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Thread: Intermittent Cath Question

  1. #1

    Intermittent Cath Question

    Just started IC. 3 x day . DoN it a month now.

    Use closed system.

    Question?

    Is is ok to leave cath in for 40 or more min. Id like to just leave it n for as long as possible.

    I just cathed and got 300cc. Can I just kick back. Im sterile.
    My only concern is dry out of cath. But then whats the difference from indwelling ???

  2. #2
    Why not just use a Foley to start with... then you could kick-back all the time!

    Regards.
    Millard
    ''Life's tough... it's even tougher if you're stupid!'' -- John Wayne


  3. #3
    Senior Member
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    My husband (C6/7) uses intermittent cath with closed system also. In the middle of the night , he goes like crazy, so we often leave it in for a couple of hours in the night - sometimes just because I'm so tired that I put it in and fall back asleep It does dry out after that long. You have to be careful removing it - It doesn't seem so dry that its hurting him or causing any problems. We've been doing it this way for a long time and its been okay ...

  4. #4
    Senior Member
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    Indwelling isn't very healthy for your bladder as far as I understand - atleast not in the long term. Not only that, but if you have any hopes of getting bladder control back, intermittent cath is the best way to "train" your bladder. If you do it this way , you kind of have the best of both worlds

  5. #5
    The catheter can dry out, but I am not sure how long that takes. You might want to call the manufacturer and find that out.

    It is not a good idea to leave a catheter in place if that is not how you manage(or plan on managing) your bladder. You are giving the bladder mixed messages - that sometimes it has to hold urine and others it doesn't. I do kknow there are people out there that do keep a catheter in place over night and it works for them. In my opinion, it is not the ideal, but I do understand the need for sleep.

    I am concerned about your program. Every 8 hours is one too few a cath for my liking. The urine is sitting in your bladder for quite a while. What are your volumes and how much/what do you drink?

    CKF

  6. #6
    Regarding IC....

    After IC and urine stops flowing (20min or longer) i put condom cath on and sometimes within an hour i'm voiding.

    I presume its fluid intake vs output.

    How fast does fluid to get to bladder.??

    Or is this normal?

    Other:

    Urologist and I are trying Myrbetriq 1 a day 25mg.
    Dr wouldn't scope until ua-cs results. Im never septic,,just ''autonomic sweats''.
    Mystery continues.

    Im still working on this ''autonomic sweating '' pblm.

    Just got ky-jelly for IC. After searching forum look like ky should be ok.

  7. #7
    When did you last have urodynamics? It should be possible to go 4 hours between caths without leaking if you are on the correct anticholergic medications (or Botox) and are monitoring your fluid intake correctly. You should aim to cath every 4-6 hours, and not have any one cath amount over about 450 ml. With a 14 Fr. catheter, you should be able to drain this amount from your bladder in less than 3 minutes.

    Myrbetriq (mirabegron) is not used much in neurogenic bladder due to SCI. It is designed for "overactive" bladder syndrome. It helps with bladder spasm, but does NOT reduce bladder pressures, which is an important feature of the usual anticholenrgics (Ditropan, Detrol, Sanctura, Vesicare, etc. etc.) normally used in SCI. High pressures can only be detected through the use of urodynamics, and if your pressures are too high, you will not only leak between caths, but over the long term can damage your kidneys. High pressures also increase your risks for UTI. High pressure can also be the cause of autonomic dysreflexia (your "sweats"), which can be dangerous.

    Your kidneys make urine continuously. How much is regulated both by your fluid intake, your blood volume and blood pressure, and by hormones (especially anti-diuretic hormone or ADH) from your pituitary gland.

    It is really not a good idea to leave a catheter in place a long time when doing intermittent cath. It can increase your risks for developing urethral problems such as urethritis and strictures. I had one client who fell asleep with a red Robinson in place and it actually slipped up into his bladder completely...was not discovered for several months, during which time it formed stone around it, and caused repeated UTIs.

    Done correctly, intermittent cath not only has a lower rate of UTIs, but also is more likely to help preserve normal renal function, and has a lower rate of urinary stones than indwelling catheter use, as well as much lower rate of bladder cancer. With an indwelling catheter you also have to drag around a urinary drainage bag or wear a leg bag all the time, and if it is urethral, it definitely can limit your sexual activities.

    (KLD)

  8. #8

    not a good idea to leave a catheter in place a long time

    Quote Originally Posted by SCI-Nurse View Post
    It is really not a good idea to leave a catheter in place a long time when doing intermittent cath. It can increase your risks for developing urethral problems such as urethritis and strictures.

    (KLD)
    What do you consider a long time???

    Ive def. got overactive bladder , precisely why he prescribed it and will help if i have bladder spasms.

    I must be drinking too much.

    Before bed IC i get 300-400cc quickly but i drink prob 300-500 cc at this time and approx 1-1.5 hrs later i get additional 500, leaving cath in. And generally void 1200 cc overnight (condom cath). Morning cath generally 300-400cc

    Since I IC'd at 3:30. I've reflex voided 500cc with slight AD 'sweats'

    Myrbetriq is fairly new. Not alot of pharma info out there. I asked about detrol etc, Doc like this.

    I've had 2 sphincterotomies. 2 years ago most recent.

    Brain freeze: What are the blockers called that help prevent AD?? Alpha? Neuro? We're gonna try that next if urodynamics and scoping show no abnormalities.

    Thanks Sci-Nurse


    no way i could go 4 hrs without voiding unless i change intake (i guess)
    Last edited by FLAX; 06-20-2013 at 08:33 PM.

  9. #9
    Quote Originally Posted by FLAX View Post
    What do you consider a long time???

    Ive def. got overactive bladder , precisely why he prescribed it and will help if i have bladder spasms.
    Anything over 10 minutes is a long time.

    Overactive bladder occurs in AB people with volitional control over voiding, not in SCI. It is much more likely that you have a reflex bladder, not hyperactive.

    Quote Originally Posted by FLAX View Post
    I must be drinking too much.

    Target fluid intake for someone on intermittent catheterization is 2400 ml. daily, with 1/2 of that taken prior to noon, the rest prior to 6PM, and nothing after that time to avoid excessive urine output at night. You will have less problems with diuresis at night if you wear compression hose during the day to prevent edema in your legs and feet. You may also want to discuss with your urologist if you perhaps have inappropriate ADH hormone excretion at night, which is a problem for many people with higher SCI. There are drugs that can be used to manage this.


    Quote Originally Posted by FLAX View Post
    Before bed IC i get 300-400cc quickly but i drink prob 300-500 cc at this time and approx 1-1.5 hrs later i get additional 500, leaving cath in. And generally void 1200 cc overnight (condom cath). Morning cath generally 300-400cc
    .
    Yes, it is normal to make a lot more urine in the 1-3 hours after getting into bed. Limiting your evening fluid intake will help with this some, but most people manage this by cathing more often after getting into bed. You cathing only 3X daily is not really considered safe.

    Quote Originally Posted by FLAX View Post
    Since I IC'd at 3:30. I've reflex voided 500cc with slight AD 'sweats'
    The AD is a excellent sign that you have a high pressure bladder and are voiding with excessive pressures. When did you last have urodynamics??

    Quote Originally Posted by FLAX View Post
    Myrbetriq is fairly new. Not alot of pharma info out there. I asked about detrol etc, Doc like this.
    Why does he like it? Because he is getting free samples or other benefits from the drug rep?? Can he show you research studies done with this drug for people with SCI?? Is he a specialist in neurologic urology?

    Quote Originally Posted by FLAX View Post
    I've had 2 sphincterotomies. 2 years ago most recent.
    These may help you empty better using a condom catheter, but will prevent you from staying dry between your caths, and may also cause leaking around an indwelling urethral catheter or with the use of a SP indwelling catheter. They don't reduce your bladder pressures.

    Quote Originally Posted by FLAX View Post
    Brain freeze: What are the blockers called that help prevent AD?? Alpha? Neuro? We're gonna try that next if urodynamics and scoping show no abnormalities.
    Just taking blood pressure control drugs when experiencing AD without finding and treating the CAUSE of the AD is a potentially dangerous plan. The cause of the AD needs to be found, and eliminated. It in of itself can be dangerous or even life threatening. AD is your body's way to telling you that something is wrong...if you block the symptoms you loose this warning system.

    (KLD)

  10. #10
    Quote Originally Posted by SCI-Nurse View Post
    Why does he like it? Because he is getting free samples or other benefits from the drug rep?? Can he show you research studies done with this drug for people with SCI?? Is he a specialist in neurologic urology?


    (KLD)
    .

    Yes he is a specialist in neurologic urology and Department Head of Urology at Scott & White.

    thanks
    Last edited by FLAX; 06-20-2013 at 09:42 PM. Reason: thoght

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