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Thread: Catheter Removal - Pain ... why... question...

  1. #1
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    Default Catheter Removal - Pain ... why... question...

    Well this evening I had my yearly (ok, more like every two ) appointment with my Urologist.

    Mostly because I had a bit more severe IC symptoms once again and wanted to make sure everything is ok...

    Doesn't look bad so far, albeit of course have not gotten all the results.


    Well amongst a good number of tests, one involved my object of hate: Catheter.

    Now I've had this a few times in my life - and the situation was always the same:
    putting it in: no problem at all... basically it's mildly uncomfortable, with an "odd" sensation... but not too bad.
    Also, taking it out is not a big deal...
    BUT peeing afterward hurts like shit for like two days ... and with my IC, well it ain't no fun, as I pee /dribble a lot, and well the pain is basically "constant" for the first day and lessens (hopefully) by the end of day 2.

    I forgot (again) to ask my urologist: WHY. WHY does that hurt.
    I don't think he uses a wrong size... I don't think he did anything wrong.
    I know HOW the procedure works quite in detail (as I was trained to do this for home-care situations years ago)... and I can detect nothing wrong with what he does... and yet the 2-day pain when urinating.

    Has anyone gotten similar "results" with caths?

    Can it be that my urethra is that easy to irritate?
    Can it be from the actual material of the cath (some mild "allergic" reaction or so??)?

    I'm not worried - as I had this in the past the same way... I'm just curious WHY that is as I can't really figure out why.

    I am aware that many people seem to have a burning sensation for the first one or two times they urinate after the cath - but two days?

    Can it be a reaction to the sterile lube or the anesthetic substance (I guess it's lidocain based)..?

    Well maybe someone knows a way around that, for the next time I'll be confronted with this.


    Don't get me wrong - there's worse stuff... it goes away and I'll forget it again...
    None the less I wouldn't mind to avoid it.

  2. #2
    Adultbaby
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    ajsco's Avatar

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    It may be worth getting a sample of your urine tested to see if there's and infection as that is common with catheters.

    If it hurt on withdrawal, if it was an indwelling catheter, the balloon may not have been fully deflated. When I was in hospital in May, I got out of my bed, with the cath bag still on the side of the bed and started walking towards the toilet, which I failed to realise. And the I just pulled the bloody thing out, god that hurt, it felt like I'd just given birth through my penis. that did hurt for a while afterwards, so it may have been the balloon not being fully deflated.

    Your sphincter could have been in a spasm, so if you force something through it it's not going to be happy, which could explain how this has intermittently happened before.

    And yes it could've been an allergic reaction, some caths are latex based so it could have very well been that or a reaction to the anaesthetic.

  3. #3
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    ajsco,

    No - as I had written, there was NO pain during either insertation or removal...
    And the cath was put in following sterile procedures to the dot and was NOT in my bladder for a long time - so infection is out of the question (to 99% at least)...

    So that is why I wonder - I mean I know all that can GO WRONG... but none of that happened - it's just this odd pain for like two days after the removal - even if the cath was in for no more than what must have been like 20 - 30 minutes.

  4. #4
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    terig's Avatar

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    When a catheter is put in, it stretches your little pee tube, when it's removed, your little 'stretched' pee tube doesn't like you peeing on it, only for about 4 hours, then it all settles down, after say 8 hours, get back to your 'quack'


    Oops sorry, dam auto corrects werk overtime
    Last edited by terig; 07-Oct-2013 at 02:39.

  5. #5

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    Having just been studying anatomy all evening, I can tell you that the lining of the urethra, through which urine runs from the bladder to the external world, is not lined with the same tough 'skin' as the rest of the outside of the body. Instead of this thick, multilayered cell coat it has a thinner multilayered coat close to the bladder, and a single layer of columnar cells closer to its end. Because of this, it isn't meant to be abraded such as when a catheter is removed, and so this will consequently cause pain. I would talk to your doctor about it, as he may be removing the catheter too quickly or something. I have no idea yet.

  6. #6
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    Quote Originally Posted by terig View Post
    When a catholic is put in, it stretches your little pee tube, when it's removed, your little 'stretched' pee tube doesn't like you peeing on it, only for about 4 hours, then it all settles down, after say 8 hours, get back to your 'quack'

    God forbid
    (I do hope my doc didn't put a CATHOLIC in my urethra ... that would have been excruciatingly painful )
    (sorry couldn't resist).

    That is why indeed there's differtent sizes cath, and so far I don't think that is the issue.

  7. #7

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    Quote Originally Posted by EPO1 View Post
    God forbid
    (I do hope my doc didn't put a CATHOLIC in my urethra ... that would have been excruciatingly painful )
    (sorry couldn't resist).

    That is why indeed there's differtent sizes cath, and so far I don't think that is the issue.
    All said and done, it may be that you might have a undiagnosed allergy to them. Have you given thought to the possibility your Urologist may be one. FYI, acorn is a lapsed a catholic. Say no more.

  8. #8
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    Quote Originally Posted by acorn View Post
    All said and done, it may be that you might have a undiagnosed allergy to them. Have you given thought to the possibility your Urologist may be one. FYI, acorn is a lapsed a catholic. Say no more.
    I shall say no more

  9. #9
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    Ive waited for a bit before replying to this just to see if someone else would manage to do it well enough.

    Anyways, Ill start with i doubt it is an allergic reaction to the catheter or the anaesthetic. The reason is that these symptoms only occurred after the catheter was removed and thus, would not signify an allergy (although, in some people there can be a delayed reaction but ill get to that in a minute). So, generally speaking if the allergy was to the latex or the lignocaine (which is the numbing agent in the gel that they should have pushed into the urethra before they inserted a catheter, if they didnt do that and only used the gel on the catheter for insertion then there was no anaesthetic) then you would have pretty much gotten symptoms within a few minutes. The body works pretty much the same regardless of the allergen but the really common thing is that it occurs rapidly. Much the same way that when someone is stung by a bee within 10 minutes their face swells up. However, symptoms are usually relatively localised (assuming you arent an extremely allergen sensitive person) so for most people, this phase only causes a but of swelling at the site (or whatever the allergen is)

    Now, onto the part that i mentioned about some people having a delayed reaction ... People dont realise that during an allergic reaction there are actually 2 phases of it. There is an initial phase which occurs within a few minutes and for some people, it can bearly be noticeable whilst others will have quite a bad reaction, the degree of reaction depends on the person's immune system. After this initial phase, then comes the second reaction .... usually the main event for most people. It occurs in this fashion because the cells that cause it need to get to the area where the allergen is and the first phase helps with that. The first phase also triggers these cells to release the products in their cells (and this is where anti-histamines work as an fyi, they stabilise the cells so they dont release their products). However, the amount of cellular products that are released is significantly more here then during the initial phase, hence why i call it the main event. Once all these products are released then someone who may have had some slight swelling in the beginning from their bee sting will not break out massively in hives, they will have severe swelling in their face and potentially, restriction of their airways. And this whole process takes a variable amount of time (depending upon the person again). It can be 30 minutes to 2 or 3 hours so it is highly variable but it is the phase that most people who think of an allergen describe happening.

    So like i said before, it doesnt seem like an allergic reaction as you only describe the pain in when peeing and you have no systemic systems.

    Now, for the pain ... kiwiboy got the anatomy of the urinary tract almost correct in that the cells that line the tract are vastly different to skin and thus, they dont like being exposed to any kind of friction (and yes, even with lubricant there is still friction). As he mentioned whilst there is a multilayering in both the skin and the urinary tract, it is only the skin which has a special protein which makes it tough ... keratin. As cells move up the layers in the skin, they produce more keratin and once they reach the top layer, the cells are actually dead, have no nucleus (a sign that cells can still have activity as without a nucleus they cannot produce any proteins or maintain activity in the cell very well) and become packed with keratin. So having many layers of these means that our skin can withstand a pretty good degree of mechanical stress placed on it.

    The urinary tract does not have this protein but transitions from this multilayered pattern (without any special proteins) of one type of cells (the columnar type) to a thinner multilayered type of cells (called squameous) ... [this is the part where kiwiboy wasnt 100% correct]. This makes sense not to have the protein that i was talking about before in the urinary tract as people do not have any mechanical forces there (unless people get a catheter put in). The layers are important when they function as they allow for protection from corrosiveness of urine (as urine is usually slightly acidic but can be variable depending upon a person's fluid balance, etc.) So, as a catheter is being inserted, it will cause mechanical force which damages these single layer cells and 'sloughs' off some of the cells from the multilayer parts. So once the protective mechanisms have been damaged, there is nothing stoping your urine (which is slightly acidic) from irritating the cells underneath (now to be clear ... i do not mean the cells underneath the urethra, i just mean that the first few layers of the urethral cells have been taken off and now the cells below that which are not fully matured and arent able to properly protect themselves). This irritation is what you are feeling as pain. And the reason why it lasts about 2 days is because of the fact that that is how long it takes for the lining of the urethra to be properly restored.

    Hopefully that helps explain why.

  10. #10
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    Quote Originally Posted by Zeek61 View Post
    ...The layers are important when they function as they allow for protection from corrosiveness of urine (as urine is usually slightly acidic but can be variable depending upon a person's fluid balance, etc.) So, as a catheter is being inserted, it will cause mechanical force which damages these single layer cells and 'sloughs' off some of the cells from the multilayer parts. So once the protective mechanisms have been damaged, there is nothing stoping your urine (which is slightly acidic) from irritating the cells underneath (now to be clear ... i do not mean the cells underneath the urethra, i just mean that the first few layers of the urethral cells have been taken off and now the cells below that which are not fully matured and arent able to properly protect themselves). This irritation is what you are feeling as pain. And the reason why it lasts about 2 days is because of the fact that that is how long it takes for the lining of the urethra to be properly restored.

    Hopefully that helps explain why.
    Thank you - wonderful explanation!

    Had a phone call with my doc just about an hour ago - and he said, that people react different to it and that with some it takes longer than with others to "heal"....
    But your explanation was much more thorough - so thanks again.


    -

    Now I just need to hope that there are no protestants introduced until the catholics are gone

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