Self Catherization: Issues and Problems

Hi Paul,

Welcome to the little CIC club here and thanks for the nice words.

Don't know how much you've read in this thread (gets kind of unweildly) but in your case (no natural voids (NVs) ) try and schedule your daily cath frequency so that it doesn't exceed 400ml which usually translates into around 6x/day with normal fluid intake and without natural voids.  That will keep your bladder from stretching and if you're lucky it will rehab your bladder which means over time you may get back some, perhaps most, of your bladder function. I was lucky in that regard and for the most part no longer have to cath these days.

Comfort wise, I always recommend trying a few different caths to find the best one for you. My two favorites, and the ones I recommend for starters, are the Coloplast Speedicath Coude and the new Coloplast Flex Coude. Most folks find size 14F a good starting size but you can either go up or down depending on results. I started with 14F but now use 12F.

Like you say, I think you will find the freedom CIC gives you empowering, as you can empty your bladder completely any time you want while at the same time protecting your kidneys. Meanwhile you can take your time looking at TURP alternatives, several which have come on the market recently but IMO still need more evaluation time, if one can wait. Or, you can go my route, and just stay with CIC and see how that goes. 

Good luck with CIC, if you have time try and read the complete threads, and we're all here if you have any questions. 

Jim

Thanks once again, Jim. In the Great White North we have a choice (at least in my neck of the woods - Montreal) between traditional TURP and laser, although if we choose to pay private set-ups other methods such as urolift are available. My urologist has never pushed an operation on me (by the way the waiting time is only six weeks for TURP) and so this along with my research has always disinclined me. I rather feel as though I have finally joined the alpha males by doing CIC. Whenever I describe it to others they begin to tremble and break into a complete sweat. Hah! (as the Pacino might say).  Paul

Paul: I rather feel as though I have finally joined the alpha males by doing CIC.

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It took me a number of months till I turned the corner of viewing CIC as a defeat and squeamish procedure to something empowering, life changing, and honestly a non issue. It's wonderful, and a testament to your attitude, that you have picked this up from the beginning. Part I guess is that you don't seem to be having any major initial problems as some of us do, and part I guess is just your positive attitude. 

With CIC you literally take control of the matter with your own two hands.

Jim

Hi Jim, Today I had a consultation with a URO who does URo Lift  .  

He said he wanted to do another urodynamics test so he could see the tracings,whatever that means . I am going to call the URo office that did my urodynamics . He said this will tell him if he needs to put a pacemaker in my bladder. He does not say the URO Lift is a guarntee to get me out of retention., he did" Not Say" I should have an ultra sound of my prostate. I am getting confused i thought i needed the size of my prostate to see if i qualify for the Uro Lift. He said he could do the uro Lift

 with  my copy  of the   cystoscopy. He thinks it's more a bladder problem?He did say the uro lift would not prevent having  GL Or Turp. He did say Even with turp this could not guarntee getting me out of retention.

Whats your opinion of thei URO?

thnaks,

frank,

My understanding is that bladder pacemakers are for either overactive or underactive bladders without obstruction.

But in your case, wasn't your diagnosis an obstructive prostate? So I'm really not sure where he is going with this.

So maybe he wants another urodynamics to see if you have a nerve problem and not obstruction? But then why would he want to do a Urolift if it's just a nerve issue which btw your previous urodynamics said you didn't have. So really beyond my pay grade here but his approach doesn't make sense at face value. 

Where did you find this fellow and what are his credentials? I don't suppose another urodyamic test would hurt but I would ask him first how a bladder pace maker would work if you have retention caused by prostatic obstruction? 

And btw, they can test the pace maker on you externally before they do the implant, but it still doesn't make sense unless you don't have obstruction.

Jim

So I thought about this a little more and the only thing that makes sense is that he first wants to do the Urolift and then if the Urolift doesn't work (you still can't empty by yourself) then he would try a bladder pacemaker. 

The questions I would ask him are:

1. Is this the order he would proceed -- Uroloift, see if it works, then bladder pacemaker if Urolift doesn't work.

2. Does he offer an external test of the pacemaker before implanting it?

3. What exactly is he looking for with a new urodynamic test?

4. Has he done any Urolifts followed by bladder pace makers on someone with complete retention and what kind of results has he gotten?

I would also run this all by your current urologist and see what he says.

Jim

 

Jim, I told him that after i cic i get the urg to pee after 2 or 3 hours.He then referred to my urodynamics test.Despite the increased detrusor pressure

there was no voluntary detrusor activity associated with a void. This study is consistent with an increased bladder capacity and increased detrusor activity with poor bladder compliance.Then he said if after the uro lift I could be incontinent,then he would make a small incision in my bladder for the placemaker?

This doctor is at UIC. thanks for your observation JIm.

frank,

JIM, My Uro said a nerve problem would not show up on a urodynamics

test. i assume a nerve problem would be the same as a neurological probem?

frank,

Urodynamics will test and measure both the muscle and nerve function of the bladder. 

Jim

I think he's suggesting you have oveactive bladder in addition to bladder outlet obstruction which is possible. When you cath on the urge after 2 or 3 hours about how much comes out of the catheter?

Do you currently have urge incontinence where you leak urine between cath's? If so, how much of a problem is it. I think that is where he is going with his diagnosis -- overactive bladder/urge incontinence and obstructive bladder. 

Jim

Hi Jim,This is the message. Another urodynamics test to show PICTURE TRACINGS, LIKE AN EKG. This test they will do different, they will put cold water also to try to simulate the bladder,to see.

If i can void  during this test, i beleive that will tell if it's my prostate obstruction,latereal lobes is the reason for retention.I can quailfy for uro lift-having{ laterel lobses},if i had the other {median lobes }

don't know if this the correct spelling, then i would not quailfy for uro-lift.If i can not void then the next step is the trial test for bladder pace maker.If this works then the nextstep is to put a pacemaker in my bladder.

Does this all make sense JIm? I' still don't know if all this is going to work? There is a potential that i could have to wear diapers? i don't know if all this is worth the chance?At 87,almost 88 i don't know how CIC would  work as i get older?

Thanks for your thoughts.

frank,

Are you incontinent now? If not, why are they telling you that you may have to wear diapers after a Urolift?

Also, my understanding is that a bladder pace maker is only used if the prostate is not obstructing. Haven't they already figured that out by now?

I don't see any harm in another urodynamic test but have more questions than answers about the pacemaker and potential incontinence issues. 

Jim

JIm, If they put a bladder pace maker in they have to make a small incision in my bladder . From what i understand ,this  is used for over active bladder as well as urine retention,which i have completly . I am not incontinent now. i don't understand why the bladder pace maker would have perhaps a reason to be incontinent?Do you see a reason for this?

Not the uro lift.

frank,

 

I didn't see incontinence listed as a side effect of a bladder pacemaker. It's also not listed as common side effect of Urolift. So I think you have to ask the doctor why he brought up the issue of incontinence since you don't have it now. 

I would also ask him that you have heard that bladder pacemakers are only used if there is no obstruction, yet you have obstruction. See what he says.

Jim

Frank, I am also in complete retention. Please let us know what your

doctor says about the pacemaker! Very much interested. ZDZISLLA

Paul, I"ve been doing it for around 8 months...and It's the best!  I now can empty my bladder completely and so I can go for hours without having to look for a restroom.

Yes, Paul, brave men cringe at the word "CATHETERIZE!"  :-)   A few years back, a close friend said he'd rather deal with his cancer, than "stick a straw up my dick!"  Well, that ex-biker friend died shortly after that (yes, I miss him.), and I am still doing CIC.  

And one of the really cool upsides of CIC, is that after cathing before bed, I sleep through 20 of every 30 nights, each month! (I keep a log for reference.) Not bad, that!  And the other nights, when I'm up to pee, are usually due to a late-evening glass of wine or beer.  

Cartoon,

I was one of those "brave men" who cringed at the thought of catherization. In fact, I almost fainted the first time I did it at the doctor's office. It's incredible how both the body and mind adjusts. Today, for me it's about as

cringe worthy as brushing my teeth.

It's a shame that most docs don't push CIC more at least as part of Watch n' Wait. Their push and encouragement could get many past the "cringe" point but instead, they usually just back off if the patient resists and suggest something else. If they did half the sell for CIC as they do for their surgeries, more men would discover CIC's benefits.

Very sorry about your friend.

Jim

Yeah, that "follow the money" thing.  Or they hand out those rubber catheters and say, "TRY THIS!"  The uro-docs make more on the surgery...  :-(

 

Amazing how quickly it becomes second nature and how fears dissolve with success. The experiences of this group have been tremendously helpful. If spmeone calling himself "cartoonman" can do it then surely a solid citizen like myself can step up to the plate. Hah!   Cheers, Paul

cartoonman, Hi ,tell me your secret ? How do you sleep through the night? That sound great. I must have an over active bladder. i cic,then 2 or 3 hours i have to get up and cic again. I wonder if this could be a nerve condition? 

What is your volume output?

Do you have this problem?

frank,

Yes, Paul.  I think the secret is, "DON'T TAKE THINGS TOO SERIOUSLY!"  

Well, I sleep through the night all but 6-8 nights a month.  And in my case, it's easy:  Don't drink notable amounts of fluid after 8:00pm or so.  Cath FULLY before bed.  That's about it.  I never had a salt problem, and don't think I want to create one now.  So I'm not a big consumer of salty stuff (JimJames, your pretzels are safe! ) .  

Maybe it's due to a lifetime of clean living?  HAH!  Not even close on that one!    I probably started my problems on a motorcycle trip form Ottowa to Vancouver in 1970.  Actually from NJ to Vancouver, via Ottowa, then down and back up the Pacific coast and then across the US.  My kidneys hurt, just remembering that long-ago summer trip... 8,000 miles/12,800km.

OMG!!!! What a trip!!!

Frank, let me put my two cents of minimal experience in there. I notice quite a bit remains if I remove the catheter too quickly. Once seemingly drained, I now push it back and forth a bit whereupon sometimes quite a bit more exits the room and then it's lights out.  Paul

Cart: JimJames, your pretzels are safe!  [cool] ) .  

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That's "potato chips" to you sir

8,000 miles on a 1970 motorcycle suspension. Surprised you even have kidneys

Jim

(1)  POTATO CHIPS???  In that case, guard your stash, Mister!  

(2) Not only was it a motorcycle suspension, but it was a three-cylinder TWO-STROKE (Think:  RINGDINGDINGDING! and VIBRATIONS GALORE!)    And yeah, kidneys of steel, man...  

Count me as another, like JimJames.  Before doing CIC, I thought to myself, no way, can I do it everyday for the rest of my life.My life, is over is what I was thinking!  If I had to wear a Foley everyday for the rest of my life, I would be depressed !!!

Go forward 8 months, CIC, is the best thing I ever did for my condition.  Take for instance yesterday,  I had to be with a bunch of friends for 8 hours.  We were riding around the entire island doing pigeon stuff. I only had to stop once a friend's house to do my CIC. For the rest of the day, I was fine.  In the old days before CIC, I would constantly have to be on the lookout for a restroom. It wasn't bad either, I went into my friend's bathroom, took out the handy-wipes, took out the fr14's and in around 7 minutes, I was done.  It was the first time I had to CIC other then my own bathroom. If anyone is reading this and is considering doing CIC, I say please give it a try, you will be relieved and happy that you did!!!

I also like Vancouver,i stayed there 6 weeks. I guess the the reason i have to cath every 4 hours is a overactive bladder. I wish i knew? Even before cic i always had  frequency. I might have a few sips of water throughout the night ,but not always. Thanks for your advice.I just eat at Red LObster, after lobster etc,i got home just intime ,i believe it was food poisining.

Diarrhea,

frank,

Hi, Cartoonman, I like your proceedure on how to slept through out the night.Question ? do you have a natural void? This is what i don't get?

If you have a NV,why do you have to CIC?

Thanks for your info

frank,

Dennis, yes, CIC is my friend, too!  :-)  

With an alcohol wipe, my trusty FR 14 SpeediCath and a steady eye, I perform the "JimJames Dive-Bomb" approach and am in and out of whatever loo I need to use.  And in under five minutes.  

SO much better than that brief, horrible one-week experience with a Foley, Aug of 2014.  I'll take the CIC anytime, while I await a better solution for BPH! 

I have NV only when my bladder is holding 400cc or more; otherwise it's CIC all the way! I had Uro-Lift in Dec of 2015, but it worked for only a couple of months.  I void when I get a natural urge to, and it is usually 300-350cc when I cath.

I'm currently reviewing options, and awaiting reports on iTind.  

Thanks for that info.I get the urge also ,i have to cath 6 x a day,sometimes 5.

I sure wish i could get a NV.You said Uro Lift was only  good  for a couple of months? Why was that? Thanks for this info?frank,

I use Hydrogen Peroxide instead of alchohol.  The reason is that I read a book about Hydrogen Peroxide, and it is supposed to be good for the body. The food grade type. I don't use the food grade type, but I think it may be safer than using alchohol, because I cic at least two to three times a day, and that totals up to a lot of alchohol on the penis.

dennis, have you tryed the BZK ANTISEPTIC TOWELETTE?

FRANK

Any further info on the iTind clinical trials? Anyone know or have an idea of when the procedure might be available in the US if the trials go well?

Frank, I guess I was just one of those for whom Urolift wasn't successful.  I don't know why it didn't work, and neither did the Uro-doc.  He did the FDA trials, and has done hundreds, and said he only has redone 3 of them.  Mine would be #4, but he's not convinced (and neither am I) that it would be successful, for him to do a second round of implants.

 

Hi Dennis,

I've used witch hazel pads, which seem soothing.  But mostly, as in every day for most of 2 1/2+ years of cathing, I use plain old household alcohol on TP.  When I'm out and about, I take the little alcohol swipes (sold at pharmacies in tiny foli packets) along.  The have served me well, without side-effects.

I bought a box of "Wet Ones" for when I am not at home.  So far I've only used it once.  I plan on bringing it with me when I go to the Big Island of Hawaii, in July.  Hydrogen peroxide, would be too dificult to use on a trip, I would think.