Self Catherization: Issues and Problems

Any burning or pain when doing a natural void? Are your nitrites positive or negative?

Probably wise avoiding antibiotics unless you really need them. Positive leukocytes, blood and even nitrites are fairly common when you CIC. Antibiotic treatment only necessary when symptomatic and it's debatable whether you are. 

Public bathrooms aside, you're actually better cathing more to get rid of a uti. The reason being that more residual means more stagnant urine and that's where bacteria breed. So, ideally you would actually increase the frequency of CIC while at the same time increase your fluid intake to flush the system out.

Jim

Nitrates are positive also. Since October I've used the strips and everything has always been negative.

Yeah pain and burning with the natural void. Guess doing it more often would be better but I'm kind of a wimp

I'll see how large  the PVR is in the morning and go from there.

As always thanks for the advice

Sometimes there's a fine line between "colonization" (don't treat with antibiotics) and a UTI (treat with antibiotics). So, my advice again is to try and flush out the system but if things get worse, consider antibiotics. You might want to culture now so if you need antbiotics you will know which one to use. Most accurate culture would be from a catherized sample. I would therefore urinate just enough to clean the urethra, then clean penis head and meatus with whatever antibacterial you use, then I would cath into a sterile cup like you get from your urologist or a drug store. 

Jim

Well I've been drinking lots of water and urinating every hour or so.for the last 24 hours. This morning I decided to just catherize without a NV before to see what my PVR was and it was only 180 ml so I'm feeling good about that. The test strips are still showing +++ for blood and the luekocytes protirn and nitrates are still positive but only barely. Didn't see any clumps of blood and it only took 15-20 seconds to enter the bladder although there was still some burning for the last few inches.

I'm thinking I'll keep drinking lots of water and catherize again in 12 hours.

I'm traveling again tomorrow so I'm a little concerned about that as that seems to have been the start of my problems. 

!!!!! Whoah, WHRN1951! "contaminated the catheter"????  Don't mess with THAT!  Esp. in a public restroom!  I've had my share of UTIs while CIC-ing, and I have thrown away catheters that I accidentally contaminated, to avoid any obvious threats.  Don't use 'em if there's any doubt, seriously! 

And if you use JimJames's World-Famous Method  (Holding Old Peter straight up while you carefully aim and slide the catheter (held vertically) into the old pee hole, then there is almost zero likelihood of contamination. Word to the wise...

I travel too, and have just gotten used to the idea that it takes a few extra minutes to do it right.  And of course, always using a stall, not a urinal---don't need to scare anybody!  :-D

 

Still painful when urinating? What about the fever? I still think a culture is not a bad idea at this point. You probably don't need to take any antibiotics at this point, but if things get worse you will know better which ones to take. I've been forturnate due to my schedule (and my bladder's schedule) that I have been able to avoid public rest rooms most of the time. When I did use them, I tried to use the stalls and set things up on paper towels to try and keep things sterile. That and plenty of hand sanitizer. Good luck.

Jim

I use public stalls numerous times in a month.  The SpeediCaths come with a hanger and a stick-on tab, which work on most surfaces/in most situations. There's always someplace to lay the alcohol pad envelope.  Using JimJame's "World-Famous Dive-Bomb the Pee Hole Technique," I carefully clean the tip with the alcohol pad, open the SpeediCath cover, remove cath vertically, holding only the green tip, and lower it in expert fashion into where it should go.  I suppose it's more of a challenge for those who didn't suffer circumcision before they were old enough to say, "Hell no!"     But for me, I no longer even clean my hands, as they don't come in contact with anything that goes inside me.  I AM one of the 25% of men's room visitors who DO wash their hands before leaving! (Figure is a gross one, from an actual medical/social study of guy's habits...  UGH!)

Cartoon: The SpeediCaths come with a hanger and a stick-on tab, which work on most surfaces/in most situations. 

-------------------------

Maybe it was my egg-shell painted walls, but never trusted the stick-tab after it fell off the first time. I use the open-it-up-and-stick pack-under-left-arm pit-method. Then, after cleaning the door, I reach across to my left arm pit and pull the sword out of the sheaf. The King Arthur Method?

-- Jim

:-D  "The King Arthur Method"?!?!?!  Great!  And yes, I had one of those "Now it sticks, now it don't" experiences, so I look before I stick--- and if it looks iffy, I almost always find some glass or metal or chrome surface that works.  And yes, occasionally under the arm.  It's most important to have a clean sweep as the sword exits the scabbard (to continue with Arthurian references), to avoid ANY contamination!  

Also, because of two different bad experiences, I do NOT open the package until I've "swabbed the deck."  Awful moment it was, 18 months ago on honeymoon in SOuthern France, to finish the procedure during a 2:00am wake-up call, only to see, on the toilet tank, the UNOPENED ALCOHOL PACK!  Oh, woe was me!  And how to say, "Monsieur Docteur, I have BPH and now have given myself a UTI!?!?!"    

I remember the 2am unopened alcohol pack well Nothing to do but try and forgetaboutit and go back to sleep! 

Jim

Hi, jwrhn,

After my PAE 6 months ago I had a nasty UTI. Still had some symptoms after my 1st course of antibiotics. Started taking D-Mannose, supplement that got a good review from the national institute of health. You can look up info about it online. I buy mine from Whole Foods in capsule form and take  1 in the morning and 1 in the evening. The label says your urine will smell when you first start taking it--and howdy, it does! But it soon clears up. I haven't had a UTI since.

Stebrunner

Steb and Jw,

D-mannose only works for gram negative bacteria such as e coli. I think Jw may have a gram positive based on his positive Nitrites. I tried D-Mannose and no luck but I also had a gram positive situation. Glad it worked for you, however, and probably a good prophalactive against e coli. 

Jim

Maybe you are more able to be philosophical in ways I can't!  I immediately begin awaiting symptoms, or planning remedial lime juice guzzling...  :-)

Hi, Jim,

In the past couple of days, I've hit my personal best time of 15 secs two more times! I think it's because I've been using a new yoga pose. If you want to check it out on Youtube search for The Pelvic Floor Sumo Pose. I focus on the relaxation side of the pose while I'm doing CIC. Don't worry, I'm not pressuring myself for a fast time, but I often count off when I start inserting the catheter. If I hit the external sphincter and get hit resistance, I stop counting and focus on relaxing. Can't believe how easy it's been to get through on these personal best times, though. It's also been helping my NVs.

Stebrunner

Stebrunner,

I think the expression is "you've come a long way baby"! For those not familiar, not that long ago Stebrunner took longer to self cath than many take to commute to work! 

I took a quick look at "Sumo". So are you cathing then in a squat position? Are you doing your NV in same position? If you are, it sounds like on the natural void you are focusing more on relaxing the detrussors than contracting (pushing) the urine out. I always found that the most effective whatever the position.

Speaking of different positions including the squat, as you might remember I'm at the point now where I'm only cathing maybe once every other week. However, I do run into these episodes of near acute retention on occasion with a full bladder. Lately I've been experimenting with different strategies to get the flow started in those situations, and one is walking around and/or doing a few squats. Also been trying different positions as well some new (to me) reflux voiding techniques using warm (50 c) water compresses on the bladder area.

Jim

Almost missed the point on my last post. I'm also exploring the theory that some of these dynamic and reflexive techniques to start the flow may also be helpful in increasing NVs, although I don't want to be too greedy since I'm often below 50, but still it's interesting and might also be helpful for others. I will post more on this later but to over simplify one reflex technique -- simply soak a wash cloth or small towel in hot water right out of the tap, which should be around 50 degrees Centigrade. (I've ordered a water thermometer from Amazon to be exact!). Then place the hot towel on your abdomen area for twenty minutes or until you feel an urge to go. Having a cup or urinal nearby helps if you don't want to do this in the bathroom. I came across this and a few other tips in some studies of temporary post operative AUR caused by anathesia. There are also some more radical positions but I'm hesitant to post them because they are not supposed to be used if any obstruction, however should be OK if for example you had your obstruction removed via TURP but couldn't void strictly because of an atonic bladder.

Jim

Hi Jim + Steb, Did you guys try this yoga pose : upside down ? Hank

Hey, Jim,

When I do the Sumo pose, I only squat about 3" or 4". I push my tail bone out a bit and relax my breathing. Soon I will feel my sitz bones start to relax and move apart. Still getting the hang of it, but it seems to be helping a lot. You're right about my NVs. On those I totally focus on relaxing my detrussors.

My habit over the years has been to rush and push--and this has been true with bowel movements, too. Likewise I've been relearning how to relax on those and to let my body do its work. Until a few months ago, when you and Neil started posting about relaxation techniques, I had never heard of the pelvic floor. Now i'm finding it's pretty darn important.

Stebrunner

Hi Hank,

LOL! That's a funny visual! When I first started CIC, there was a night I just couldn't seem to get past my external sphincter. I tried all kinds of things to get through--and I actually stood on my head, hoping to shift my prostate away from my urethra! Didn't work, but I laugh when I think back on it.

Stebrunner

So what is your cath frequency these days? Are you doing NVs with every cath? When you do cath, generally what is your NV volume vs cath volume?

The relax vs push seemed to help me from the beginning although now I sometimes alternate relax/push during a NV. I would focus on keeping the internal sphincter open but can't be sure if it's doing that and/or the external sphincter since in theory the interal sphincter is involuntary but whether 100% involuntary probably has not been studied. Recently, I read something about a voiding study where the instructions to relax the sphincter had better results than to push out. So I think we're on the right track here. Last night before sleep I decided to see if I could more fully empty my bladder even though there was no urge. So I tried a reflex void technique, namely the hot towel on bladder -- and out came around 125cc. Not a big deal, and probably more of an experiment, but I might have gained/lost one trip to the bathroom. Only went once and I have been averaging twice this week.

Jim

Hi Hank,

Funny you mention that. I have what is called a bladder diverticulum which is like a pouch attached to the bladder but because the pouch walls have no detrussor muscles the diverticulum does not necessarily empty when the bladder does. Since I've never had video urodynamics, the follow is conjecture -- but what seems to happen is that first my bladder empties during a NV and then the diverticulum empties later into the bladder. So, the idea with standing on my head was to see if I could empty the diverticulum into the bladder mechanically rather than the two-step void process. Not sure if I was able to or not (can't really do a good head stand these days so it was a so-so shoulder stand) but if I ever do spring for a home bladder scanner, it will be an interesting experiment as I could actually get a pre-headstand and post-headstand image of the diverticum

-- Jim

Hi steb, I am so glad you checked it out already (head stand pose). I was always curious about it. Kidding aside, I read somewhere on the net that there are 2 yoga poses that help BPH. One is the head stand, the other I don't remember its yoga name but I called it " crooked twist". You sit down with both leg stretched first. Then you lift one leg up and hook it over the other at the knee. Then you hook the arm of the other side over the hooked leg. Is looks like a pretzel when done right.

BTW, I tried the sumo pose. It seemed to help with my NV a little bit. I think the pose opened up the pelvic area and left more room for the prostate. That's all there is. Unlike you yoga masters (you and Jim) making it into something more complicated like meditation and relaxation, etc. I plan to try it out with cathing soon.

Hank

Hi Jim, I would like to try that hot towel on bladder technique. Can you give us more details. How hot ? How long ? How wet ? Hank

I am going to post more detail on this at some point but briefly try 50 degrees Centigrade/122 F which should be what water comes out of the hot faucet at. Probably not necessary but I just ordered an inexpensive water thermometer from Amazon, I think about 8 bucks. I think the time was 20 minutes but if it starts to stimulate the urge to urinate, I would just urinate at that time. When I did it last night, I was leaning back on my couch with a beaker to catch the flow. I also combined it with very light rhymic tapping (not pushing) on the bladder.  If I locate it soon, I will private message you a study or two showing different techniques and comparisons, so please experiment. Welcome your or anyone else's input on how it works out. 

Jim

Thanks Jim. Also for the PM link. Hank.

Hank,

For those following, a second reading of the study found even better results -- although not statitically significant -- at lower temperatures (77-86 degrees F) compared to the 122 F I tried. Both temperatures yielded significantly better results than the control. 

There is another study where the subjects actually soaked in a bath but in this study the higher temperatures yielded better results.

Jim

Hi, Jim,

The past 2 days I thought I was coming down with a cold so I upped my water intake. Last night I woke 2 times and had NVs of 150 ml each. Probably should've cathed after the 2nd one but waited until I got up for the day. Then my NV was 250 ml and CV was 325 ml for a total of 575.

My 1st NV/CIC of the day is usually my largest--frequently with a TV between 400 and 500 ml. My CIC frequency is 5 times a day--sometimes 6. Later this afternoon I had two NVs of 200 ml and 100 ml within 30 mins. About 45 mins later did my CIC with NV of 100 ml and CV of 150. Seems now that I'm not coming down with a cold--maybe the extra water and Vit C stopped it. I'm trying to stay healthy as I'm scheduled to have bladder stones removed in 10 days.

Never thought that relaxing techniques would make that much difference in my NVs or CICs until I learned some of them. Once in a while I forget to use them when doing a NV--then remember halfway through. Suddenly I get a 2nd wind--my stream increases, and I get more out.

I often get hestitancy getting my stream started, but it doesn't last long. Somewhere on this forum, someone said taking a warm shower and suddenly changing the water to cold helped him with hesitancy and retention. Can't remember if he used the warm/cold water method on his abdomen or on his back. I hate taking a cold shower so the idea didn't appeal to me! LOL!

Stebrunner

Hi Jim, Today i had the urodynamics test.I thougt i would get the results right after,however i have to wait for next appoint with my Uro.

I could not pee ,however she said i had some activty. This test was a straight urodynamics test ,she said it should tell me why i cannot do a NV.

She also said if i still burn after 2 days of doing cic i should call the office.Sound like if this is the case i would have a UTI? Does this all make sense?

Thanks my friend,

frank

Frank,

Glad you got the urodynamics, will be interesting to see what they say. When it's ready, make sure you get a copy of the complete report for your files.

Were you burning before urodynamics or just after? Did they give you one or two pills of antibiotics to take for the procedure? 

Jim

Hi Jim. I was not burning before test . I took 1 cipro pill 30 min before test. After test, and for 24 hours i was bleeding. The pain wasn't that bad,however they said if i burn after 2 days i should call the office. I noticed blood clots when i did my cic,for up to 24 hours. Is this normal after  urodynamics test? it's ok now.I did ask if they were doing a video ,they said Dr just ordered a straight urodynamics test. I don;t like the fact that i have to wait till my next appoint  in March to get the results of this test. This Uro is so busy i have to wait 2 to 3 months for an appoint.

Frank,

Hi Frank,

If you're still having burning or bleeding now from the urodynamics I would call the doctor's office. I would also ask to speak to the doctor or nurse so that they could review results on the phone. No reason to have to wait. Also, have them send you a hard copy of the report for your records.

Jim