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Thread: Bowel & Bladder Control for High-Level SCI

  1. #11
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    Yikes, I'm really confused now.

    The urologist just said that (1) it's okay to keep him on the foley cath rather than a suprapubic, (2) he's lucky that he hasn't had more UTI's (two in 19 months), (3) he can't wear a condom catheter, (4) consider not having him wear a foley and to bring him in the following day for a scan to check if he can empty his bladder, (5) the ER doc is probably wrong because if my Dad had a lot of scar tissue, they wouldn't be able to insert the 16Fr foley (a coude - the previous time, the ER nurse rec the silver ones), and (5) a "no" to my question about his regaining b&b control?

    There was no mention of drugs. Should I ask for drugs (Osybutynin, Vesicare, or Tamsulosin -- which may not help?) to help him to empty his bladder?

    Just to clarify -- if my Dad does not have the foley to help drain the urine, he is at risk for AD and to damage to his kidneys. Drugs may help to empty his bladder. Is this correct? Or, is he at risk irregardless and the foley helps only short-term?

    I'll ask about the voiding pressure.

    If helpful, my Dad was injured about 19 months ago.
    Last edited by Joey_SF; 05-20-2013 at 08:49 PM.

  2. #12
    We put all those with indwelling catheter on Oxybutynin 5 mg twice a day to keep the bladder from shrinking. And the indwelling is fine, Just be sure and tape it and move it form one leg to the other and keep it loose so no pressure on urethra because splitting can occur. I have patients who have worn a foley for 40 years without problems and I have others who got the splitting or hypospadias in a couple of months. And if he isn't having a lot of UTI's I would continue with that.
    CWO

  3. #13
    Senior Member chris-k's Avatar
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    Quote Originally Posted by Joey_SF View Post
    Hi Betheny - thank you so much. Sorry, dumb question - what is IVP? Did you do any exercises or something "healing" to help to regain b&b control?
    Order "Bladder Management Following Spinal Cord Injury: What You Should Know" from the PVA. They are free as PDF's.

  4. #14
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    Hi CWO -- thanks for the advice. Uh, so a danger is that my Dad's bladder will shrink or his urethra will split? What is hypospadias? Will there be any warning signs before these happen?

    Okay thanks -- I'll look for the PVA doc.

  5. #15
    The bladder will shrink over time from the foley as te foley keeps all pressure off the bladder so it does not stretch as it normally does, when filling normally. Like with straight cathing, the bladder will not shrink because you let it fill, therefore stretching the bladder out as it fills. With the foley, the urine basically flows straight through, and the bladder does not stretch, so over a period of time, the bladder will shrink down. Just out of curiosity is he able to try straight cathing?
    BobbieLee
    SCI from L5 to S2-S3, complete Cauda Equina Syndrome , symptoms from waist to feet, as well and as far up to the stomach. Spinal cord surgery for removal of tumor Jan 2009

  6. #16
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    Joey sf, as to your question? Has any one with a high injury ever regained b&b? Well I have 100% for bladder and probably 85% bowels! Neither one feels the same as pre sci and I'm c5 incomplete . My bladder returned around 3 months post sci.u

    May I also add they could check if your dad was empty after voiding quite easily, at almost any clinic or inpatient /outpatient rehab clinic that has ultra machine! Just have him drink a lot of fluids b 4 going in or have them bring one to his home and check after he voids himself !

  7. #17
    Senior Member alan's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    We put all those with indwelling catheter on Oxybutynin 5 mg twice a day to keep the bladder from shrinking. And the indwelling is fine, Just be sure and tape it and move it form one leg to the other and keep it loose so no pressure on urethra because splitting can occur. I have patients who have worn a foley for 40 years without problems and I have others who got the splitting or hypospadias in a couple of months. And if he isn't having a lot of UTI's I would continue with that.
    CWO
    They never put me on anything like that. It's been 4.5 years with Foley now.
    Alan

    Proofread carefully to see if you any words out.

  8. #18
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    Thanks Ggerry!

    Just wondering - did you do any exercises which helped to get back the control?

    Hey Sunnydayz,

    My Dad was straight cath'ed when he was initially injured and in the ICU.

    He then was transferred to a facility where they kept him on a foley. We asked about straight cath cuz he had a UTI. But, it seems that they don't do straight cathing at the sorta-rehab place.

    We discovered that he could pee about 8 months after his injury -- when his foley accidentally came off.

    Thus, pls forgive my dumb question -- would he be peeing in between the times which we straight cath him?

    And, I'll ask about the Oxybutynin -- I'm nervous about any drug cuz after this injury (and the loads of drugs) my Dad has become super-sensitive to drugs.
    Last edited by Joey_SF; 05-26-2013 at 08:49 AM.

  9. #19
    Most cervical injuries have neurogenic detrusor overactivity (NDO) with detrusor sphincter dysnergy (DSD) so yes they have spasms and "pee" but it doesn't empty and the pressure can be very high and if too high, over time, kidney issues can develop. that is why urodynamics should be done if thinking about having him void or do IC. with an indwelling you don't need to do urodynamics.
    Urodynamics testing would give you the information you need.
    CWO

  10. #20
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    Q: I've been reading posts and there's discussions about "leaking." My Dad does leak -- one time, this was the reason for 5 attempts for a foley change for the month. What is a leak indicative of?


    Uh oh, the urologist didn't tell me to do anything "differently" and he did not prescribe any medication -- he said that we could continue with the foley. He shrugged a lot and was just very lackadaisical. He didn't talk about "high" pressure or about any long-term problems. During the urodynamics test, they had to stop the testing because at the 2nd round, my Dad's blood pressure went up.

    The reason my Dad was referred was because the ER doctor couldn't insert the foley and used a dilator and guidewire, initially diagnosed a "penile urethral stricture" (is this another term for scarring?), and recommended the suprapubic.


    Actually, we were referred to another doctor, but she was fully booked. So, we were scheduled with this "younger" doctor who could schedule an appointment quite quickly. The coordinators also told us that this younger male doctor specialized in penile urethral stricture (the female doc was less "into" to this).

    I'll ask to see the more experienced female doctor -- since my Dad doesn't have this "stricture."

    So, the next step is:

    1) ask about the need for Oxybutynin

    2) schedule an appointment to check if my Dad can empty his bladder

    3) Straight cath options? any luck with electrical devices?

    ****************

    Hi CWO

    Q: Gosh, I don't entirely understand your post -- are you saying if my Dad has an indwelling catheter, he doesn't need to do urodynamics testing? But do urodynamics to check if he needs an indwelling catheter or can "void" (empty his bladder?) on his own?
    Last edited by Joey_SF; 06-02-2013 at 12:23 AM.

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