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Thread: Switching from cath to condom bladder management

  1. #1

    Switching from cath to condom bladder management

    I am post 5 months t9 paraplegic 19 years old and have used until now intermittent catheterization technique.
    Last days I am noticing big changes in my sensitivity below and cathing became harder every day to reach bladder.
    Today it hurt me so much I am not going to use that technique anymore.
    Hoping its a good sign that the sensitivity there will come back, fingers crossed.

    Thing is I dont know how to deal with it from now on. I've used condom catheters overnight so I dont cath in the middle of the sleep and most of the times they fill good. 300-400 ml or more.

    Is it safe to rely on the reflex drainage ?
    I know the risks of bladder overfilling and infections if bladder doesnt completely drain but how can I be sure ? Is there any test I can make ?


    Also , if i have any sign of sensitivity how can i train the sphincter muscle to release the bladder completely ?

  2. #2
    You cannot train your bladder or your sphincters.

    Reflex voiding is used by some men with SCI but is rarely recommended any more for a number of good reasons:

    • You may be voiding with high pressures, which put your kidneys at risk.
    • You cannot tell how high the pressure is in your bladder without doing studies called urodynamics (cystometrogram + sphincter EMG).
    • Your bladder pressures can change over time (usually they get higher), so urodynamics needs to be done at regular intervals (at least every 2 years).
    • If you don't empty completely (likely) the residual urine left behind is a reservoir for infection and stone development.
    • You have to wear a urine drainage bag all the time.
    • You may need to have surgery (sphincterotomy) to cut the external sphincter to decrease drainage resistance and bladder pressures. This does not always work, but the surgery is irreversable, and you cannot then go back to intermittent cath without having to wear an external condom catheter between each cath.
    • Over time, it is not uncommon for your bladder to "wear out" or decompensate, meaning that it will not longer empty. You may then need to go to a different type of bladder management.
    • Skin breakdown problems and device leakage (often due to penis retraction) are fairly common problems.


    Can you get and try a lubricious (prelubricated) catheter? These do much less damage, and hurt less when passing them for intermittent cath. What does your urologist say about your problems cathing? Have you had tests for a urethral false passage or stricture?

    (KLD)

  3. #3
    Senior Member
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    Just my own opinion, I wouldn't use a condom catheter. I have only one damaged kidney now due to using them, I didn't do follow up checks with a urologist. I thought that as long as I was passing urine I was okay.

  4. #4
    Senior Member ChesBay's Avatar
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    I have been using a external condom cath (without adhesive) and intermittent cath for the past 37+ years.

    I find it easier to cath after my bladder has kicked off some in leg bag. I think sticking to cathing is advisable in the long run for health sake. The bladder changes as you get older.

    Here's the type of external cath I am referring to. It frees me up to go out and not have to worry about my fluid intake and kicking off.
    Good luck.
    http://www.exmed.net/p-2059-rocheste...-catheter.aspx

  5. #5
    I can understand why you would be hesitant to use an intermittent catheter when you can feel it. Many changes can occur in that first year post injury. Is the use of lidocaine a possibility? Talk to your doctor about it.

    I have used a condom catheter and intermittent catheter. My bladder would never fully empty and I had a ton of urinary tract infections when using the condom catheter. Also, I found out that I had a high pressure bladder and luckily did not cause any damage.

  6. #6
    I self catheterise because it works best for me plus I believe it is the least detrimental to my health.
    Most times it is easy to insert the catheter but there are times when the sphincter will do its job and restrict entry. That is when focusing on relaxing and breathing easy, works for me; being anxious will work against you every time.
    Do not force the catheter or attempt to rush the procedure. I have to remind myself NOT to be complacent with this or the hygiene aspect.
    If it is available, lubricant is also important. Although I am skeptical of introducing chemical gel, dry entry is not good for you.

  7. #7
    Quote Originally Posted by ouch View Post
    I have used a condom catheter and intermittent catheter. My bladder would never fully empty and I had a ton of urinary tract infections when using the condom catheter.
    I agree ouch; that is also my experience.
    When the hint of infection is noticed ( by myself, or others ) Aloe Vera gel from the plants in my garden works for me.
    Non of that processed, possibly sugar laden commercial product.
    I have tried Cranberry juice a number of times with no effect; but once more it is often laden with sugar and offers nothing more to me than as a sweet drink.

    Work your way through it Martin. Talk to those whos life is as yours is, think on and try, then choose whatever works best for you. ATB

  8. #8
    As KLD stated, using reflex voiding I just asking for problems. It is best to use intermittent cath or in a pinch a suprapubic catheter. I would encourage you to use a lubricant with lidocaine in it if you are having sensation when you cath. Also, see if another type of catheter might decrease the irritation. Speak wiith your SCI doc or urologist and see if they have any thoughts on the subject since they know you much better.
    ckf

  9. #9
    I used a condom cath for 13 years and things went pretty good, but when things went bad they went really bad. First signs were BP shot up to 228/180, and a trip to the ER to find out through a ultrasound that i was storing 1300 ml in bladder which
    caused a sever case of Hydronephrosi. Kidney were swollen but since it was't prolong no damage was done. I'm a quad so i can't do intermittent cath myself so i now use a foley with no poblems except preventing UTIs. I wouldn't even think about
    going back because kdney damage or stoke is not a good trade off.

  10. #10
    Well said!
    ckf

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