Self Catherization: Issues and Problems
Posted , 44 users are following.
Self catherization (CIC) is a proven and tested method of emptying your bladder completely. And while most people find it an easy and painless procedure, understandably some have problems, especially in the beginning. This thread then deals with problems and issues people may encounter with CIC.
For those not self cathing, or for more general information on the topic, there is an ongoing thread here:
2 likes, 1488 replies
jwrhn1951 jimjames
Posted
One of the last posters on the old thread brought up issues with cataracts and tamsulosin. I'm wondering if the same problems can be caused by finesteride.
More to the point is there evidence that these drugs can increase the growth of the cataract. Last time I had an appointment with the eye guy he said there were catatacts but I should not have to worry about them for a few more years. If I'm going to be doing CIC indefinately it would be good to see what I'm doin..
zdzislaw jwrhn1951
Posted
Don't worry to much about cataracte. I am still taking Alfuzosin and I had my two eyes very successfully operated on for cataracte despite problems with macula. I wish the prostate would be so well treated...
dennis47445 jimjames
Edited
Jim, So this is the new thread? I'll be looking forward for the comments and updates on everyone.
jimjames dennis47445
Edited
Hi Dennis,
Yes, new. The older self cath thread was started to stimulate discusson of self cathing as an alternative to TURP, PAE, Urololift, etc. It later morphed into more of a "How to Self Cath" thread which may or may not be of interest to someone not self cathing. Plus it started to get very long.
So this thread is more for people who are already self cathing who either have problems or tips for others. It's also a good place for people to summarize/update their self cathing experience. I plan to do that myself soon.
Jim
jimjames
Posted
It was suggested I include a link to the older self cath thread so here it is:
https://patient.info/forums/discuss/self-catherization-an-alternative-to-turp-greenlight-holep--336874
michael72708 jimjames
Posted
Hi Jim,
Just to give a quick recap. I'v been cathing on and off for about 2 years. Partially as a result of Urolift gone bad. I feel very accomplished in CIC and have basically come to pretty the same method you use. Within the last 2 months I had the PAE procedure which seems to be helping but has not been miraculous for me. They say there can be improvements up till 6 months. I'm continuing to cath with Dr Bagla and my own hope to further reduce PVR.
I wrote before that the catheter felt like it was snagging on something occasionally on the way out ( maybe once a week or less) and was even a bit stuck one time. Slightly twisting side to side and pushing back in seemed to work for that problem. Last night upon attempting catheter removal it was absolutely stuck and no technique seemed to work so ultimately I pulled harder than I felt comfortable with and it came out. Doing some research for CIC removal problems (for which there's not much info I could find) they recommending really relaxing for up to 10 minutes (hard to do with a catheter stuck in), coughing, side to side movement which I tried and didn't work. Litereature mentioned catheter could stick to "bladder mucosa" through eyelets but it seemed as if catheter was about 1/2 out but I was pretty freaked out and unfortunately didn't note exactly how far out it was so can't be sure at all. My guesses at this point is some kind of stricture but I believed you said that would have an effect on way in, some function of suction through evelets, possible encrustation in the urethra of one or more of the urolift staples or other unknown possibilities If it keeps up I guess I'll have to go for a systoscope. I'm trying to avoid irritation of the urethra but this may call for investigation. Any thoughts or suggestions Jim?
jimjames michael72708
Posted
Jim
michael72708 jimjames
Posted
Speedicath hydrophilic size 12 with coude tip. Maybe 1 to 2 min max. Haven't timed it. BTW this sticking occured in end of the night and bladder was closer to 550 ml urination and cathing combined. More than I usually let accumulate but I woke up a bit later around 5AM instead of 3AM so bladder was fuller.
jimjames michael72708
Posted
When it gets stuck, would you say that the coude tip of the catheter is between the internal sphincter (bladder entrance) and the external sphincter (prostate resistance point) or between the external sphincter and the tip of your penis?
In any event, 12F is pretty small and doubt if you could go to a 10 and effectively cath because it would be so flexible, but maybe worth a shot, not sure on that.
One thought is to use an external lubricant like Surgilube and really glob it on. Also, have you tried a different catheter as the eyelets are not all the same? Or even a non coude? It may turn out that one brand/shape sticks less than another. If it really becomes a problem you could try a different material like the red rubbers. Also, if your cath distributor has a help line, maybe speak to someone as they may have heard this problem before and might make some suggestions.
As to strictures, etc, I guess they would have to have a look if the problem keeps continuing. My doc did tell me that if I had strictures I'd know it but he's told me lots of stuff and not all of it was correct
Jim
jimjames michael72708
Posted
Just wanted to add that in thinking it over, I had a few incidents probably over a year ago where the catheter felt stuck but did come loose after I tugged and twisted it for a few seconds. Never stuck as bad as you described. If memory serves me -- and it often doesn't
-- it was when I was experimenting with irrigating the bladder.
I mention that because while my usual "in-out" catheter time back then was probably under a minute, with the irrigation process the catheter was probably in for several minutes and it's possible that the hydrophilic lubricant starts breaking down with time, just a thought. The times I'm talking about are not the entire process but from when the catheter enters the urethra until it leaves the urethra, which would include of course enough time for the urine to come out.
So, I'm wondering if this is happening more when you hit the 2 minute window than the 1 minute window? Certainly not telling you to rush the process but just to help figure out what is going on.
Last thought is on the removal technique itself. I haven't timed the removal (catheter in empty bladder until out of urethra) but my guess it's no longer than probably one second. Possibly two. I just pull it out in one quick but gentle motion, no stopping. As I pull it out, I shift the angle of my penis back up toward the ceiling just like when the catheter enters it.
So, if you're pulling the catheter out slowly, I suggest you experiment by pulling it out faster with one quick and steady movement. You might not want to break the one second mark the first time, but just progressively speed things up as long as there is no pain. It just seems like one fast motion would make things less prone to stick.
Jim
cartoonman jimjames
Posted
And there is the question that needs to be asked: Michael is the curve turned UP, towards the body (or if you're "dropping" it down into the head, is it facing towards your body? If I recall, that is the correct way, and turning it any other way is a No-no. AND... Michael, do you know WHY you were prescribed the coude tip?
jimjames cartoonman
Posted
If you're standing up, the curve is slightly upwards facing toward your body. You can double check that because the indent on the plastic funnel will also be facing your body.
Jim
jimjames
Posted
To be more specific, If you're standing up, and you drop it into your penis (penis head pointed toward the ceiling) then the curve is slightly upwards faciing toward your body. Same with the indent on he plastic funnel.
michael72708 jimjames
Posted
Hi Jim,
I really took note as I cathed before bed last night. It was almost as if the coude tip was snagged immediately after emptying my bladder. Even before I pulled it out fast or slow it was snagged. I tried aiming the penis up and relaxing and it did come out without pulling really hard. It freaked me out enough that I didn'y cath in the middle of the night when I usually have the most residual. I waited till the morning and everything was normal in the cathing department. The disconcerting thing is that for almost 2 years I cathed fairly regularly without having anything like this. So I'm really wondering what changed of course. First thought is PCa since my psa is about 17 but I had 2 3TMRI s and a recent biopsy and 3 in the past that showed no cancer but the possibility is always there. Next thought is perhaps prostate shrunk as results of PAE or some other effect on prostate which might be causing issue. I will write to Dr Bagla in case he's seen anything like this. I read that after long term cathing there can be some scarring etc. Plus possibility of encrustation from Urolift. So I'm all over the place about the possibilities. I had called the catheter company and expect to hear from them today. I will ask them to send some non coude tip as well because that could be the problem. I called my regular urologist who did the urolift to see if he thinks I need systoscopy. A little bit afraid to irritate the urethra again with that but will do it if it seems necessary. Waiting for a call back from him as well. So anyway I noticed for sure it was happeneing in the very beginning at least last night. Thanks for all your suggestions and thoughts on this problem.
jimjames michael72708
Posted
Howard31850 michael72708
Posted
Hello Michael - I'm not one to be giving suggestions here but I was wondering if your technique is to push the catheter in about an inch after the pee starts to flow? If so, then maybe not push it in any further once the pee starts to flow and just let it empty and then take it out.
Also - have you tried a slow rotation of the tip in the bladder once you finish emptying? But make sure the coude is properly oriented again before started to remove it.
Also, if you don't push the tip in further once the pee starts, maybe try pushing it in further about half an inch to get clear of the bladder neck region. (opposite to above suggestion). Maybe it is snagging on some old scar tissue or folds in the neck region there.
Good luck.
Neil
jimjames michael72708
Posted
Hi Michael,
So assuming things are getting stuck while the coude tip is in the bladder...
It could be as simple as your internal sphincter clamping down harder now than before when the bladder empties. This is not necessarily a bad thing. One way to test this would be to insert the catheter into the badder and then remove it without cathing anything out. Or, you could just cath out a little, stop the flow and remove it. If it slides out real easy that would tend to support the internal sphincter clamping down.
If that's not it, you could try twirling it (make sure you're inside the bladder when you do this) and then quickly removing the catheter once you line up the guide bump on the plastic funnel. As mentioned, lubricant and a non-coude would be some other things to try. Although not clear, what I've read suggests the hydrophillic lubricant does not last as long as an external lube.
As to the things you've mentioned, it really could be anything but I'd start with the simple stuff mentioned above before going deep sea fishing
As I mentioned, I had a sticking problem a few times myself and then it resolved. I believe it had to do with leaving the catheter in longer than normal but can't be sure on that.
Jim