Self Cath problem

[NCPilot]

I've had to self cath for as long as I can remember.  I insert the cath through a port where my belly button used to be.  Usually I can get it go in, but this week, I am having difficulty getting it in.  Back when I had this put in, the doctor told me that I'd have to leave the cath in once in awhile to stretch it back out.  However, the last time we left it in to stretch it back out, it caused alot of pain.  I was wondering if there's an easier and less painful way to stretch the port back out.  

[rmprdl1964]

Hi, I have been self cathing since 1996. Just since the end of 2008 I have had a suprapubic catheter in. I assume that you have you stoma (entry area, hole) in the same region. Mine is just below the belly button. I now have a Foley in and need to get it changed every 6 weeks. Previously they left it in for 6 months (not recommended). I will have home care come in to change it for me, but I will ask if I could do it myself.

I'm not sure as to what pain you are having. There are two kinds of pain that I have.

One is pain around the stoma where the catheter enters the abdominal cavity. For that I use 5% xyloxaine cream to numb the area. Taping the catheter to the abdomine helps to s it stops movement of the catheter.

The next pain is more severe and is also harder to control. This happens when there is movement of the catheter inside the bladder. It causes bladder spasms.

I also assume that you are using a strait in and out catheter. The tip from this catheter irritates the bladder causing spasms and pain. You might want to think of a short tipped Foley catheter if you are planning to stretch the stoma. It is important that the tip is short and that the balloon is only inflated with 10cc of sterile water or saline solution. I have a neurogenic bladder and also suffer from pain in the bladder and abdominal region. When I have bladder spasms I use Buscopan 10mg. 2 tab. 4 @day as needed. When the pain is severe, I use Statex Morphine Sulfate 10mg. 2 tab. 4@day as needed.

If you were to use an indwelling Foley for stretching, tape the catheter to leg or abdomine to avoid movement of the catheter. Movement is irritation and is the cause of most pain. The Xylocaine 5% cream is a topical and numbs the area. It is only a temporary thing but does offer relief.

I don't know why you have to self cath, but given that I assume that your bladder is mostly epmty. Due to that any foreign object in the bladder is not tollerated. Keeping anything in the bladder of minimum size is better as it will cause less irritation.

I have noticed that when they changed my suprapubic Foley, they push the new catheter in next to the old one and once the balloon has been filled they deflate and remove the old catheter. The procedure is quite painful, but only lasts less than 30 seconds.

I experience a lot of bladder cramping and spasms. Without the Buscopan and Morphine I would be in a lot more pain. One thing that gives me temporary relief is a hot bath. I usually take the Morphine and than have a hot bath. By the time I leave the tub, the Morphine or Buscopan will have started to work.

Another thing that I have just started using recently is a TENS machine. This device delivers small electrical charge to the specific areas. It sort of works like a massage or ultrasound to the bladder region. I first experienced thins during a physiotherapy session. It worked well than and the cheap machine that I obtained gives a simmilar result. After about 5 minutes the crampiness spasms seem to subside. I purchased a cheap unit to try things out. I'm now thinking about purchasing a professional machine. They range from about $60.00 to $200.00 and up.

I hope that this imformation is to some use for you.

All the best.

Ron

[motherof7girls]

I recently underwent bladder sling surgery for stress urinary incontinence (what else). This was the 2nd surgery, I  had cadaver sling surgery in 2003 that failed. My surgery was on Feb. 12,  2010. Went home from hospital on Feb. 14th  in much pain and with a catheter. Returned to Dr. on March first but couldn't void more than 50cc on my own. went home with catheter again, and a shot of antibiotics. Despite shot i could feel a UTI coming on 2 days before my return appointment on March 16th. At this point catheter was removed, and again and bladder was filled with fluid. I could not void more than 50cc and was taught to self catheter. I was also told i would have to re-train the bladder by not drinking too much and emptying every 2 hours. Which every other time I self cath. and log amounts voided. After a few days of reporting to the nurse i was put on Bethanachol a med. to stimulate the bladder to empty. After a week of taking this I still cannot empty my bladder, especially if full, like in the morning, i cannot pee even a drop. The most i have been able to go on my own is 50-150cc. The side effects of this medicine are many including cramps and nausea. i still have pain at the incision site and underneath. It has been over 6 weeks since my surgery and I would have expected to been further along in the healing process by now. I am still off work and scheduled to return soon. I am very frustrated and depressed. Is there an end to this. I am so afraid I will never be able to pee normally again???

[NCPilot]

Hello?