Self Catherization: Issues and Problems

Hi Wilbur,

I suggested the prone position to you because not only is the angle different but sometimes cathing (or voiding) in the prone position puts less pressure on the urethra.

Bottom line is that if self cathing (CIC) works for you in the prone position, for now at least, just do it prone, and don't worry. Many people cath in the prone position, for example in hosital beds.

That said, I think you can make it a more comfortable experience. First, you want to purchase a proper male urinal with a handle and snap on (or twist on) cap. They are designed so that you can urinate into them while lying down with no mess. This way you can do it in bed or lying on the living room floor and not have to lie on the bathroom floor.

You can also try a modified version, where instead of being entirely prone, you just lean back (slouch position) in a chair, and again void into the urinal. I personally don't have a problem doing CIC standing up, but have found the in a chair slouch position helpful at times for natural voids.

As to the office, can you lock the door to your office? If so, you can do it either lying on the floor or slouching back in a chair. 

My guess is that this is only going to be temporary for you. As your body starts to get used to the catheter I think you will soon be able to cath standing up.

What catheter are you using now? As I think I mentioned before, some catheters go in easier than others. The two I would suggest first are the Coloplast Speedicath 14 F with coude tip and the other is the new Coloplast Flex Coude. I would try them in that order. Experimentation is the key to getting the right catheter. Some find the non-coude Speedicath 14F easier, but I would start with the Coude. The new Flex only comes one way. 

There are other discreet ways to cath sitting down, but I would start with the suggestions I gave you, and again, hopefully you will be able to cath standing up pretty soon.

Jim

 

Just want to add that there are closed system catheters where a plastic bag is attached to the catheter. They can be used very discreetly if you need to which means, with some practice you could use them at your desk or even on a plane seat. But I don't think you have to go that route yet, just wanted you to know that there are other solutions out there. The important thing for now is that you are able to self cath. It will get easier over time, much easier, and again, I think in a little time (and perhaps with a more slippery catheter like the ones I've mentioned) you will be able to cath standing up when you want to.

Jim

Another thought. You might also try what are called "folding cane chairs". They are very inexpensive and you sometimes see people sitting on them on parade routes, etc.

They are very portable often have canvas seats and fold up to look like a walking cane (actually can be used as a walking cane) so you could take them into public rest or plane. If you really want to be stealth, just limp a little

Some are seat height and others put you in a "perch position" which is similar to sitting on a bar stool. You might find cathing in these as easy as lying down. They will also take the pressure/tension off your thighs and abdomen which may be part of the problem you're now having. 

Jim

 

JimJames, you mean sitting on the plane's TOILET SEAT, I hope!  I'm thinking of the recent UA and AA incidents, and thinking of trying this in one's PASSENGER SEAT...  "No, Ms./Mr. Flight Attendant, I'm fine, no assistance needed..."  The passenger videos of the melee would be interesting...

 

It can and has been done in a passenger seat with blanket providing cover, a closed system making it easier. A temporary, self installed Foley with bag is another way. If they do end up pulling you down the aisle, hopefully it won't be by the catheter

Jim

Jim, I am a cartoonist––– My mind is reeling, just thinking about it!  

Actually, since CIC became a regular part of my life, I'm not sure I ever had to cath on-board.  One good session in the loo, prior to boarding, and I'm good to go, so to speak, trans-continental or to Europe without needing to think about it!  

Jim, what is wrong with ly beloved Speedicath compact for travelling? Too short or too thick for some? Work ok for me. Z

To Europe? How do you keep for 8 hours? Z

ZD, I would never insult your beloved Speedicath Compact. Tell her I'm sorry for any misunderstanding here

Seriously, I was comparing the new Coloplast Flex Coude to the regular Speedicath Coude. One difference is that the Flex Coude folds easily into a pocket while the regular Speedicath does not.

Your beloved Compact also fits nicely into a pocket but doesn't work for me because: (1) It doesn't come in a Coude model; (2) A bit too short; (3) Requires additional insurance criteria.

Have you tried the new Flex yet? One thing I like about it for out of the house is that it's contained in a protective sheath which in theory should be more protective from bacteria, both on surfaces and airborne. If you do decide to try it, just don't tell your beloved Compact as she might start getting jealous

Jim

Ah, that jealousy thing!  

And as much as I admire and respect you JimJames, I must defend MY beloved FR14 straight SpeediCath, which I've  carried in and out of so many loos, just rolled up in my jeans pocket.  As long as one is careful, the cath can be rolled in its package with no damage to anything!

At least we're not all fighting over the same cath

Jim

Meant to say wouldn't work...

What brand/model catheter and what size are you using? If it's kinking you might have to up a size for now. That's a standard protocol. Blood is normal the first few weeks. You should also consider Tamusolin (Flomax) but check with your doctor because you don't want to mix meds the wrong way. 

Technique wise, if you're standing up, you should be gently pulling your penis straight with the head pointing toward the ceiling. The idea is to straighten out the canal. In this position the bent tip of the coude should be bending toward your belly. There are youtube videos if you are no exactly sure. Tip orientation is critical. As you hit the first point of resistance, the prostate, you can then move you penis pointing more toward the wall opposite you as the catheter goes around the prostate and into the bladder. (Modify for lying postion). But again, if it's kinking, you should find it easier with the next size catheter. Later, when you get the hang of it, you probably will be able to drop down a size.

Jim

I'm sending you private message with a link to a Youtube video showing the correct orientaton of the coude tip. This may not be the same catheter you are using but it will show you the orientation. Also, note that the guideline on the funnel faces your body. The guideline also faces your body with the Speedicath Coude if that is what you're using. Not sure if this is universal or not. 

Jim

Hi, Wilbur,

Don't throw in the towel yet on CIC! Many guys on this forum can tell you how I struggled to master it--with lots of failures. When I started out, my urologist's nurse at the time, did a p*ss poor (pun intended!)  job of teaching me. Under her guideance, I ended up 4 days later in the ER with urinary rention. Then I switched urologists, and the new nurses and PAs were very good at teaching me--and I learned a lot from Jimjames and other guys on this forum.

In the beginning I was also very tense when attempting CIC--I had bad memories of the Foley catheters I had been subjected to by urologists. In the beginning I found it helpful to use a larger catheter--and I used a Coloplast Self Cath FR18--which I dubbed "Big Bertha". It has a coude olive tip and could blast through anything. The down side was that it's a catheter you have to lube yourself--but hey, if it works... I now use FR14s or FR12s.

You might also want to see if you have a urinary tract infection (UTI). I had one in the beginning, and it caused my prostate and urethra to swell, making my early attempts even more difficult. My uro gave me antibiotics, and things became easier when that cleared up.

In the beginning, it sometimes would take me 5 tries with 5 different catheters over 80 minutes to complete a CIC. Someone once said that I took longer to CIC than most people do to commute to work! LOL! I was determined to learn CIC, however, and it's now as easy as brushing my teeth!

You also might want to search Youtube for videos on how to relax your pelvic floor. If your pelvic floor is tense, it can make CIC a challenge.

Hang in there! You can master this!

Stebrunner

Thanks to both of you. I haven't tried again since the other day. I'm still a little sore, like maybe I bruised my prostate in the attempt but that seems to be resolving itself. I'm planning to try again tomorrow and will report back.

Are you having any pain while urinating? Just be aware that trauma from CIC could develop into a UTI, which if symptomatic should be treated. I had a couple of UTIs the first couple of months I self cathed but since then very few. 

Jim

No pain, just a dissipating feeling of discomfort in my groin, like a bruise.

Just keep watch. Also if you notice and pain or swelling of the testicles call your doc right away because it could be Epididymitis which would require antibiotics. I got it about a few weeks into CIC, never since. Not fun.

BTW since you're not cathing, what kind of natural voids are you getting? You want to make sure you're not retaining too much. 

Jim