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Thread: Foley catheters and getting a good nights sleep

  1. #11

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    Quote Originally Posted by ltaluv View Post
    Slomo, my concensus comes from discussions with multiple urologists, along with the recommendations of the American Urological Association and the European Association of Urology. I don't know where or when your urologists got their information, but it flies in the face of the standard of care for the past couple of decades.

    You see, the problem is not what you think. It's not that you are pushing bacteria from eurethra into the bladder - that is a very minor source of infection, as the urethra is normally sterile and the meatus is cleaned before insertion. An indwelling catheter gets an encrusted biofilm of various types of bacteria within the first day or so that it's in, and this is the source of catheter-associated UTIs. Intermittent catheters do not get encrusted, and thus do not carry this infection risk. Insertion is safe - biofilm encrustation is inevitable and carries most of the risk.

    This is also why it is critically important to keep a Foley drainage system closed. Non-sterile opening of the system requires immediate catheter change. Whomever told you that you could safely let a Foley drain it a diaper is guilty of gross malpractice, and you might consider pursuing that in court as you'll have a strong case. That is extremely high risk behavior, and I would urge others not to try it unless they want to end up with a UTI.

    I have an uncle who's driven drunk for years and hasn't crashed, so I guess we can either conclude that driving drunk is safe, or that anecdotal evidence is worthless.
    My urologist were at the Mayo Clinic Florida. I, and most the world over, considers them to be the best trained urologists, and most well informed specialists, I've ever met. And I've been unfortunate enough to have me over three dozen (maybe four, I lost count), urologist I can only describe as "quacks".

    As for the encrusted film, you are slightly misinformed. That encrusteation is mineral salts and urease producing microbes (not to be confused with bacteria infection causing microbes). This encrusteation is half the reason why a catheter can only be left in place for a month, or it will become clogged.

    Though the other half you are absolutely correct about. Yes bacterial biofilms do build up over time, and the more that thin film back ups into the bladder the more likely it is to become infectious. This is why constant flushing is imperative, so as to keep that buildup from forming too early. And as confirmed by my urologists, so long as your catheter is being constantly flushed it doesn't matter if it's an open or closed system because it's always draining out anyways. The old train of though you have been told is actually a bit outdated now. But don't let that get to you, I was once told the same thing by a bunch of old urologist quacks a well. And truth be told I know it has also stuck in part because way too mant people have no idea what well hydrated truly means. As such, they continue to err on the safe side and keep saying it's bad no matter what. Nor can I blame them for that part alone.

  2. #12

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    Google is your friend. My "outdated" information come from journal articles published in 2017 and 2018. If you have peer-reviewed research you'd like to share, I'd be interested to read it. If it's something some urologist told you, it's anecdotal, v and of limited scientific value.

    Now, as for the biofilm encrustation, you are correct that this is a mix of minerals and non-infectious bacteria (microbes, if you prefer that word). Asymtomatic bacteriuria is endemic among catheter users, with a daily risk of 3-7% per catheter day. The key thing to understand is that this biofilm is an ideal growth medium for other bacteria, some of them less innocuous than what initially grows there. This is where the risk factor arises - you have a tube into your bladder, coated inside and out with good stuff for bad bugs to grow on, and the end result is a high risk of infection. Healthcare workers generally go to considerable lengths to keep the system closed to prevent the bad bugs from getting in and beginning to grow, but even with conscienscious care the risk remains high.

    The upshot is that there has been a recent push, even in hospital settings, to replace indwelling Foley catheter with intermittent catheterization, because it is safer.

    The British Medical Journal published a study earlier this year on this subject. Another study was published in Nursing Times in August of last year. Perhaps your urologist at the Mayo in Florida is spending too much time holding and too little time on continuing education - that's why most practitioners sneer at the satellite Mayo campuses. As a hepatologist friend once told me, "The Mayo Clinic is in Rochester. Everyplace else isn't really the Mayo." One man's opinion, to be sure.

  3. #13

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    I've never used foleys to manage my incontinence, only had them following surgery. I've been using ISCs since 2012 and in that time had only 3 UTIs, all of them within the first 2 years. This includes frequently leaving a catheter inserted to drain into a diaper overnight. Still no UTIs from that either. (an ISC used this way tends to work itself out over time so it only works at night when you're not moving around). I never leave one inserted that way for more than about 8 hours (I typically sleep for 6-7 hours).

  4. #14

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    It wasn't my intention to have a "Urologist" swinging contest. As I said (or tried to say) in the beginning, I use them at night to sleep, during the day to manage my work production, and sometimes on weekends if I'm going to be out of the house running lots of errands. Getting up all night to pee, or running to the bathroom can be really frustrating.

  5. #15

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    Hi Bellybag.

    I saw that you had 2 UTI's in the past 3 years. I hat to say it but when you take the catheter in is the most problematic for UTI. It is really just better to keep the catheter in and clean for longer periods. Chang out that bag every week. They are cheap so it should not be that much of a burden.

    Having OAB I have used catheter for two years and have never had a UTI. I know im rolling the dice but better than.. OH I have to pee then out it comes. I will take a break and use diapers again every once in a while but the catheter has been a better option.

  6. #16

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    Foleys are cheap. Even if you buy a whole dedicated tray, you're not spending $10. The catheter itself is under $2. Yeah, the problem comes from them being in place a long time, but usually in hospital (typically bedridden) situations. I'm pretty sure the UTI rate otherwise isn't that bad. Just goes to show you that spending a lot of time in a hospital sucks badly.

  7. #17

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    Hi the issue is that bacteria ets into the bladder which is a sterile environment(you can pee on cuts/burns to clean them in fact)
    Indwelling has the highest risk as anything that went in is in there "Growing" and there are a number of ways to lessen risks!
    One insert yourself so only own bacteria present.
    Don't worry so much about emptying fully but more about keeping well hydrated so lessens concentrations.
    try to keep air from getting inside bladder as many with just a flip flo valve let it dangle on drainage instead of keeping it level as nearly empty so bladder is pushing it out.
    Lessening use of leg bags as cause syphoning damage to bladder walls(Hand over bath plug when emptying trial so feel the suction)
    Using Flip flo valves more so can use bladder more like it's meant to be so less of above and blockages/Bacteria growth from dribbling constantly.
    (As like a tap with a slow leak will get scale deposits growing)

    Sure we have all done things that are "Frowned" up on by medical Mercenaries! I'm just as guilty like having my Foley drain into my washable nappy set overnight often when it's draining plenty and i want to sleep longer instead of waking up to deal with it but next day make sure flushed out.

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