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Thread: Safe residual amounts after cathing through Mitrofanoff

  1. #1

    Safe residual amounts after cathing through Mitrofanoff

    I've recently had my Mitrofanoff fixed so it useable again, so I had a question about residual urine. We decided to do a little test a handful of times to make sure that we were getting all the urine out of my bladder through the Mitrofanoff. I have had a lot of problems with UTI's, so I really want to be careful with this.

    We cath through the Mitrofanoff, then immediately cath through the urethra to make sure that we got everything out of the bladder. The first 2 times we got less than 25cc's of urine out of the urethra after cathing through the Mitrofanoff. I thought that was pretty good if there is only a residual amount of 25cc's after using the Mitrofanoff. The next time didn't go as well. The urine seemed to stop coming out or was dripping very, very slowly and the person helping me thought that we had waited long enough, so then there was more residual urine left behind.

    My first question is...how much residual urine in the bladder is too much after cathing through the Mitrofanoff?

    The second question is...if the urine seems to stop coming out of the catheter but you don't think it is finished, is there anything else I can do other than push on my stomach to get it to come out? Is there a good angle to hold the catheter or a special trick to get it to keep draining?

    Thanks, Melissa
    Life is a lesson you learn when you're through.

  2. #2
    Senior Member Domosoyo's Avatar
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    I've noticed sometimes mucus from the appendix can clog the cath in such a way that urine does not flow. When a re-cath is done we get more flow.

  3. #3
    Quote Originally Posted by Domosoyo View Post
    I've noticed sometimes mucus from the appendix can clog the cath in such a way that urine does not flow. When a re-cath is done we get more flow.
    Thanks for the response, Domosoyo. I had thought of that too, but there wasn't any mucus in the catheter when we pinched it shut and pulled it out. I think we may need to try moving the part of the catheter that is outside of my body to different positions to see if it will help it flow.

    Did anyone ever tell you how much is a safe residual amount of urine that can be left in the bladder after cathing through the Mitrofanoff?

    Thanks, Melissa
    Life is a lesson you learn when you're through.

  4. #4
    It may be different for a mitronoff but in a bladder 200 ml or less of urine should be left in the bladder
    Pbr

  5. #5
    It is unclear whether you have an augment in addition to the mitrofanoff. However, I was wondering about this too myself as I have had both for over a decade. The first thing I'll recommend is irrigation once or twice a day if you produce mucus to any substantial degree. Bowel mucus provides a hospitable environment for bacteria to grow.

    The larger the catheter the less prone to clogging. However, too larger catheter can traumatize the stoma and the conduit into the bladder.

    I get very little urine out unless I put substantial pressure on my bladder and lower abdominal wall to push the urine upward. Probably only about 25% would come out on its own. I also inhale deeply and hold it as that pushes down diaphragm and increases abdominal pressure which helps expel the urine.

    One needs to be careful how far to push in the catheter. Too far and you're jammed up against either the bladder wall or the augment wall, which could block the catheter eyelets and reduce flow. If you feel solid contact when the catheter is fully advanced you're probably hitting the wall and should retract it a little bit. Whenever I get poor flow I pull the catheter out a little bit and then advance it again. When the flow stops at the end I also do this and readvance it, which often yields quite a bit more flow.

    One last thing I have been doing recently to check is that at the end when the flow has stopped, I attach a syringe with the piston fully inserted and I retract the piston very gently which pulls out the remaining urine. If you get any resistance and no urine comes out then you know there is zero left. However, to my surprise, I have often pulled out up to 3 60 ml syringes of urine (180 cc) after I thought I was empty. Once the syringe is full, squirt it into the urinal or bottle, re-depress the piston, reattach and retract the piston again, repeating as many times as necessary until nothing comes out in the syringe. Just be careful not to pull on the piston with excessive pressure.

    I will typically do this when I suspect the volume is less than it should be for a particular time and fluid consumption.

    I assume that for a catheterized bladder the residual should be zero, though perhaps for an augment it may not be so due to the different anatomy and folds of tissue that could hide pockets of urine.

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