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Thread: Can't pass catheter into bladder

  1. #1
    Senior Member Rrrrronnn's Avatar
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    Can't pass catheter into bladder

    I typically straight cath twice a day, occasionally more. I use a 16 inch FR 14 catheter. It's made of a firmer clear plastic as opposed to rubber because my hand dexterity sucks.

    Over the past couple of years, I would occasionally have a situation where I would slide the catheter in and feel it get up to my bladder neck, but it would not go in. If I turned my body slightly on my side and pulled one of my knees toward my chest, I could get it to pass through. Basically body shifting and applying pressure to my perineum would typically help.

    I remember when it first started happening, I mentioned it to my urologist while he was doing a urodynamics, but he saw nothing wrong with my urethra while he was looking through the scope on the way into the bladder.

    The past two days I have not been able to get it in whatsoever. I'm so fucking fed up dealing with constant bullshit that has to do with his disability. But, who isn't? It's as if the catheter is sliding in, but as it curves up with the urethra it gets hung up against the rim of the sphincter as opposed to going through the opening. That's my basic visualization, whether it's correct or not who the fuck knows.

    So far I'm reflex voiding, but there is a half bladder of residual. When I am able to catheterize, it's nice to have an empty feeling bladder for the next 4 or 5 hours before the voiding kicks in. So far I am still reflex avoiding, but there is still residual. This leaves A constant full feeling, along with clamminess and sweats. Every five minutes I void about 20 to 50 cc, along with the fun spasms that go along with it.

    Anyway, does anyone have any experience with this issue, and what helps?

    Thank you.
    Last edited by Rrrrronnn; 07-24-2015 at 02:41 PM.
    .
    "If ya don't have it in the hips, ya better have it in the lips..." ~ Charlie - Villa Dulce

  2. #2
    Have you tried using a code tipped catheter? These catheters have a slight bend at the end that is supposed to help the catheter through the prostate area.

    Are you using enough lubricant?

    The residuals and the spasms and sweats are not good. Residuals set you up for infection. And the sweats and spasms indicate autonomic dysreflexia which can be dangerous.

    Have you considered a suprapubic catheter?

    All the best,
    GJ

  3. #3
    Senior Member TomRL's Avatar
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    I switched to a coude tip for that reason. You might ask if something like terazosin would help. One urologist suggested I try visualizing urinating [I kid you not]. That hasn't helped much.
    Tom

    "Blessed are the pessimists, for they hath made backups." Exasperated 20:12

  4. #4
    First, I would want to be sure you don't have a false passage in your urethra, which is easier to get with the stiffer PVC catheters. You cannot always see a false passage during a cystoscopy (and usually the physician does not look through the cystoscope until they are inside the bladder). A urethrogram may show this. Treatment for this is to place an indwelling urethral catheter for 3-4 weeks and let the area rest so it heals.

    Secondly, you may have an enlarged prostate, in which case a Coude-tipped catheter may help, but a Coude-tipped catheter can get "trapped" in a false passage as easy as a straight-tipped, so I would want to rule that out first.

    Lastly, you may be having excessive external sphincter spasm causing this problem. Have you had a sphincterotomy or urethral stent in the past? I assume from your description that you are reflex voiding PLUS doing intermittent cath. Is that correct?

    (KLD)

  5. #5
    Senior Member Rrrrronnn's Avatar
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    Thank you for the replies everyone. Regarding the suprapubic catheter, that would be a last resort. It was bad enough that I had to go get a colostomy to decrease my dependence on others since I didn't have the dexterity to deal with that end. It would be a real kick in the privates to have to get the urinary system surgically modified even though I'm perfectly capable of reaching that area no problem. I am using plenty of lubricant.


    I finally managed to get the catheter to pass, but here's where things got even more interesting. I basically was unable to get much urine out at all. Oddly the catheter was able to go much deeper in the bladder as if it were still full, despite the fact that no urine was really coming out anymore. After I pulled the catheter out, I had a significant voiding contraction which resulted in all of this thick jelly substance squirting out. I have a feeling the reason why the catheter was able to go in was because it was full of this jelly. I provided a link to a picture that shows the first glob, which was followed by more similar globs of jelly with each series of bladder spasms. WTF??? It's definitely not lubricating jelly, as it holds together sitting in urine. Lubricating jelly would just dissolve in water or urine.

    http://postimg.org/image/mt8t8i29b/

    KLD & TomRL, I will look into the curved tips catheters for the future. In early June I had a colonoscopy done. Would this test/procedure have also picked up an enlarged prostate?


    I spent a few hours on my bed having these contractions every five minutes with more of this crap coming out my bladder. I have no idea what the hell is going on. Today everything is flowing ok and there's no more jelly, however I could not get the catheter in and I did not want to force it.
    Last edited by Rrrrronnn; 07-25-2015 at 01:18 PM.
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    "If ya don't have it in the hips, ya better have it in the lips..." ~ Charlie - Villa Dulce

  6. #6
    No, a colonoscopy would not detect an enlarged prostate. A manual exam (finger in your rectum) of the prostate should be done annually for all men over the age of 40, but chronic prostatitis (which can occur in men with SCI) can also make it enlarge. A blood PSA level may also be elevated in prostatitis, but generally no with BPH (benign prostatic hypertrophy). Your urologist should be doing a digital prostate exam on you as part of your annual check-up.

    The "jelly" you describe is a large amount of mucous. Mucous is produced by your bladder wall when it is irritated or inflammed. It can also be the nidus (beginning) of stone formation. You may need another cystoscopy and bladder wash out.

    So if you can't cath, how are you managing your bladder right now??

    (KLD)

  7. #7
    Senior Member Rrrrronnn's Avatar
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    So far my voiding has been going pretty smoothly after this jelly stuff has calmed down. However it's not something I would want to continue to rely upon. Thankfully when I've had issues where my voiding as occasionally ceased and my bladder overfilled (usually during overnight), the internal pressure must have made the position of the bladder neck and it's firmness favorable to accepting catheterization. I'm going to give it another try tonight when I get into bed to see how it goes. I am planning to call again on Monday and hopefully get an appointment on Tuesday with my urologist as well. I am also wondering if I should mention this possibility to him:

    3rd/4th post down - subject showed symptoms through bladder:

    http://www.steadyhealth.com/topics/o...nce-in-my-urin

    Subject showed symptoms through naval:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740315/
    .
    "If ya don't have it in the hips, ya better have it in the lips..." ~ Charlie - Villa Dulce

  8. #8
    I had similar problems with 16fr red rubber catheters and 16fr vinyl catheters. I used to have to see my urologist ever few years for a "roto-rooter" job that resulted in me wearing a foley for 48 hours. He told me I had a spastic sphincter and put me on baclofen.

    I did some research, tried a hydrophilic catheter (Speedicath) and solved the problem myself..........no more roto-rooter and no more baclofen. With the hydrophilic I don't need anything except the catheter and collection device.

    You may also want to try a smaller 14 or 12fr catheter
    Last edited by jayslx1; 08-05-2015 at 05:32 PM.

  9. #9
    Get your doctor to order Tamsulosin (Flomax) 0.4 mg po daily. It does a couple of things- relaxes the muscles in that area, may not affect your sphincter , and also if prostate enlarged (Benign prostatic hypertrophy) then it gets rids of that. You could also try a coude' catheter with a little curve on the end- put in with the end pointed upward. Also use Uroject or a lot of lubricant- the more the merrier- and if you can get the lidocaine gel it might help relax things also. If this doesn't help then you need a cysto as you might have scar tissue at the bladder neck area.
    CWO

  10. #10
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    Have the exact same issues as you do, the sphincter muscle does not want to let the catheter go through.

    Even nurses at the hospital and home health care have been unable to do it and subsequently I had to come up with a solution. This is what I do:

    I used to empty my bladder by reflex or by tapping on it and the whole bladder would get hard and empty.

    No longer able empty my bladder by reflex voiding and have switch to IC. But to get the catheter go through the sphincter muscle still rub my belly and tap on it.

    Just like I used to when my bladder used to empty all the way so now do the exact same thing except using a catheter to void, when my bladder gets hard and my penis retracts the catheter goes in no problem.

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