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self cathetarisation for enlarged prostate

Posted , 9 users are following.

frances31245
frances31245

Can anyone explain to me why urologists don't just put a stent into the urethra (above the sphicter muscle), rather than the patient having to self-cathetarise 3 to 4 times a day?  Surely this would be a better option, in terms of risk of infection and also expense.

3 likes, 38 replies

38 Replies

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  • lester90053
    lester90053 frances31245

    Posted

    Have you ever used the Foley catheter with the bag?
    • Pepasan
      Pepasan lester90053

      Posted

      I've used intermittent self-catheterisation, mainly to chack how much urine was still retained in the bladder, as Tamsulosin has usually been effective. However, I found that during an infection, the drug was not enough. I therefore asked for a Foley catheter as I didn't like the idea of a repeat visit to A & E that happened after a minor op and general anaesthetic caused  an incident of major, painful incident of alarming retention a few years before! So my GP arranged a nurse visit for Foley insertion, but we agreed I could remove it myself, using the syringe that came with the Foley pack and did so after completing the course of antibiotics a few days after insertion. I've since successfully self-catherised with a Foley (indwelling) catheter when I got yet another infection. The main advantage was getting the first uninterrupted night's sleep in my own bed at home for some 5 years!
    • frances31245
      frances31245 lester90053

      Posted

      My partner has used the catheter with a bag - not sure if it's a 'Foley' or not.  He prefers the bag catheter to the self catheter as he was having to use it too frequently, whereas at least with a bag he can forget about it until it needs emptying.  thanks for your reply
  • alan86734
    alan86734 frances31245

    Posted

    Dear Frances: Not being a doctor I can only recount my own experiences and hope that they will help.

    I was experiencing reduced urine flow and moderate post void retention. As a second option, following failed chemotherapy, I was prescribed weekly self-catheterization to reduce urinary retention. After a few weeks into this regimen I noted that my urinary flow had improved significantly. My diagnosis was changed from 'enlarged prostate' to 'likely stricture'.

    The inserted catheter provides clear passage through both the stricture and the inner sphincter allowing the bladder to empty completely. Withdrawing  the catheter permits the sphincter to close immediately while the  stricture closes very slowly.

    Unfortunately I had to undergo some surgery which disrupted the above regimen. Self-cathing was suspended for 6 weeks pre-op and another 6 weeks post-op. The only catheterization performed over this entire 12 week period was the routine indwelling catheterization which remained in place for approximately 3 days.

    Upon completion of the final 6 week period I resumed my self-cathing routine. The catheter passed through the stricture and sphincter with surprising ease given the prolonged wait times that had preceded the procedure.

    Frances, does this answer your question?

    In any event, please feel free to get back to me with your comments.

    • frances31245
      frances31245 alan86734

      Posted

      Thank you Alan.  I hope your healing continues.  It is my partner who is using the catheter.  It is all new to him and me, as it was three weeks ago when he found he could not urinate at all.  After a few trips to A & E, they fitted a catheter with a bag.  He hasn't seen a urologist yet - appt. on 25th February - so he doesn't know if the enlarged prostate is benign or cancer.  If it is benign, - thanks to replies on this page I have found out about the Urolift, which sounds like the answer.  He had to return to hospital for the catheter with bag to be removed after about 8 days (I'm not sure how long these in situ catheters are supposed to be in?).  Anyway a nurse mentioned self catheterisation, which my partner tried.  But after only one day found it wasn't suitable because he was having to use it all through the night - so he's gone back to the catheter with bag.  thanks for replying
  • Guest
    Guest frances31245

    Posted

    Frances,  I just copied this text from the EUA guideline on BPH written in 2012, on the section about tolerability of prostatic stents, hope his answers the question.

    "Tolerability and safety: In general, stents are subject to misplacement, migration, and poor tolerability because of exacerbation of LUTS and encrustation [386]. The main immediate adverse events include perineal pain or bladder storage symptoms. A systematic review of the UroLume reported a 16% failure rate within 12 months, mainly due to stent misplacement or migration (37%) or recurrent obstructive or irritative LUTS (14%). The overall failure rate at 5 years was 27% (50/188 stents) [392]."

     

    • frances31245
      frances31245 Guest

      Posted

      Thank you so much Twiglet.  I can understand now why the stent wasn't offered in the beginning.  In my 'simplistic' mind I couldn't see why my partner had to go through so much pain and discomfort in this day and age when a simple stent would solve the problem.  But now I understand that the stents can move and cause more problems.  Anyway, I've now learned about the Urolift which sounds like a good solution - if my partner has benign prostate enlargement.  Thank you.
    • frances31245
      frances31245

      Posted

      By the way, does anyone know what LUTS is?  And have I misunderstood about the stent and the Urolift and UroLume?  Are they the same thing?  I'm confused.
    • cartoonman
      cartoonman frances31245

      Posted

      LUTS is general Lower Urinary  Tract Symptoms: 

      https://patient.info/health/lower-urinary-tract-symptoms-in-men-leaflet

      The Urolume, which is a kind of stent, is reviewed here:  http://www.ncbi.nlm.nih.gov/pubmed/11992061    The article concludes:  NOT A GOOD IDEA!  The stents have a habit of migrating; not good!  Also heard this from my doc.

      Encourage your sweetie to read all he can about UROLIFT; come back with questions.  

      Also, in what part of the US do you live (if here)?

      Emis Moderator comment: I have replaced one given link with a link to the equivalent article on our site.

    • cartoonman
      cartoonman frances31245

      Posted

      Hi Frances,  I responded earlier, but my reply is being "moderated," as I included explanatory links.  Meanwhile, Pepasan clarified what LUTS is.  Urolume is a form of stents, which were tried and have been eliminated because of inherent problems, including migration of the stents to places not wanted!  

      UROLIFT is completely different!  If you Google "Urolift," you will find videos and explanations.  That's how I started learning the details.  And as you know, I'm now a "Happy Customer!"  :-)

  • Pepasan
    Pepasan frances31245

    Posted

    Lower urinary tract symptoms (LUTS) are storage, voiding and postmicturition symptoms affecting the lower urinary tract
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