Self Catherization: Issues and Problems

@Keith:  Urology clinic doesn't really want to approve my continual self-cathing unless I'm doing something to treat my enlarged prostate. 

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You have to find a better and more informed clinic or urologist that will support your very reasonable decision to continue with CIC for now. What you say bordelines on either ineptitude or malpractice. 

CIC is a time proven method to empty your bladder, which means it will protect both your bladder and kidneys as well as any surgery. It can be either a long or short term strategy, and a very resonable way to extend the watchful waiting period until you decide what surgery or procedure, if any, you want. 

Beyond that, the last thing you want is to enter into any surgery or procedure without the proper testing, including cystocsopy and urodynamics.

I have taken both tamsulosin and 5mg daily cialis. They worked about the same except no retrograde orgasm with cialis and some erectile boost. It will not pick up your libido, but can enhance performance. 

They probably want you on it to see if it can stimulate some natural voids, and that is fine. If it doesn't help, you can just stop because again, your bladder and kidneys are protected by CIC as long as you keep your volumes under 400ml. Last point important for various reasons, so increase your CIC schedule if the volumes start going over.

You say you're only cathing 3x/day which seems on the low side for someone with no natural voids. For example, if your total 24 hour voids are 2000ml, that would mean you would probably have to cath 5 or 6 times a day to keep volumes below 400ml. I would suggest a void log at this point. Just log time of CIC and the amount in ml. Also, be careful of lowering your fluid intake as you don't want to get dehydrated, plus you don't want you urine to concentrated.  Better to drink a little more and CIC a little more than vice versa. 

Glad your creatine is normalizing. I assume they also did a bladder/kidney ultrasound study? Did they find hydronephrosis (water in the kidney)? That also should resolve quickly with CIC. 

Overall, sounds like your improving and have a good grasp on things. I would stand my ground and not get pushed into anything you are uncomfortable in the least about. And as mentioned, probably best to find a place more supportive and comprehensive in testing, etc. 

Jim

 

Thanks Jim.  I do think they were rushing me in a little quickly; but to be fair when my Urologist made the surgery appointment and when the P.A was preparing to see me, they didn't know I was self-cathing so they may have thought this was more of an emergency situation.  She was pleased to see (when I asked about it) on her laptop that the two blood indicators for my kidneys and prostate cancer were dropping to more normal levels since I started cathing.

 I think I will see about getting the prescription changed to 25 mg of Cialis instead.  I trust your advice and knowledge and have read about RE with

Flomax on other posts; not to mention the other side-effects.  I'm supposed to go in the end of this month for a cystoscopy.  The doctors have done an ultrasound on my bladder but not kidneys.  I assume they're following this with the blood tests.  This last visit they took blood for themselves and I haven't heard from results of that yet.  

Things do seem to be changing a bit with my NV.  I feel like I need to urinate sometimes about 4 hours after cathing but then it goes away.  If I am able to get out any NV at all I can bet that when I cath its going to be around 300 to 460 or so.  I know, I am trying to keep it under 400.  I was doing 4 a day for awhile but was only getting out about 250 half the time.  I know I am changing my water intake and coffee intake;  I just got done with hep c treatment with which I was drinking unusual (for me) amounts of water.  I'm probably normally dehydrated and I'm just used to that.  Drinking a lot of water along with coffee may be what got me into this problem.  

 

Keith,

Maybe I misread what you said before, but it sounded like the clinic would not support self cathing unless you committed to some sort of procedure or surgery in the future. You already have my comments on what I think about that mentality!!

Daily Cialis is not 25mg unless you want to start a career in p*rn The usual dose is 5mg Day. As I said before, it can't hurt but probably no better than Tamsulosin except regarding the side effect profile. 

@keith: I was doing 4 a day for awhile but was only getting out about 250 half the time. 

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Are you sure? With no natural voids and a 4x/day CIC schedule,  that means your total 24 hour urine output is only 1000ml?

As to the feeling of needing  to urinate going away, sounds normal with a stretched bladder and I wouldn't worry about that right now. If you are able to naturally void with or without Tamsulosin (or Daily Cialis) always give it a try when you feel the urge and/or before you self cath. And if you have to err, err on the side of more CIC than less. 

One tip to exercise your bladder muscles if you're not doing any natural voids. While you're doing CIC, GENTLY push out like you're voiding. You will know if the detrussors are working if the urine starts coming out of the catheter faster. You don't have to do this every time you cath or even for the entire 30 seconds or so of your cath void, but a good idea to do it a little here and there.

Jim

 

<Are you sure? With no natural voids and a 4x/day CIC schedule,  that means your total 24 hour urine output is only 1000ml?<<

No, I'm not sure.  I started a log about two weeks ago but didn't keep it up.  I understand the importance of doing that.  I'll try again.  I find it inaccurate using the beaker the way I am.  I insert to cath sort of pointing at the ceiling as instructed; once I push past the prostate and into the bladder out it comes and it usually shoots out a little before I get it aimed down into the toilet.  I'm getting better at it.  But then by the time I pick up the beaker and put it in position I've already lost quite a bit so I'm just adding on about 20 ml for that.    I"ve definitely noticed that when I sweat from doing yardwork or something it decreases my cic volume.

The Coloplast FR14 straight cath really works fast for me.  I've tried pushing a little as you suggest and I don't notice any difference in flow out of the catheter but its already coming out fast so I don't know if the diameter of it can handle any more pressure.  My NVs seem to be increasing just a little bit.  Haven't measured it but I would guess that sometimes; maybe once or twice a day I void about 80 ml before cathing.  Pitiful; but its something.  

Yes, I get it about the Cialis.  5 not 25.  I think your advise is right on for me.  

  

You'll soon get the hang of voiding into the beaker without spilling. Also sounds like you can try a size smaller now, FR12, and see how that works. If it does, then you will have less friction and a slightly smaller flow rate which should not only help with getting the void into the beaker, but also with the "pushing" exercise as there will be more resistance. Meanwhile, 80ml is fine at this point. 

Jim

Don't want to "bug" you; just wanted to confirm.  I just received a shipment from coloplast that I've been waiting for.  Almost gave up on them.  They sent me coloplast hydrophillic 12 with coude tip.  I tried one and your right: pushing slightly with the smaller flow; I can see and feel the difference when I push.  

I think I could have gotten by with the regular tip.  That coude tip feels a bit sharp while going past the prostate but I can get it in using the dive bomb method.  I feel I could have gotten a 12 straight in as well but I don't see a big problem with these.  

I have the line on the green cap pointing up; I'm sure thats correct.  Took longer to drain than the fr14 but thats ok.  I'm going to start logging with next void.  

I've been self-cathing for almost 3 years.  Early on I received a box of coude tips that were sent by mistake.  I used them, not knowing the difference, and experienced what you experienced.  Unpleasant and I'd not recommend using them, ESPECIALLY sine you've used straight tips and it worked fine.  Just my 2¢.

Thanks.  Yes I remember your post and that is a lot of why I'm a little squeemish about using these.  Did you decide that you might have not aligned the tip properly one time and did some damage?  I am surprised at how sharp that tip is.  It took so long to get these (120 day supply) I hate to have to send them back.  I actually requested samples but I probably shouldnt have called my medical supply place (medicare) for that.  If they don't send me at least a 3 month supply they can't bill medicare.

BTW - I ordered these because I thought the curved tip might be better since my main problem (I think - haven't had a cystoscopy yet) is an enlarged prostate and the straight 14 is a little difficult to get past.  I was using non-hydrophillic so maybe sometimes I don't get the lube on there right.  

If your cathing standing up, and your penis is stretched with the head pointing toward the ceiling, then the line/bump on the green handle should be pointing toward your belly. I will send you an illustration later via private message. As to the pushing exercise, I would do it gently, and not necessarily for the whole void or even every void. In fact, I've found larger natural by focusing more on relaxation than pushing. 

Jim

I was very careful about orienting those little suckers!  I gently tried it the OTHER way, just to check---and was reassured that I'd been doing it correctly the correct way.  

I undersand your thoughts about returning, but I sure wouldn't use 120 of those suckers!  Suggestion: call the supplier and ask them how to fix this.  They have been very helpful with me...

I am able to order as little as 2 boxes (60 catheters) as month from my distributor, and it's covered by Medicare. Check your PM later. As long as you're experimenting, you might want to try the new Speedicath FLEX Coude. The coude tip is shaped more like a ball, so not sharp at all. It's an interesting catheter but does require both hands, so "dive bombers" need not apply

Jim

Hi cartoonman, I have a question for you/ You have been doing CIC for 3 years,do you think it gets harder to do CIC as  you get older? My Uro says

 it's gets harder to do as you get older. Whats your opinion on this? It will be 1 year in Oct, for me.At 87 i'm still hanging in there.

frank,

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I am just like you cartoon. I ended up sending boxes of Coloplast coude fr12 back, even I could have kept them for free. Those suckers are inconsistent. They are usually easier to navigate for sure, but once a while they would cause bleeding. Hank

Thanks gentlemen.  I've used two of them so far and neither one has been as easy and comfortable as just the straight fr14 non-hydrophillic.  I made a mistake by trying to get some samples from the medical supplier that my Uro set me up with.  I should have just dealt directly with Coloplast or whoever I'm requesting samples from.  I think I have some coming and hopefully I can try an fr12 speedicath straight tip one.

Frank, I'm 68,   I find it easier now than it was three years ago.  Practiced hands now,  you know?  Can't speak to your age, as I'm not there yet, but imho, at 87, you're already older!    If it works, keep on keeping on!  I had a Urolift that stopped working; I'm waiting for iTind to be approved at this point.

Hank, as I understand it, bleeding =  switch to straights.  Who needs to lose blood?

Keith, I'm a fan of JimJames WOrld-Famous Dive Bomber Method.  The  Coloplast FR14s work great for this, and are hydrophyllic.  For me, the key is least mess n fuss possible, including one handed insertion.   I don't think you can order directly from Coloplast; I have had good luck from Comfort Medical.

Heh cartoon, I am also waiting for iTind. My symptoms are still mild so I do not think anything else more invasive is worth considering. Hank

Hey man, Thanks for that response.You said you had Uro Lift and it did not work? Were you in complete urine retention? No NV

Thanks cartoonman,

frank

Hi, Have you had any UTI in 3 years? Iwas told to get to the EM and do a urinalysis,then take a cipro after the test. After they get the results they will tell if cipro is the right antibiotic.I was told if i have a temp of 101 and foul smellimg urine i should do this? How do you approach this problem?

Thanks,

frank,

Frank, I had NV only if I didn't CIC... and allowed it to build up.  The problem was, that my PVR was 500-800cc!  Which made me decide to follow JimJames' World-Famous Method.  

Frank, I've had plenty of UTIs, though none since last November. I could easily feel the change in my body, and would IMMEDIATELY go for meds (usually Cipro) from the nearest "Doc-in-a-Box."  The last episode in Nov. required a super-antibiotic, as Cipro didn't touch it.  

If my experience is worth anything, it is to NOT go into denial, but rather to become extra-sensitive about what's happening.

Hi Cartoonman, I had a cystoscopy today. Dr said i have a very enlarged prostate,also median lobe

Uro Lift would need 6 implants, won't work for me ,he said i could get a NV if i had the laser GL.No guarntees. i could go back to CIC.He also said age is the reason for the enlarged prostate.

sounds like i have a similar problem like yours.

frank

Having a notable medial lobe rules out Urolift for you, yes.  I did not have that, so no, we do not have similar problems.  I had the Urolift, 6 impllants.  Which worked for only a few months. I've been doing CIC for a year while awaiting the .results of the iTind studies.