs are more specialized than others in that regard and are usually found at the major teaching hospitals and often have presented papers on that subject.
Jim
frank74205 jimjames
Posted
Jim, My frequency issue--I get the urge to urinate 2 or 3 hours after CIC. Void is always under 400 ml.
There are days when i can hold of 5 ,6,or 7 hours. i was told "Never" to wait over 6 hours to CIC. I guess i have a peculiar urinary system?Jim do believe waiting even 7 hours if you don't get the urge is bad for the bladder?
Thank JIm.
frank
frank74205 jimjames
Posted
Hi JIm, Whats your opinion on a prostate pill,I read wear this pill "Advanced Prostex " can shrink the swoolen prostate? I wonder if it's possible to shrink it enough to get a natural void?Whats your opinion on this JIm?
Thanks
frank
frank74205 jimjames
Posted
Hi Jim, Do you think a prostate supplement could shrink the prostate?Ive been reading a book healthy prostate in 90 days without drugs or surgery, has me thinking about this.Wouldn't it be nice if there was a pill that could do this?It would be so much better than meds.What do you think Jim?
frank,
jimjames frank74205
Posted
Hi Frank,
Haven't heard of the book so cannot comment. Just keep in mind there are lots of scams out there preying on men with prostate problems.
Jim
frank74205 jimjames
Posted
Jim In your opinion and i know it's better than mine. Do you think a prostate supplement could shrink
the prostate?Wouldn't that be great if this could happen?
frank,
jimjames frank74205
Posted
Hi Frank,
Not that really up on supplements but I wouldn't take all their claims at face value.
Jim
mike588 jimjames
Posted
One of the drugs, finasteride claims to do that, but also makes you lose libido and some get ED. It wouldn't surprise me if some "supplement" could do that if it had the same chemical properties.
If you think about it logically if there WERE an effective supplement we all would have heard about it and the BPH forum on patient.info would be full of information on it.
So my vote is a big no, unfortunately and sadly. Perhaps some supplements can prevent it getting bigger but once it's bigger there's not much you can do unless you want to take the horrible drug finasteride or similar ones.
frank74205 mike588
Posted
Hi Mike, Ingredients for shrinking -prostate Glycine,—-LGlutamic Acid,——LAlianine
Check this prostate pill see these items are in there
There is a prostate supplement called Prostavol that has these ingreidents.Have you heard about this pill? I just sent for it. Wouldn't it be great if it did shrink the prostate?This pill states that it will shrink the prostate?It has a 90 day money back guarantee ?Have you heard anything about a supplement that will shrink the prostate? I have BPH along with complete urine retention.I do have my doubts?
frank,