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Thread: filling the foley balloon?

  1. #1
    Senior Member ~Lin's Avatar
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    filling the foley balloon?

    Sorry to start a new thread just for this, but my lidocaine lubricant thread is so old even though I bumped it to discuss urojet more I thought it might be better to start a new one for this different question...

    You're ALWAYS supposed to use sterile water (or saline, etc, but sterile) to fill the balloon on a foley, correct? Last time I had my catheter changed (Tuesday) they had me use tap water, which I didn't know until after it was done. It was the first time I changed my catheter myself so I changed it in the office with them guiding me before I'm on my own at home next month. I think I said something about sterile water, because she corrected me and said no sink water. I was like what? And she repeated that you use regular sink water, that she was told to always use tap water to fill the balloon on the foley. I know that the water in the balloon slowly leaks out, and that if you have the catheter in for a long time you need to top it off etc as a result, and you only use sterile water to flush your bladder with so why would you just use tap water to fill the balloon?! Especially since the whole procedure of changing the cath is supposed to be sterile with everything that goes inside to limit UTI risk, so why ruin that with using tap water? Is this really standard procedure? I see my urologist Jan 8th in the clinic so I'll also bring it up with him in case this nurse was incorrect. She was the one who started changing my cath last month as well. (I had a raging UTI after, probably a coincidence on part of the nurse, because we also had complications and the uro had to come assist and it became a really traumatic change scraping up the inside of my bladder which I believed to be the cause)

    I was getting paranoid about the tap water, and started considering changing it out. But also felt like maybe the damage was already done so to speak. Then I noticed the catheter said 5mL on it, and we had put 7 in it thinking it was a 10. The last 2 changes I'd had a 10mL balloon and severe pain going past 7mL on the fill the first time so we just stuck with 7 after that. So THEN I started being paranoid about increased chance of the balloon popping now too. I went ahead and pulled out a sterile luer lock syringe, emptied the balloon, and refilled it with 5mL of hydrocleanse (microcyn stuff) hoping that makes up for the initial tap water.

    So, am I being totally paranoid? Or is this bizarre to fill the balloon with tap water?
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  2. #2
    Sterile water is the standard for filling the balloon. What type of catheter do you use? Most often indwelling catheters are changed using a catheterization kit, which includes the sterile drape, sterile gloves, sterile lubricant, sterile water in a syringe, cleaning swabs (usually betadine or CHG) or cotton balls with cleaning solution and a pair of forceps to use the cotton balls for cleaning, and some come with the catheter already attached to the drainage bag. Other kits are "add a cath" kits to which you add your own specialized catheter.

    Did this nurse not use sterile gloves and other sterile materials such as above?? Bringing all of those things separately is a PITB, and would make it much more difficult to maintain sterility during the procedure. If she inserted the catheter without maintaining sterile technique, I would be much more concerned about this than with them using non-sterile water in the balloon. Unless you are using a all-silicone catheter, water should not leak from the balloon unless the balloon is defective (which is why sterile water is recommended). Latex balloons do not leak water unless defective.

    As far as filling, I know it does not make sense, but a 5 cc. indwelling catheter balloon is designed to be filled with 10 cc. of water.

    Was this nurse from an agency? An RN or an LVN/LPN?? If you have concerns about how she did any procedure for you, you should contact her supervisor at the agency. She works for them, not for your physician.

    I would definitely not use your Hydrocleanse with a latex catheter, as it is very likely to damage the latex balloon and cause it to fail (due to the bleach that is an ingredients in this solution).

    (KLD)

  3. #3
    Senior Member ~Lin's Avatar
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    I have a latex allergy and use all silicone catheters. Is it ok to leave the hydrocleanse or should I remove it and replace with sterile water? And thats why the balloon leaking, in fact at this last catheter change we only pulled 3ccs out from the 7 that was put in. My previous catheters said 10 on them with the 7 ccs in, this one says 5. I spray hydrocleanse into my catheter twice a day, I put in a few ccs in the morning after disconnecting my night bag, sort of just cleansing the catheter. And then about 20ccs through the catheter into my empty bladder at night and I connect the bag directly to my valve, and I wait until I feel the need to pee to open the valve and drain the hydrocleanse I put in along with urine for the night.

    My catheter changes have been done by the urology nurses at my urologists office, so yes she works for my urologist. They have never used a kit, though my supplies at home will be a foley insertion kit plus my silicone foley. During the changes she did, she did not maintain sterility though did put on clean gloves for the insertion, and avoided touching low on the cath where it would be going inside. There were no sterile gloves opened, just the gloves off the wall. For me inserting it, same thing no sterile kits/supplies opened, just supplies collected on the tray, the catheter being opened and not touched, lube (from an opened tube) squirted onto the end without touching the catheter, then I picked it up wearing non sterile gloves avoiding touching near the end, though I was unable to insert it without going ahead and pinching a bit above the balloon to steady it and put enough pressure to get it to go in. I don't know if my kits will have sterile gloves but I hope they do. For cleaning my stoma she just handed me a wipe, I didn't see the package but I believe just a benz-chloride one.

    I had wondered about the lack of sterile gloves, prior to having my changes I'd watched a youtube video on changing a SPC and they prepared everything, and then switched to sterile gloves for the insertion. And I was a bit nervous when I had to touch the catheter, I commented to the nurse I was going to have to (she mentioned to avoid touching down low on it) but she didn't say anything about changing gloves yadda yadda... In fact I just remembered last month when we were having trouble, she left the room with the catheter just barely inserted and the end resting in a cup, and it slid so I had to grab it, and when she came back I let her know I'd had to pick it up/been holding it. She didn't seem to care, so after a couple seconds I added "so you might want to wipe it down with an alcohol swab since its no longer sterile..." I honestly expected her to throw out the cath and grab a new one, but I do understand indwellings are much more expensive than intermittent caths so next best thing would be the alcohol I thought.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  4. #4
    With a pure silicone catheter you should be fine with the balloon solution you used, but the amount should be increased to 10 cc.

    Indwelling catheters should be inserted with sterile technique, whether done at home or in the hospital or office setting. This is very clear in the CDC guidelines on use of indwelling catheters, whether chronic or not. This is entirely different than the clean technique which is fine for intermittent self cath.

    http://www.cdc.gov/hicpac/cauti/002_...sumORecom.html

    (KLD)

  5. #5
    Senior Member ~Lin's Avatar
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    I am unable to tolerate more than 7cc in the balloon.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  6. #6
    Quote Originally Posted by ~Lin View Post
    I am unable to tolerate more than 7cc in the balloon.

    I have read quite a few posts on this site where people do not fill with the recommended 10cc. And, like you they have found that a couple cc less than 10cc is more comfortable.

    All the best,
    GJ

  7. #7
    Senior Member ~Lin's Avatar
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    thanks gjnl. I'm not concerned about it at all. Especially since we only removed 3 ccs last time! I think I'll probably leave it at 5 for right now to not mess with it and open another syringe, but since the balloon leaks over time add another 2 ccs in another 2 weeks.

    At my first catheter change, I had excruciating burning pain in my bladder from going over the 7 ccs, and even once they removed ALL the fluid from the balloon most of the pain didn't go away, it just decreased slightly. We went back and forth about 3 times trying to put 10 in the balloon but it became absolutely unbearable past 7. The lesser, but still quite bad, pain lasted about an hour so we didn't want to repeat that when I started experiencing discomfort the second change even after having used 20mL of urojet! From those experiences and since they're just fine with me having 7, I definitely won't go above that.

    I'll be making sure my changes at home are more sterile, and bring the technique used on me up when I see my Dr in clinic!
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  8. #8
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    I had the same problem when I had to change brand of catheters. With the new catheter I was unable to fill the balloon with 10 cc of saline without it causing pain and leakage around the catheter, I cath through my urethra. After comparing the new catheter to an old one, the tip of the new one extended farther from the balloon. Just guessing but I believe when the balloon was filled the tip was forced into my bladder wall at times, that's why I had the pain and leakage .

    I found a new brand that is identical to the older brand that I used and haven't had any issues since.

    Just a suggestion but trying different catheters might make a difference in the pain that you are dealing with, Lin.

  9. #9
    I agree with you. When ever I put more than 7cc I have leakage during the month. It took me years to figure out 10cc was causing the problem of leakage. I now put 5cc and feel much better.

  10. #10
    Senior Member ~Lin's Avatar
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    Interesting about the balloon positioning! I occasionally get this pain in my urethra (that's what it feels like anyway, suprapubic catheter) and I wonder if the tip of the catheter gets against the opening to the urethra or even forced into it sometimes. Like for example, during a bm it can happen from contracting my abdominal muscles. It's more severe pain during that time, but just occurs randomly sometimes. So maybe it's like you say, and being caused by a longer distance between balloon and tip. I've had bardia catheters so far but have a rusch in right now so I'll see if it's any better. And I believe I'll be using a Coloplast starting next month, I'm trying to remember what brand my supply company said they would be. They sent me a medline brand but the silicone was super stiff so it's going back and they looked over available brands. My connective tissue disorder results in the stoma deforming already, catheter position or movement "stretches" the site open, so when I felt the difference in rigidity with what I was sent I thought no way.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

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