Bladder spasm during selfcath?

[Pino]

Hi,

i have got a small question for those who are doing self cath. For some days now i have to do it at least four times a day, and it happened now two times that my bladder cramped while doing it, with the result of a big mess below me, because the pee is running out beside the catheter.

I ordered 14ch instead of 12ch already, but i am not sure that will solve that problem.

Is there anybody with similar experiences? Any tips?

 

[Diaperman95]

Hi,

i have got a small question for those who are doing self cath. For some days now i have to do it at least four times a day, and it happened now two times that my bladder cramped while doing it, with the result of a big mess below me, because the pee is running out beside the catheter.

I ordered 14ch instead of 12ch already, but i am not sure that will solve that problem.

Is there anybody with similar experiences? Any tips?

I use a 16 or 18fr with a coude tip. They come in a sterile wrapper with a foil pack of water that you break open so it can activate the lubrication already on the tube. I prefer the18 my self. It drains faster and it is bigger. You are stretching the urethrae helping to keep it open and with out strictures along with helping it empty with the tube you are stretching parts and bladder neck opening. and a 18 is not huge and pain it just goes faster. Don't cath right after you pee. often your bladder is flared and the fact you just peed half of it out it is going to contract and even m9r hurt more. So if you pee first wait tell it has settled back down a little before you pass that catheter. Let me know if I can help with any thing else. Also buy sterile lube if not using one that comes lubed like mine.

 

[Pino]

I use a 16 or 18fr with a coude tip. They come in a sterile wrapper with a foil pack of water that you break open so it can activate the lubrication already on the tube. I prefer the18 my self. It drains faster and it is bigger. You are stretching the urethrae helping to keep it open and with out strictures along with helping it empty with the tube you are stretching parts and bladder neck opening. and a 18 is not huge and pain it just goes faster. Don't cath right after you pee. often your bladder is flared and the fact you just peed half of it out it is going to contract and even m9r hurt more. So if you pee first wait tell it has settled back down a little before you pass that catheter. Let me know if I can help with any thing else. Also buy sterile lube if not using one that comes lubed like mine.

Thanks for that advice. I have tried several types and found only one working for me.

I cant use the straight ones, only the flexible type, otherwise it hurts to much.
They are pre lubed, Hollister Vapro Pocket, an American manufacturer i think, the Coloplast Speedi Cath are O.K., but the top hurts me more than the Hollister.

The best top i tried is the Nelaton, Tieman / Coude does not work well, Ergothan hurts even more.

"Stretching the urethrae" seems to be necessary since the Botox injection, i will try bigger sizes next days (again).

 

[ltaluv]

I second what Diaperman95 said. I also use a Ch 18 Tiemann Coude with a water sachet - mine are Lofric Origo made by Welspec. I find these more slippery than other hydrophilic ones I've tried.

If you use a Coude with it's bent tip, make sure the to points towards your nose. If you accidentally rotate it while inserting it, they can be very difficult or impossible to get into the bladder, and that's when I sometimes get spasms and leaks. I tend to pee right before I cath, which for me minimizes any leakage since my bladder has already pushed out all that it can. I also often cath while standing over the toilet, so any drips don't make a mess.

I retain 200-250 ml and have a comfortable bladder capacity of 350-400 ml, so I end up cathing every time I need to pee. That's generally 8 times a day, but can be more if my IC is hurting. Peeing without cathing is almost pointless because I still feel like like I need to pee even right after I finish.

 

[CheshireCat]

Most days I can pee then self-cath immediately, but there are periods of time when the bladder does not cooperate. There are two ways I handle it based on what I was taught by one of my urologists.

First, I sit and pee, then stand up and pee, then sit and pee. The motion of sitting/standing/sitting helps the bladder to empty more. I wait 5-15 minutes, then self-cath. If urine is passing outside the catheter because of spasming, then the next time I need to pee, I self-cath without peeing first. Either emptying the bladder more than normal or not emptying the bladder will help with spasming.

When I first started this journey of incontinence and retention I required a FR12 because of the severe pain and shock that followed. It took over a year before a FR14 could be used. Because I have now a prostatectomy (cancer), when I started self-cathing I was asked to try a FR14, FR16, and FR18 by the education nurse (with her watching). I was prescribed FR16, as it was the best fit. But when my bladder spasms, I still pass urine outside the catheter.

More stuff you need to learn for yourself.

 

[Diaperman95]

I second what Diaperman95 said. I also use a Ch 18 Tiemann Coude with a water sachet - mine are Lofric Origo made by Welspec. I find these more slippery than other hydrophilic ones I've tried.

If you use a Coude with it's bent tip, make sure the to points towards your nose. If you accidentally rotate it while inserting it, they can be very difficult or impossible to get into the bladder, and that's when I sometimes get spasms and leaks. I tend to pee right before I cath, which for me minimizes any leakage since my bladder has already pushed out all that it can. I also often cath while standing over the toilet, so any drips don't make a mess.

I retain 200-250 ml and have a comfortable bladder capacity of 350-400 ml, so I end up cathing every time I need to pee. That's generally 8 times a day, but can be more if my IC is hurting. Peeing without cathing is almost pointless because I still feel like like I need to pee even right after I finish.

I do it over the toilet also.

Pino the coude have a dot or a bump on the flange or top of the catheter where the pee comes out, so you can make sure it is facing you and the tip will always be facing the same direction. Much like diapers you really need to test drive a few other types because we all have different needs.

 

[Diaperman95]

Thanks for that advice. I have tried several types and found only one working for me.

I cant use the straight ones, only the flexible type, otherwise it hurts to much.
They are pre lubed, Hollister Vapro Pocket, an American manufacturer i think, the Coloplast Speedi Cath are O.K., but the top hurts me more than the Hollister.

The best top i tried is the Nelaton, Tieman / Coude does not work well, Ergothan hurts even more.

"Stretching the urethrae" seems to be necessary since the Botox injection, i will try bigger sizes next days (again).

Most important thing is to be clean. You can even use a alcohol swab to wipe down first but I buy iodine swabs like the big Qtips. My catheters have a protective sleeve that you can grip while inserting so your hand never touches the catheter tub its self. I personally think the clear plastic ones that are a little more ridged are easier to pass than the the rubber kind. I have used 1000's of both. I think it really is a matter of preference.

 

[Pino]

I retain 200-250 ml and have a comfortable bladder capacity of 350-400 ml, so I end up cathing every time I need to pee. That's generally 8 times a day, but can be more if my IC is hurting. Peeing without cathing is almost pointless because I still feel like like I need to pee even right after I finish.

That are exactly my stats now, but i only get paid 4-6 catheters a day but i have to drain up to 8000ml - here is a problem.

In the meantime tried ch14 and 16ch of my favorite type and i will change to the ch16 for next order.

I am still new to this and will have a try on several types again in the near future, for now i am happy i found one i can work with.

As always i think this place is great for advice, i got no answers on my German forum.

I the beginning i was very reserved about an ABDL site, but it was a good choice to come here.

 

[Wilfulwetter]

Hi,

i have got a small question for those who are doing self cath. For some days now i have to do it at least four times a day, and it happened now two times that my bladder cramped while doing it, with the result of a big mess below me, because the pee is running out beside the catheter.

I ordered 14ch instead of 12ch already, but i am not sure that will solve that problem.

Is there anybody with similar experiences? Any tips?

You are using the catheter wrongly. Are they prescribed for you?

 

[Pino]

You are using the catheter wrongly. Are they prescribed for you?

Yes, of course i got them prescribed. Why do you think i do use them in the wrong way?

 

[Wilfulwetter]

Yes, of course i got them prescribed. Why do you think i do use them in the wrong way?

Because you shouldn't have pee coming out of your urethra as well as the catheter. Are you sure the cath is the right size?

 

[Diaperman95]

I the beginning i was very reserved about an ABDL site, but it was a good choice to come here.

I had the same mindset. I did not think I would get much out of it. I even used a old email address I never use to set it up. But it has been a real blessing. I never thought I would stay over a year and for sure never thought I would have 1600 plus comments. I am glad to be here and glad you are too.

 

[ltaluv]

That are exactly my stats now, but i only get paid 4-6 catheters a day but i have to drain up to 8000ml - here is a problem.

In the meantime tried ch14 and 16ch of my favorite type and i will change to the ch16 for next order.

I am still new to this and will have a try on several types again in the near future, for now i am happy i found one i can work with.

As always i think this place is great for advice, i got no answers on my German forum.

I the beginning i was very reserved about an ABDL site, but it was a good choice to come here.

I don't know how it all works in Germany, but here in the US my insurance can dictate how many catheters I get a month. My previous insurance would only let me have 200 per month (6.7 per day) which was not quite enough. Fortunately, my urologist was kind enough to give me a couple of extra boxes per month out of their own supply so I could cath as often as needed. I switched insurance when I switched jobs, and the new one lets me get the 240 a month that I typically use.

 

[Pino]

Because you shouldn't have pee coming out of your urethra as well as the catheter. Are you sure the cath is the right size?

Well, this was discussed above and i ordered higher ch already, but, as CheshireCat said, it may happen either way.

A bladder spasm is not controllable and generates a lot of pressure, that is why people get incontinent in the first place.

 

[Pino]

I don't know how it all works in Germany, but here in the US my insurance can dictate how many catheters I get a month. My previous insurance would only let me have 200 per month (6.7 per day) which was not quite enough. Fortunately, my urologist was kind enough to give me a couple of extra boxes per month out of their own supply so I could cath as often as needed. I switched insurance when I switched jobs, and the new one lets me get the 240 a month that I typically use.

The Urologist can write the prescription and everything below 6 pcs a day should be no problem with the insurance. Higher amounts can be tricky and the insurance may say a different solution is better in that case. For example a "abdominal catheter" or simply a Foley.
You will have a lot of discussions, that is for sure, but if necessary, i will of course go for it.

 

[Teddy]

Because you shouldn't have pee coming out of your urethra as well as the catheter. Are you sure the cath is the right size?

Bladder spasms for me caused urine to bypass the cath. They are powerful, hurt like hell, and are debilitating.

 

[Diaperman95]

The Urologist can write the prescription and everything below 6 pcs a day should be no problem with the insurance. Higher amounts can be tricky and the insurance may say a different solution is better in that case. For example a "abdominal catheter" or simply a Foley.
You will have a lot of discussions, that is for sure, but if necessary, i will of course go for it.

I think the important thing is to remind them that we all are different and what works best for one person my not work best for you. I not sure I would jump to a super pubic catheter since it is most likely a temporary situation caused by the botox injection. Maybe a foley if nothing else helps. Hopefully they won't take a full 6 to 9 months to go away. With any luck maybe after a month or two things will settle down a bit. I hate passing a tube and would hate it even worse if I could not go a all without it. Maybe ask your doctor about a drug called Urogestic Blue. It is much like AZO's and changes the color of the pee to a blue green that stains everything. But it is the only meds I ever found that help with the spasms. I really don't have anything better to recommend. Best of luck and let us know what you figure out.

 

[Coffeelover]

Most days I can pee then self-cath immediately, but there are periods of time when the bladder does not cooperate. There are two ways I handle it based on what I was taught by one of my urologists.

First, I sit and pee, then stand up and pee, then sit and pee. The motion of sitting/standing/sitting helps the bladder to empty more. I wait 5-15 minutes, then self-cath. If urine is passing outside the catheter because of spasming, then the next time I need to pee, I self-cath without peeing first. Either emptying the bladder more than normal or not emptying the bladder will help with spasming.

When I first started this journey of incontinence and retention I required a FR12 because of the severe pain and shock that followed. It took over a year before a FR14 could be used. Because I have now a prostatectomy (cancer), when I started self-cathing I was asked to try a FR14, FR16, and FR18 by the education nurse (with her watching). I was prescribed FR16, as it was the best fit. But when my bladder spasms, I still pass urine outside the catheter.

More stuff you need to learn for yourself.

I do the same thing like you in the past several years, it seems like I cannot completely empty my bladder when I sit in the toilet for business, afterward, I have to stand up and pee again.

 

[EcoIncon]

I second what Diaperman95 said. I also use a Ch 18 Tiemann Coude with a water sachet - mine are Lofric Origo made by Welspec. I find these more slippery than other hydrophilic ones I've tried.

If you use a Coude with it's bent tip, make sure the to points towards your nose. If you accidentally rotate it while inserting it, they can be very difficult or impossible to get into the bladder, and that's when I sometimes get spasms and leaks. I tend to pee right before I cath, which for me minimizes any leakage since my bladder has already pushed out all that it can. I also often cath while standing over the toilet, so any drips don't make a mess.

I retain 200-250 ml and have a comfortable bladder capacity of 350-400 ml, so I end up cathing every time I need to pee. That's generally 8 times a day, but can be more if my IC is hurting. Peeing without cathing is almost pointless because I still feel like like I need to pee even right after I finish.

I know this is a little off topic but perhaps is useful info. I was retaining about 150ml. According to my urologist as long as the number is under 100ml, they don't worry too much about it. I get bladder infections like crazy if I cath. I also know what y'all are talking about with the spasms and leakage around the catheter. As far as the leakage is concerned, the goal is to empty the bladder so I never worried much about it. The spasms, however, hurt and I didn't care for that!

My PT had me work on a technique while sitting on the toilet. I was taught to press down firmly on the bladder with both hands (done by pressing into the pelvic cavity from just above the pubic bone). Using this technique I can get my PVR down to 50-80ml. Less infections and no cathing for me lately.

 

[Pino]

I had no bladder cramps for some days, seems like the Botox has now the full power. My bladder fills up to 600ml, but from 400ml on it gets painful, but not as painful as before without the Botox.

My stricture seems to be better either, so the cathing seems to work here, it is still uncomfortable to pee, though.

All in all i think it is much better than before, i had no leaks in days, i still wear some pants for protection, but i did not need them for some time.

My only worry is now that i get used to the new situation and what to do, when Botox looses its function. I am worried a new Botox procedure will damage the urethra even more.

End of June i will have urodynamics again, we will see how that turns out.