Self Catherization: Issues and Problems

(1) If you are not using Magic 3 catheters or SpeediCath, get some and use those.  "The choice of Professionals," and most often recommended by us.  If the nurse gave you the rubber ones, you are using ancient technology, and she did you no favors.  They are cheap for the hospitals and wretched to use.

(2) Do NOT repeat NOT go for a TURP without reading up (on this site and elsewhere) of alternatives.  The downsides and side-effects of TURP are common and more so than most urologists admit.  

(3) It's late and it's been a long day for me; others will surely offer you more info and ideas.  This is a great place to do some learning.

Thanks. I have Magic 3 and they worked well in the hospital with her supervision, but at home nothing happened the first time, and the second time urine only came out once i withdrew the catheter. I know it'll get easier, but afterward i peed on my own and it was like passing razor blades (but still a relief, since i had hardly urinated in the last two days--it's almost like the cath cleared a path in there.)

?I have a Urolift scheduled but don't plan on doing anything more invasive if that doesn't help--at least not yet. Doc says it may not work, but he is encouraging and agrees to try it.

Hi Wilbur,

It can take a little while for some of us to get used to self cathing. I had a rough time in the beginning and took me several weeks until my body started to adjust. Today it's like brushing my teeth, just quicker. No pain, no nothing.

Some catheters work better than others. The two I would suggest you try initially are Coloplast Speedicath FR14 with Coude tip and the new Coloplast Flex FR14. You can get them very fast if you have an Rx. 

There are generally two points of resistance you will feel. First is around the prostate and the second is when you enter the bladder. I'm thinking what happened is that you never made it through into the bladder at home. If you did, urine would have come out of the catheter. 

Push gently, but keep going until you pass both points of resistance. Again, you might have stopped too soon. With me, my urine doesn't start to flow until there's only about an inch of catheter left but it's different with everyone.

Please report back with feedback and we can give you more tips. Best advice is to be gentle but do not be afraid to keep going until you pass the second point of resistance (bladder sphincter). Sometimes you have to wait a second, try and relax at that point, and then push again. Some people find a little cough helps. Some find a very gentle subtle twist back and forth helps get in. 

As advised, I'd put off any type of surgery, including TURP and Urolift, until you get your bladder issues sorted out. 

Overall you sound pretty together for your first day. I was a wreck for my first few days but it's amazing how both the mind and body will soon adjust.

Jim

 

Thanks. I urinated some this morning on my own with no pain, and I am sure you're correct--i didn't get the cath all the way into my bladder. But I'm so nervous i was either doing it wrong or damaging something that I'm going to call the nurse today to get one more demonstration. I know i can get the hang of it, and I can't tell you how much it helps just to read the posts on here. I really want to get my bladder issues sorted out, and would love to do so before the Lift, which hasn't been scheduled yet.

?I'll report back tonight. Thanks again. This thread is a lifesaver.

JimJames, I agree almost completely with your suggestions for Wilbur, with one notable exception:  the coude tip!  For those with deviations, it is essential; for those without, it is to be avoided.  I get the "straights," but early on, the supplier shipped me a box of coude tips, which I dutifully, painfully used, until I learned of the difference (maybe on this site?!).  Wilbur needs this bit of distinction/clarification!

Also re points of resistance... yes, two.  I have thought, or in my case experienced, the first point to being the passing through the first sphincter, where I often have release of ca. 25-50cc of pee, and the second passing through the prostate restriction/second sphincter, where the reservoir is then tapped.  And yes, I have the same 1" of tube remaining exposed...

Hi Cartoon,

You said: "... I agree almost completely with your suggestions for Wilbur, with one notable exception:  the coude tip! ..."

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I respect your opinion but to clarify for Wilbur and others, it's just that, an opinion. I have seen nothing in the literature to support avoiding coude's and advocating straight catheters for men with BPH. On the other hand, there is much support in the literature for Coude tips for men with BPH, and not just for those with "deviations". 

This is not to say that the Coude tip is best for all men with BPH, and your case is an example. That said, it's just one example. 

So again, my suggestion is to start with the Coude, but yes, of course experiment with a straight, I'm all for experimentation. But to say that coude's should be "avoided" just isn't correct. 

As to technique, very important the Coude is oriented properly except in the case of the Coloplast's new Coude Flex which has a different design and requires no specific orientation. That is another cath I recommend as a starter cath to compare with the Coloplast Speedicath Coude. 

Jim

 

Jim, I got some samples speedy cath flex. Question When i take it out of the pouch hold it up vertically the fluid runs down out of the funnel,am i doing something wrong. thats the way you tube shows this?

Thanks 

frank,

Frank,

Only used them twice about a month ago and can't remember if any of the fluid ran out. Did you try them. How did they work?

Jim, Yes i tryed one sample .My output was 450 Ml I haven't had that output for a while.Maybe this catether is taking out more urine? I don't know yet. I do like the less chance of infection with this catheter.I called coloplast and they said  after taking catheter out  hold it vertical and let the excess fluid drain out the funnel end.

I think i"m going to like this catheter.

frank,

Ha ha. Way to go cartoon ! At least someone else too took a stand against the coude.

Hank

Wilbur,  I am in complete retention. I started CIC 8 months ago,i refused Turp,and glad i did. They now tell me because of my bladder dysfunction,there would be a 50 or 60 % chance i still will be in retention. Do you have complete retention? No NV? I woud do the CIC  I am going to see a URO about URO LIft. Talk to your URO about this proceedure?

frank

For Hank and Cartoon, and  other coude challenged individuals I suggest trying the new Coloplast Flex Coude. Very gentle and no tip orientation necessary not that I'm suggesting anyone here would insert one incorrectly

Anyway, I tested the Flex few weeks back and if I had to go back to cathing on a regular basis, would seriously consider either switching or at least using the Flex when away from home. Frank also just reported back favorably on the Flex.

Other than of course that it's sort of a coude one advantage is that the sheath protects the catheter from contamination. The closest thing to a closed system I know of. Even with precautions and my "dive bomb" technique, I always wondered what was floating around in the air in public rest rooms. The Flex should significantly protect you in that regard.

Jim

 

Frank,

Glad the Flex is working out. Not sure why it's necessary to drain the fluid, but I suppose you could try it both ways (drain it and not drain it) and see if it makes any difference in insertion. Thinking back, I really don't remember fluid coming out but maybe that is because I didn't hold it up vertically  like I do with the regular Speedicath. If I ever have a chance to use it again, I will be more observant. What French size did you use? 

Jim

I've talked with him about urolift and he says although it hasn't yet been FDA approved for retention it might help me. But he told me not to get my hopes up. I don't have complete retention. I go small amounts on my own periodically during the day. I'm very wary of the more drastic procedures. Of them all he prefers holep.

Back at the hospital. Nurse tried twice with the magic 3 and she couldn't get it to work either. Then she tried one with a curved end with no result and finally one with a larger diameter with extra lube and some numbing agent and drained 350 from me. She sent me to rest eat and drink and return this afternoon for another go so she's sure I can do on my own. Today was pretty awful

The curved tip is called a Coude tip. Find out what catheter she used and what was the size. Sometimes you have to go up a size to get it in, especially in the beginning. When things calm down I bet you will be able to go back down a size. Meanwhile, contact Coloplast and get some samples of both the Speedicath Coude and their new Flex Coude. The nurse may not be familiar with the latter because it's new. Get several sizes to experiment with. Given the initial trauma, and depending on how susecptible you are to UTI's, you might ask the nurse for a prophalactive antibiotic get you though the week. Things are going to get better. We've had fellows here who have had similar experiences in the beginning who now have no issues. Personally, I was a wreck the first week but now it's like a total non issue. Takes me less than 10 seconds with no pain, no nothing. Not that I'm suggesting you do it that fast! In the beginning take as much time as you need and be gentle. I think you will find it easier for you to get it in than the nurse since you can feel it along the way. In fact, instead of the nurse cathing you this afternoon, try and do it yourself under her guidance.

Jim

Frank,

BTW the Coloplast Flex Coude now comes in two versions. The "standard" and the "pocket". It's the exact same catheter but the pocket version is folded more in the packet so it will fit more easily into your pocket when out of the house. That said, the standard version should fit into most pockets as well. 

Jim

Well thanks for this input Jim!  In my case, when I was a cathing "newbie," I was specifically told that because I did not have "obstructions," that I specifically didn't need the coude tip.  And I don't know whether "obstructions" in the system are more or less common than "no obstructions."  And I can't tell you what sort of obstructions they were referring to.  All I have is experiences, and in my case, using the FR14 straight-tip was easy-peasy from the get-go.  I mean, REALLY easy.  The coude tip, by contrast, made me think of a previous lifetime experience with The Spanish Inquisition, on the "receiving end!"    Even oriented correctly, it was a full box of nastiness; Old Peter still remembers those awful times!  That's why I think it's an imporant item to consider.  Especially for newbies on this thread.  Of couse and as they say, "Your mileage may differ..."

HEY, Jim!  Who 'you callin' "coude-challenged???"  I just prefer to stay clear of any and all abusive relationships.  My relationship with straight tips has ALWAYS been good.  And if it ain't broke...

Didn't work. I tried with guidance and then she tried. Three more caths including coude tip, and all with a numbing gel. Eventually, she felt so terrible that she said we needed to quit and she would speak to the doctor. I passed almost as much blood as urine. She told me to try again tonight if I felt up to it. I don't. She is having several sample caths shipped to me. 

Sorry about that. The possibility always exists that you have what is termed a "false passge" which is sort of like a dead end in the urethra. Your doc can check that out if he wants. More likely, just a difficult beginning. Maybe rest awhile and try again. Also, a muscle relaxant like Tamsulosin (Flomax) or even a little valium might just relax things up enough to let the catheter pass through. Again, the gentlest cath I have ever tried is the new Coloplast Coude Flex. It's specifically designed for hard to cath situations like yours. BTW is the person helping you a cath nurse or just a nurse in the office? Some offices have more experience with self cathing than others. 

If it ends up not working and they tell you to go on a Foley, my suggestion is to ask for a suprapubic catheter instead. Much more comfortable than a Foley and no tube in the urethra. No bag if you get the "Flip Flo" valve. The suprapubic will empty your bladder completely and still allow you to pratice self cathing at your own pace. Can't do that with the Foley. If/when up to it, I would try the muscle relaxants first with different catheters including the new flex coude. You also might want to try cathing from the prone position into a urinal. I have found lying down often opens up the canal more than from the standing position.

Jim

On a serious note, you might want to sample the new Coloplast Coude. It's not a traditional coude tip so absolutely no bend, sharp edges or anything like that. Again, one thing I like about it is that the sheath protects the catheter from contamination almost like a closed system. A good feature for public rest rooms, etc. Trust me, it won't hurt you

Jim

Clarification -- it's the new Coloplast FLEX coude.

Welcome! At least you have an intelligent doctor! I have had an unnecessary TURP and am self cathing all the time. You are really young. Sth can probably be done for your bladder? Good luck!!! Zdzislaw

I habe just got some samples! Not tried yet.

Hi Jim,

I asked for the new Flex coude 2 weeks ago but have not received them yet. The Coloplast rep probably had problem veriifying my prescription with my doc's office. It happened before when I asked for the compact and I gave up, never got any.

Hank

BTW, if the original coude is so goooooood as you think it is, why are they replacing it with the new Flex coude ? I bet you Coloplast received enough complaints from people like cartoon and I.

Hank,

They aren't replacing the regular Speedicath Coude at all. I still think it's the best catheter on the market and most here except for a few outliers agree They are just adding a new design based on customer feedback, most of which had to do with portability, because as you know the regular Speedicath's don't bend very well. I also have a suspicion that the patent on the IQ cath may have run out because they look very similar in design.

BTW it now comes in two versions. The standard flex and the pocket flex. Exactly the same catheter but the pocket version is folded twice so it will take up less space in your pocket. That said, I found the standard fit into my front jean pocket without a problem.

And again, forgetting the coude debate, the near closed system design is very innovative for a non-bagged catheter and I really think it will cut down on UTIs in the long run.

Jim