Catheterisation

I had a second visit with the Continence Nurse the other day, and she surprised me by suggesting I start thinking about intermittent self catheterisation. I really, really, don't want to do that, because the idea reminds me of the way I've reacted during the UroD studies, and my lack of flexibility in my hips.

This is for overflow IC.

Would it be wrong of me to suggest that I'd rather be permanently cathed, than go through the stress and angst of doing ISC?

I can see why they're suggesting it, to mitigate the risk of back pressure damaging my kidneys.

She's given me some pamphlets to read up on, but I'm only becoming more apprehensive thinking about it all.

Indwelling caths have a whole slew of problems, primarily infection risk that really makes them contraindicated unless there is no other way.
Given there is some renal issues in play, it's unclear at a distance to say if a foley would be a good idea or not. You can certainly ask them about it.

My grandmother was bedridden and permanently cathed for the last few years of her life; if I recall correctly she had to take antibiotics daily to control the infection risk.

My aunt is in a nursing home right now on a catheter, which I think is a bad idea. Her lymphedema sores have left her needing to fight off sepsis, so anything else that poses an easy gateway for germs is too risky IMO.

For me, the act of inserting or removing a catheter was always the worst part. More recently they were always painful. Though insertion is also where you get the highest risk of infection from, so I didn't worry about infections from just keeping it in.

Anyone who has followed me even a fraction will know that I've been catheterized long term, several times in my life. I have never once gotten sick from an infection from it either. I've seen some people are generally prone to infections though, and inserting just one can trigger an infection in them. Each folley catheter can stay in for about a month, but then needs to be changed out. So very long term catheterization will mean many change outs.

It will vary from person to person, but for me when I first had to use them decades ago they were not painful in the least. I had always been sore from inserting them, but that soreness would go away after a few hours. After that it was just a slight notice reminder it was in place. Unfortunately I found out the hard way that repeat and long term use of catheters can lead to a urethal sensitivity.

Within the last few years I had to start using them long term again too. It was painful to insert or remove them with each change out. I had also experienced a constant soreness or low level pain while they were in as well. It was not fun.... Thankfully I've since had asaga of surgeries that have now allowed to freely and constantly pee without issue, so yeah no more catheters.

With every time I've had a folley in, I had also let it openly drain into my diaper. I did confirm with my urologists decades ago, and again recently, that doing this is ok as long as you're not prone to infections. I was also told you need to stay well hydrated to make sure the catheter is constantly flushing itself clean. Frequent diaper changes are also a must, so I made sure to change every 8 hours or so while cathed. Again, this never once led me to get sick from an infection in the many years I've been through it.

I am not a doctor, but I have read that silver-coated indwelling caths can reduce the likelihood of an infection significantly, and are rated for 4-week installations. I've heard that in order to be extra careful, people will change them out every two weeks, and have no issues. The problem of course is that Foley catheters aren't generally considered a DIY sort of thing (even though you COULD do it yourself, with proper instruction), and going to the doctor every two weeks could be inconvenient (and expensive).

ISC really is the best option (on paper)... but I, too, wouldn't be happy about it.

PlotTwist said:

I am not a doctor, but I have read that silver-coated indwelling caths can reduce the likelihood of an infection significantly, and are rated for 4-week installations. I've heard that in order to be extra careful, people will change them out every two weeks, and have no issues. The problem of course is that Foley catheters aren't generally considered a DIY sort of thing (even though you COULD do it yourself, with proper instruction), and going to the doctor every two weeks could be inconvenient (and expensive).

ISC really is the best option (on paper)... but I, too, wouldn't be happy about it.

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Directly from my last urologist, all folley catheters are ok to be left in place for up to 6 weeks. However, they can get clogged by then so it's standard practice to change them every month. The silver coated catheters are for those who have a history of getting infections, or when their immune system may be compromised. They are obviously more expensive, and insurances often won't approve of them unless absolutely necessary. Also, standard latex catheters, are just as effective as red rubber or silicone too. The only real difference is ease of insertion and patient comfort.

And again, the highest risk of infection from catheters is the insertion itself. (Usually from unclean environments and catheter contamination) Intermittent self catheters therfore have a higher chance for infections than indwelling folleys.

After back surgery, I had to cath myself for about six weeks until the swelling around my spinal nerves went down and things started working again. Like you, I thought it was going to be horrible but it wasn't bad. I got a narrower cath and really there was no pain, especially since I was doing it instead of the male nurse. Oddly, it was a female nurse who taught me how to self cath. Yes, "it" was out in all its glory as she showed me how to do it. And yes.....very embarrassing but I couldn't go home from the hospital until I learned, which I did in about 15 minutes.

Ozzie, self-cathing is your best option. I self-cath and can assure you that it became easier over time. Indwelling catheters are much more dangerous.

--John
(double incontinent)

willnotwill said:

Indwelling caths have a whole slew of problems, primarily infection risk that really makes them contraindicated unless there is no other way.
Given there is some renal issues in play, it's unclear at a distance to say if a foley would be a good idea or not. You can certainly ask them about it.

Click to expand...

Infection is not a problem unless a person is unclean. I use a Foley catheter and it drains into my diaper. My urologist (top uro in Philadelphia) said it’s fine to do. You just need to stay hydrated and change it once a month. I change mine every 2-3 weeks. I’ve been doing this for well over a year and haven’t had any problems. There is a lot of misinformation about them here. Talk to your urologist to get facts. No one here is a urologist.

mayhem said:

Infection is not a problem unless a person is unclean. I use a Foley catheter and it drains into my diaper. My urologist (top uro in Philadelphia) said it’s fine to do. You just need to stay hydrated and change it once a month. I change mine every 2-3 weeks. I’ve been doing this for well over a year and haven’t had any problems. There is a lot of misinformation about them here. Talk to your urologist to get facts. No one here is a urologist.

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I've already commented in agreement with exactly this (if it ever shows up). Confirmed it with my urologist at the Mayo Clinic in Florida.

Nothing I said rises to the level of "disinformation." Please avoid being insulting.

willnotwill said:

Nothing I said rises to the level of "disinformation." Please avoid being insulting.

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Lol. Get a grip man. I didn’t single you out, and yes, what you said is absolutely innacurate and wrong. You’re not a urologist (I won’t go further, albeit I easily could) so your comment is null and void. I specifically told the OP to talk to their urologist because you/we lack the actual knowledge to make a proper decision. Do not let you persecution syndrome get in the way of helping others. If you want me to become insulting, I could do that easily, however I avoided that. You made it an imaginary issue because of you own insecurities.

You did single me out. If you don't want to appear to single someone out, don't include their entire post and then start spewing complaints.


Also, please try to make your point without name calling.

I've been self-cathing for about 7 years and it's been completely hassle-free. In all that time I've had three UTIs that needed antibiotics, and maybe a half dozen more that cleared up on their own just from drinking a couple of pints of extra water a day. That's much fewer than the 1-every-other-month I was getting previously, that were due to having 400ml of stale urine permanently sitting in my bladder.

ozziebee said:

I had a second visit with the Continence Nurse the other day, and she surprised me by suggesting I start thinking about intermittent self catheterisation. I really, really, don't want to do that, because the idea reminds me of the way I've reacted during the UroD studies, and my lack of flexibility in my hips.

This is for overflow IC.

Would it be wrong of me to suggest that I'd rather be permanently cathed, than go through the stress and angst of doing ISC?

I can see why they're suggesting it, to mitigate the risk of back pressure damaging my kidneys.

She's given me some pamphlets to read up on, but I'm only becoming more apprehensive thinking about it all.

Click to expand...

In the course of your diagnose - was there a word of possible medication that relaxes the sphincter or such in order to make voidings easier/possible? Do you have residual urine?
Don´t know your chart and I´m as hell not a doctor. But there might be a way to avoid catheterisation, medical personel is quick to favor ISC instead of using diapers and the like or a permanent cath(though in some cases it is highly recommended for reasons of health). I highly despise ISC(well, caths at all) so I feel ya. Maybe there is a way to ease the symptoms by medication/training?
Might be worth seeing more docs and get more opinions.

Cheers

willnotwill said:

Nothing I said rises to the level of "disinformation." Please avoid being insulting.

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Sorry but my also top urologists in the country also disagree with you on this (as do I). Like Mayhem said, folley type indwelling catheters are less [\U] prone to infection that indwelling self caths are. Again, this is because of bacteria being introduce when inserting the cath. Since intermittent self caths are insert much, much more often, they are what carry the increased risk. The only exception to this is with someone who is prone to infections anyways, or is unclean. Thry are exception, not the rule.

I'm curious though, have you personally experienced long-term indwelling catheterization, or are you just repeating what you've heard?

I've been using foley catheters and bed side bags for three years now. I have urge incontinence and was getting up 4-5 times per night to go pee. Now all there's just the roll over get comfy type of waking up. No more running to the bathroom all night. I've had 2 UTI's in the three years because I do things very clean.

Can't say I've had a lot of experience with catheters, but from what I did experience, I'd never even go near any catheter at all, let alone use them on my own and regularly, too... Though, if there isn't much choice, I think a long-time Foley catheter is better...

Hi

I have had quite a few experiences with Foley catheters as I have OAB from enlarges prostate issues. My urologist did also suggest intermittent Catheters also .. The biggest issue I had with them is that after using them for a couple of weeks there was soreness. And yes the insertion is the most important problem. Let’s face it you are using 2 to 3 catheters a day and introducing the possibility for infection many times a day.

After my first bout I learned how to use a foley. I did all my research and the need for proper cleaning and the convenience of having to insert once was a relief. Yes, there are risks of infection. But I think they are the same as intermittent .. I also found that on a lighter side that the convenience of not having to pee really helps in the pain and urge. Now the longest I have had a folly in is 4 weeks. I have never had a problem but I am also a healthy person. I don’t have immune issues and still young. Stay away if you have immune issues or are over say 65.

Read up before doing this. I do highly suggest it.

redhawkpath said:

Hi

I have had quite a few experiences with Foley catheters as I have OAB from enlarges prostate issues. My urologist did also suggest intermittent Catheters also .. The biggest issue I had with them is that after using them for a couple of weeks there was soreness. And yes the insertion is the most important problem. Let’s face it you are using 2 to 3 catheters a day and introducing the possibility for infection many times a day.

After my first bout I learned how to use a foley. I did all my research and the need for proper cleaning and the convenience of having to insert once was a relief. Yes, there are risks of infection. But I think they are the same as intermittent .. I also found that on a lighter side that the convenience of not having to pee really helps in the pain and urge. Now the longest I have had a folly in is 4 weeks. I have never had a problem but I am also a healthy person. I don’t have immune issues and still young. Stay away if you have immune issues or are over say 65.

Read up before doing this. I do highly suggest it.

Click to expand...

Why stay away if you're over 65?