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1221035 tn?1301000508

Self-cathing

What size ISC Catheter do most women use? My doctor gave me 12f.....but now that I know they make a 10f; I would like to try the smaller one.
Anyone know any reason that a smaller size should not be used for ISC??
24 Responses
572651 tn?1530999357
I just. Posted reply on my journal entry but I will give it here too in case someone else needs this info.  The usual size for women is 14 or 16.  A 12 or 10 would be child sized.  If you are experiencing difficulty with cathrizing, I would suggest that you need a lubricated catheter.  Either a hydrophilic )(water) or one that you apply a sterile gel to would help.  After a while of ISC the ureter can get irritated.   I hope this helps.
572651 tn?1530999357
Sorry for all the typos I am on the tablet and not laptop.
1221035 tn?1301000508
I just checked....mine are 14f. don't know how I messed that up.

today is my first day of self cathing....and I seem to have bladder spasms when I am done.

I have only done it twice so far. I am peeing about 25cc, and then getting another 200-300cc with the straight cath.
572651 tn?1530999357
Those numbers confirm this is essential for your kidney and bladder help.  I hope it quiets for you.  -l
1221035 tn?1301000508
Thank you....
   Have you tried different brands? Is there a brand that is better?.....my uro/gyn just gave me handful an told me I could just wash them out and use the same one 4-5 times before throwing it out.
   Is this something you will have to do for the rest of your life? Mine may be just a short time. I had a hysterectomy and pelvic organ prolaspe surgery on Aug 6th.....however, the main reason I went to the uro/gyn was because I was having difficulty urinating. Upon exam, he noticed a severe (stage3) prolapse. So we were hoping that the prolapse was causing some if not all of my bladder issues.
   At this point, he said there could just still be a lot of swelling; so not to give of hope just yet.
1221035 tn?1301000508
Oh...and I also meant to ask how often do you cath in a day? Are there times you just go to the toilet and not cath?
At this point I am on the toilet 8-10 times a day...and I know that is too many times to cath.
thanks again :)
1221035 tn?1301000508
Sorry I am bombaring you with questions....hope your day at work went well. I do have another situation/question.

I think I am having bladder spasms!! I felt really full and like I needed to pee. I sat on the toilet and nothing, then I straight cathed and nothing!! Yes, I was in my bladder. It was really weird, It felt like my uretha tighten around the catheter and wouldn't let the urine come out. So, I removed it, waited a few minutes, got a new catheter and 300cc of urine came out

I know everyone says it doesn't hurt, and actually doing it doesn't...but after, I feel sore down there and my bladder is tender. Not sure that will make sense to you.
572651 tn?1530999357
There are so many brands out there, it can be trial and error until you find one that is comfortable for you to handle and use.  I can't believe the uro said to reuse the catheters.  That is definitely not in your best interests - even medicaid and medicare allows patients to have new ones for every use.  

I would ask for the prescription for caths and find a supplier to send you samples to try.  Then pick the one that you think will be good for you.  

Because the catheter is rigid  plastic or silicone, I don't think the spasm could actually close the catheter.  The bladder itself may be collapsing in some way from the spasms, though.  

If you get on a regular schedule to cath, you will cut down on the number of times you are in the restroom.  The frequency often comes from not having an empty bladder.  Currently I cath 4-5 times a day, depending on what I am doing (how far away from the restroom I will be) and how much liquid I have taken in. And yes, I can urinate without cathing, but that doesn't empty the bladder.

Don't give up on the possibility this is a short-term solution.  please ask for a prescription and stop reusing the catheters....

1221035 tn?1301000508
I received various samples of different catheters today, one was the speedycath....have you tried that one?

Oh my goodness, I could not believe the difference in the comfort! and I also received different sizes. This rep told me women use any size from 10 french and up; and it all depends on what works best and is most comfortable. So far, I prefered the 10f.

I know you said you cath 4-5 times a day....does that mean that is also the number of times you urinate each day? Guess what I mean, is do you cath after EVERY time you pee??

Thanks so much for all you help on this sensitive subject. I hope others will be able to benefit from this post either now or in the future.

Blessings,
Daisy :)
1221035 tn?1301000508
I wasn't sure if you just missed this:

I am wondering if you cath after every time you urinate....and you only urinate 4-5 times a day now....or, do you pee more than that and just pick 4-5 times to cath??

I hope that makes sense.

Thank You so much.....
572651 tn?1530999357
the latter - cath 4-5 times a day, but alos go on my own naturally.  I hope that helps
1221035 tn?1301000508
thanks LuLu....:)

hope I haven't frustrated you with all my questions, this is just all so new to me and a bit overwhelming. It seems I have bothered you with all my questions.....sorry :(
1045086 tn?1332126422
Hi.  Glad you found a good catheter to use.  Is the speedy cath one of the ones that is pre-lubricated?  Maybe it looks like a tube-in-a-tube?  At least the catheters for women are nice and short so they hide away pretty easy.  It makes a HUGE difference when you can use the best size, material and lubricant for YOU.  

The only reason you would need to up-size from that 10f is if you start to get any leakage around it (not likely with intermittent cathing).  The smaller and softer the catheter you use, the less irritation there will be.  And YES, irritation causes spasms.  The urethra isn't keen on space sharing :)  Repeated irritation can end up causing swelling or micro abrasions of the tissues and THAT allows micro-organisms to stay behind and grow.  Urinary tract infections follow.  Using those new catheters should help.  Cathing less often will also help.  

Spasms can make you feel like you need to pee even if you don't.  They may also cause leaking, urgency and/or frequency.  But retaining urine in large amounts can cause those things as well.  That's why you need to get a sense of your own 'urinary rhythm' (how much urine your kidneys make each day and the times of day they make the most).  

For you, cathing less frequently might also help you maintain bladder tone so that day will come when self-cathing is needed less - or hopefully - not needed at all.

If you have been voiding and cathing as the urge comes you may already have a good sense of the times of day your bladder is fullest or times you retain most.  As a general rule you will do okay if you aren't able to completely empty your bladder EVERY time you void.  You usually want a complete void 3-4 times each day (the number varies with environmental factors, special health concerns and individual needs).

I'd probably start with cathing after your first morning void.  You always want to make sure the over-night urine is gone.  If you have been taught to 'double void' or have self-learned any voiding 'tricks' to get more to come I'd keep using the techniques with every void, including before every ISC (intermittent straight cath).

Void without cathing for 4-6 hours as long as you aren't feeling pressure from a too-full bladder.  Then, sometime around lunch do another ISC after voiding as much as you can.

Continue to void without cathing another 4-6 hours then void and ISC around supper.

It's always a good idea to retire for sleep with an empty bladder so that's the last ISC of the day.

That's a guideline.  
If you can't void on your own at all,
If you drink lots of caffeine or other fluids at some point,
If your body doesn't 'release' fluid until you elevate your legs,
If you run on long days and short nights,
If you want to assure comfort for a special event,
Or have other individual needs, you will probably need to add another ISC.

Your doctor may want you to do something different so make sure you ask there too.  S/he knows you as an individual.  

BTW, the most likely reason to get no urine when the catheter is in the urethra would be end-point location.  The catheter tip either doesn’t make it completely into the bladder or it is inserted too far and is sitting above the fluid level.  The latter especially happens with women if one of the long catheters is used.  Always withdraw a catheter slowly to check for this possibility if nothing comes.  Take the catheter out slowly after every successful cath (pausing each time there is any additional flow) to be sure the bladder is truly empty.

Second BTW, cleansing and re-use of urinary catheters in the home is an approved practice (but NOT in a hospital or medical office setting).  I still think it is much better to use a new sterilized catheter for every ISC when possible.  The doc (or his nurse) should have (at a minimum) stressed the need to be very careful about hand washing before each cath and using a super-clean (yet not sterile) technique when self-cathing.

Looks like I’m back to wordiness.  Maybe I never left.  Hope this mini-novel gives you a decent starting point.  We probably both need to pee by now.  LOL
1221035 tn?1301000508
thank you so much for all the information....it is really helpful, and exactly what I have been looking for.

My doctor thinks I have DSD, it is when the bladder muscle and urethra mucles are working at the same time instead of opposite like they are suppose to.

Yes, the speedi-cath compact is the one that looks like that, about the size of a long lipstick container. So far it is the most comfortable....not to mention how convenient.

I have gotten fairly good at it now, here at home...but I use a large mirror. I have no idea how, or if, I would ever be able to do it in a public restroom.

Do you self-cath? You have so much wisdom and great advise. If you do, what catheter do you use??

Thanks again for all the help!
572651 tn?1530999357
Great replies up there from twopack, full of lots of solid medical facts.  Perhaps that needs to go into a HP?

I was looking for another piece and came across this one that includes Daisy-girl's comments at that time. Girl, it sounds like you were lucky in putting this off for over two years.  :-)    I hope you find something in those samples you like.  The speedi-cath  for me has the down side that it is shorter - I wish it was maybe just an inch longer but I love the idea and the basic product.  As you pick your choice, be sure you find out which one will be covered by your insurance. I recently had to switch suppliers and caths because of the difference between hydro and nonhydro caths.  
1221035 tn?1301000508
thanks LuLu....not sure what you mean "looking for another piece and came across this one that includes Daisy.girls comments at that time"

I don't know if you are aware, but they make a speedi-cath compact plus (that is about an inch longer).

Also, there is a company called Summit Express Medical, they accept what ever medicare or your private insurance pays (within reason) and NO out of pocket expense.....they do include and have the speedi-cath compact (which I love); they do not have the speedi-cath compact PLUS. They have the magic 3 with the sterile water packet included, and many more. I think if the payment is 80%, they waive the 20%

How many MS patients have to self-cath?

Is this something we will have to do for the rest of our lives, or can it get better??

thanks everyone for all you help!
Avatar universal
I get my catheter supplies at http://selfcatheters.com/ and they can answer all of your questions like this and help you choose the right catheter for your needs. I highly recommend them.
198419 tn?1360242356
Daisy Girl - glad you received the help you needed!

TwoPack - Your solid info is a must for our Health Pages! Let me know if I can be of asistance with that!
-shell
Avatar universal
I have just started to have to self cath more often.  Usually I was only doing it when I could not go at all.  However my urologist wants me to do it three times a day to see if my retention is worse then we think.  I was doing fine the first few days then I cathed on Sunday night and nothing came out I normally get 50ml or more after voiding on my own.  I could see urine in the tube, it would come to  drip and drip out.  it looked like a suction.  You know when you put a straw in water and close off the top and slowly let it drip out of the straw.  Well I tried removing the cathater and it took over 40 min.  I had to sit in a warm tub and let myself relax.  I took a day off because I hurt soo bad.  Today I tried again and the same thing.  It only took 10 min to remove the cath because I sat in the tub right away.  Any ideas?
572651 tn?1530999357
H i and welcome to our little corner of the web.  I must first sadly tell you that twopack died unexpectedly a few months ago and left a void in this community.  

The stuck catheter is something I have not heard of .  What size cath do you have and are you experiencing spasms:?  Please be sure to  let your doctor know about this problem - you may need to change brands or sizes.

best, Laura
Avatar universal
I am using a 14 straight rounded tip.  Its what medicare pays for I guess.  im calling tomorrow.  I beleive its spasms because once it comes out I bleed.  Ill keep you posted
572651 tn?1530999357
That kind of trauma is not good - be sure to talk to the doc and get this taken care of before you cause serious damage.   good luck with the doctor.
147426 tn?1317265632
Hi, If I can jump in here....I self-cath about 7  to 8 times a day.  With the Botox at high enough doses to get rid of the chronic and constant bladder spasms, My bladder is too weak to contract sufficiently to empty the bladder ever!  But, I still have strong urges with 200-300cc in there.

I use a plain, old 14F Coloplast non-lubricated catheter for the most part.  But there are times when I have significant urethral spasm after the urine has emptied.  In fact, I can tell  when the stream has shut off because of a tiny twinge of pain.  This is with every void.

I also have times when I clearly need a lubricated catheter.  I can feel that the bladder has spasmed down around the openings of the catheter and there is a resistance to withdrawing it- not to mention pain.  I try to slowly rotate the catheter 1/4 to 1/2 turn and this will usually release the suction, but sometimes it just hurts more.  These are the times when I have the urethral spasm for quite a while (like 30 minutes) after urination.

I also frequently pass little tiny blood clots (the size of the head of a pin) during these times, so clearly I have been traumatizing my urethra.  I have been putting off talking to my uro about all this, but writing it out has convinced me to do it soon.

Anyhow, I just jumped in here to say I have had the "suction" problem of difficulty and pain in removing the catheter sometimes.  My old uro (who was awesome, but moved to the VA, said it was the bladder that closed over the catheter's holes. The rotation trick usually works.

Your problem of literally not being able to remove the catheter sounds like a mechanical problem possibly associated with bladder wall spasm or urethral spasm on the tube.  Yes, do talk to your uro.  I mention all of this because I have an anatomical problem in the urethra.  I also have trouble inserting all catheters  I hit a "wall" and have to re-aim the catheter and push it past.  I have a little pouch that the catheter always goes into.  My uro visualized it during cystoscopy.  Your uro might need to do a cystoscopic exam looking for any abnormalities, such as polyps, tags, pseudo-pouches, and signs of trauma from what you recently had to go through.

Trauma and inflammation decrease the natural function of the urethra's ability to keep bacteria out of the bladder, thus predisposing one to UTI's.   (Hmmm, maybe that's why I have had so many recently.

Do as I SAY, not as I do, please.

My recommendation is to use the catheter that allows the most easy insertion and removal.

Man, this was garbled.  Sorry.

Q
572651 tn?1530999357
Oh - another thought -
is you cannot get lubricated or hydrophylic catheters approved for coverage, ask you supplier about including packets of sterile lubricant?  At one point my supplier was doing that and they were little one use  packages - smaller than a ketchup pack you would get at a fast food place.This worked well...
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