Self Catherization: Issues and Problems

WAIT!  You cath out ONE LITER with your condom catheter overnight??? Or was that a typo?

Welcome to the club!!!

Help refresh my memory a little. My understanding is that your main problem is incontinence after GL? What about retention issues? What type of natural voids were you having prior to self cathing? Do you know what your post void residual (PVR) was prior to self cathing?

Moving to your current situation. Are you saying you get 250-300ml coming out of the catheter on average? Are you doing a natural void first? If so, how much is it averaging? You should do a natural void first if you are able to. How many times a day are you cathing? 

Interesting that you're using a condom catheter at night. 1 Liter total correct? That sounds similar to some overnight volumes I've had. 

The big question is, since you're not cathing during the night,  what is your PVR (post void residual) for your first cath in the morning?

As to a little blood at the end, perfectly normal and expected. You may or may not see more blood both on the tip or in your urine for the first several weeks. False urgencies (you feel like going but nothing there) is also pretty common until your body adjusts. It's really good to hear that you're not having any problems getting the catheter in. That's actually the way it is for most people, I'd say over 90%. Some here do have problems (Think Neil ) but again most find it pretty easy. 

As to the catheter itself, the Speedicath Compact 14 is a nice piece of engineering but isn't really 14F all the way since it telescopes. I believe it goes up to FR16 or even higher at its widest point. Also, it currently doesn't come in a Coude tip, but since you've had GL, you may not need the Coude since you prostate size has been reduced. One thing about the Compact, however, is that it's about 2" shorter than the regular Speedicath Hydrophillic. Many men find it a little on the short side as you're supposed to push the catheter in around another inch or so after the urine starts flowing. How much of the catheter is showing when your urine starts to flow?

I hate to tell you to switch catheters when you seem to be doing so well, but that's not going to stop me I suggest you get some samples of both the regular Speedicath 14F and the 12F. Try the 14 first, and see how it goes. Both of these catheters are narrower than the one you are using because they don't telescope. The only disadvantage I have found with the Speedicaths is they don't travel well because they kink when you bend them. So, one good strategy is to use the regular Speedicaths at home and to use the Compacts when away from home.

Not sure about pain in perinea. What is the history of that again? 

Jim

Yes. One liter. Now when I started cathing during the day this quantity tends to diminish. At the beginning of my using condom catheters (only at night) without self cathing during the day I even got two liters once. My natural void is very small, yet I keep leaking.

When I was admitted to the ER two+ years ago, they drained 2.5 Liters... not something to brag  about!

I've been advised to make sure there is less rather than more left in the bladder.  Less to generate nasty conditions known as UTIs, for one thing...

JimJames may have more to offer about this... 

Jim, I had GL followed immediately by TURP because I also have PCa (since 2002, no prostatectomy or radiation, long years watchful waiting, lately Lupron).

My problem this year has been: NV almost nonexistent, urges every 15 minutes max, but only a few drops out, leaking if try not to go and total incontinence at night. Retention some 300ml, my uro said.

My wife found the info about condom catheters and this already changed my nights. I even got two liters in the bag one night. But during the day it didn't change much.

It took me some courage to start self cathing. My compact catheters were sent to me, in the number of 5, as a sample from Coloplast (my wife again). This is my 4th day today and I cath only once during the day, mostly at 3 pm. At night I wear my condom catheters ( the kind that does NOT have any glue!) and obtain some 400 ml at night now that I cath.

Yesterday I tried a regular long catheter Speedicat 14 Coloplast and it felt uncomfortable. I must be on the short side 😀 because no problem with the lenght being insufficient. This is related to PCa maybe and ED since 2010.

It turns out that catheters are covered by my French insurance ( by the way, I am not French, I am Polish). So I got a precscription for my lovely compact Speedicaths in two versions: 14 and 12. And for condom catheters as well.

I don't feel like cathing in the morning. I feel quite ok after my night with condom catheter. I get up at 9 or 10 a.m. ( retired) and go to bed around 10 p.m. sometimes earlier. You think I should cath more than once? My afternoon cathing gives 300-400 ml after several small NV during the day.

I am a little worried about the cystoscopy planned for Jan6. Won't it interfere with all this? Thanks!!@

Hi ZD,

I would cath at least a couple of times first thing in the morning after you take your condom catheter off.  The purpose would be to measure how much urine you are retaining. Depending on the amounts, you might want to adjust your cath schedule. 

You mention that you have urges every 15 minutes but nothing or only a few drops come out. Are these urges consistent throughout the day? How about right after you cath at 3PM. Do you still feel these urges every 15 minutes or do they go away for awhile?

As to catheter length, it really is only indirectly related to penis length. Remember the catheter has to wind around the prostate, etc. So a longer catheter could just mean a bigger prostate and vice versa

The cystoscopy shouldn't interfere with the self cathing if that is what you're asking. I assume it's a flexible cystoscopy? 

I only thought the Compact came in one size. Are you saying you have two different sizes or just two different prescriptions? Can you give me the product code of the compact you're using. I tried to look them up online but Coloplast's website is very badly organized to say the least.

Jim

After cathing my urges calm down. They calm down as well after the night condom. I will look up the codes. I believe they gave me Compact 14 and Compact 12 unless the pharmacist mixed sth up!

Hi ZD,

Since your urgency subsides after cathing, then there's a strong possiblity that if you increase your cath frequency to 3 or 4 times a day that all of that urgency would go away. Even twice a day would be better. Again, I strongly urge you to do a test cath first thing in the morning to see how much urine is still in your bladder after a night on the condom catheter. As long as you're going to self cath, you might as well get the maxium benefit out of it.

Jim

I will give it a try as you say.

In the meantime, I have checked my compact Speedicaths and 

you were right, there is just one type of them, ref. 286920, on the box it is written that they are good for 12-18.

When I tried regular, non compact caths (Coloplast, 14), I had problems

because it bent too much, thus more pain, more fuss...I don't know why.

I feel pain when passing the two sphincters. ZD

 

If I have to have cancer, prostate cancer, is at least slow growing for the most part.  My neighbor down the street, has had lymphoma for around 5 years.  He has been treating it all by his-self.  He goes on-line, and tries various alternative treatments.  I can see the tumor protruding out from his skin.  He looks healthy, with nice color in his skin, and his weight is a just a little on the heavier side.  He even paid around $4,000 for a Riffe-machine{sp}.  He said that he changes the frequency so as to kill cancer cells...at least that's what I think he said.

ZD,

Whatever catheter works best for you is the best choice! I wish I could use the compacts when traveling, but  I need the Coude tip. I do hear however that Coloplast will be coming out with a new Coude Compact sometime next year.

Jim

Merry Christmas to you and everyone one on this forum!  Lets hope for a better year for all of us in 2017.

ZD, That's great! Did you cath first thing in the morning to see how was in your bladder after a night on the condom catheter?  The general rule is that you don't want more than 400ml in your bladder at any one time. That would be the sum of whatever you cath out plus whatever natural void you had just prior to cathing. And don't be hesitant to cath more if you need it. Up to 6x/day is fine. You will be surprised how good you will feel when you empty your bladder completely on a regular basis. 

And Happy Holidays and Merry Christmas to you as well!

Ji

I don't know what to do when there is blood. I woke up today at 4 a.m. feeling some pain in the area. So I did CIC (400) ang got back to sleep with a condom catheter, only I couldn't sleep and soon I spotted blood in the bag. Might be related to the fact that I was constipated. I still feel pain. I don't know how to react. Cannot stop CIC. I believe I am in Neil's situation now. Plus PCa. On the whole yesterday I cathered 4 times 400 or a little less and I felt wonderful until this bleeding.

Hi ZD,

What color was the blood in the bag? It's normal to see some blood for the first several weeks of cathing, often longer. It doesn't sound like Neil's situation at all. He sometimes takes five minutes or longer for the catheter to pass his bladder sphincter. His is not a typical situation at all. I think it's good that you cathed at 4am instead of relying just on the condom catheter. Don't know if you are cathing first thing in the morning or not, but try and do it every once in awhile to make sure your bladder isn't being too streched overnight.

Jim

Bright red. Now I have cathed 2 more times and it is ok. I will try to cath first thing

in the morning , as you advice...Today it was good!

Still no idea why pain in the scrotum (not very pronounced but rather

constant, dull pain).

Volume under 400 at each cathing.

What do you think about coude catheters for me? I have a few, haven't

tried yet.

When you cath first thing in the morning, make sure to measure how much comes out of the catheter. 

When you say "volume under 400" do you mean the volume coming out of the catheter or the total bladder volume which is the sum of your natural void volume plus the volume coming out of the catheter. Your total bladder volume should be under 400.

Not sure what to make of scrotum pain. Probably nothing but if it gets worse or persists you should probably be tested for a UTI. I keep some Siemens 10SG Urinalysis strips at home for preliminary testing. 

Coude catheters are designed for large prostates or hard to navigate urethras. Less chance of sticking the prostate or creating a false passage. I use the Speedicath 12F Coude and am very happy with it. You may find the 14F size easier to use initially because it's not as flexible. Which ones do you have lying around?

Jim

Only the volume of cathing. I don't even measure NV, it is little, like 20-30ml.

Today immediately after the night with 600ml via condom catheter I catheres 250 more. 

Today I had some blood again and it hurt and still hurts (I have to be careful when sitting down). 

My coude catheters are Tiemanns 14. They seem not lubricated. I do

have some sterile gel, but hesitate. ZD

 

Hi ZD,

It sounds like you have a combination of both retention and overactive bladder, the latter possibly from your surgeries. My personal experience and progress with CIC has been only with retention so please keep that in mind. 

What's interesting to me is that you have neglible voids during the day but are able to void beween 600ml to over a liter at night with only 250ml left in your bladder, less PVR than during the day when you self cath.  Do you know how many voids comprised the 600ml, or did it just dribble out, or were you asleep most of the time and not aware?

It may be possible for an agressive self cathing program like I recommend help the overactive bladder aspect of your situation, but then I really don't know because that was not my problem. I have read there are other treatments including kegel excercise, and a different type of bladder retraining where you try to lengthen the time between voids, while at the same time not stretching your bladder too much.

Are your coude Tiemanns the Coloplast ones? If so, I believe they are pretty standard non-hydrophillics. I would have suggested the coude Speedicaths but I think you said you didn't like their non-coude model. 

What you might do is check out the "IQ" catheter. I saw their video on Youtube and their flex tip is very interesting. They are not available in the U.S. but  hopefully you can get them in France. 

Jim

Hi Jim! Yes, it is also puzzling to me! I don't know what happens at night, but

I void through the condom catheter around 500-600 now and first thing in the morning I had still 250 by cathing. Yet I stop drinking anything at 6 p.m.

You were right in saying that, with age, there is more urine at night. Much more.

I don't have urges for almost two hours after a good catherization, so my bladder might be not so overactive? I do Kegel and tried to discipline my bladder, but this didn't help.

Catherization, though, helps greatly. If I hadn't the pain, I wouldn't be very

unhappy.It hurts like an open wound afte each catherisation, calms down, then hurts again...Today I had big problems passing the sphincter. Yet I need catherizing since my NV is very very small. Except this mysterious leaking at night, which gave 750 today.

I will look into IQ catheters, but will France be so in advance, I doubt it...

Be well! ZD

ZD,

What surprised me was not so much the amount of your nightly void through the condom catheter, but the fact you were able to void this amount without catherization. I say this because during the day your NVs are very small.

Do you know if the urine dribbles out during the night or do you have a couple of distinct voids through the condom catheter? 

Early on in my progress I found that when I couldn't do a NV standing, I was sometimes able to do it reclining backwards in an easy chair and going into a plastic urinal or jar. You might try this and see if it works. During this period I also would rhymically tap my lower abdomen to stimulate the detrussor muscles. It's not a push, just light tapping. 

Which sphincter did you have problems with today? Around the prostate (external) or entering the bladder (internal).

Sounded like you had overactive bladder plus retention. Self cathing can help with both. The IQ cath looks interesting. 

Jim

As long as I am aware, it is just dribbling through condom catheter. No idea what happens when really asleep.

Immediately after the sleep I have problem with passing the internal sphincter when catherizing. So far this is always the internal sphincter, maybe because I had TURP.