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Thread: Erosion?

  1. #1
    Senior Member PC720's Avatar
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    Erosion?

    I've had my catheter in for about 1 year 6 months now. He gets changed every 30 days. My last Urology visit the doctor brought up erosion. He said it looked okay as of right now

    How long can I keep an indwelling catheter before something like erosion starts happening?

    I mean my penis is not really good for anything now but there's something unnerving about having it split in half

  2. #2
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    Has your urologist mentioned getting a Supra Pubic catheter done?

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    We briefly talked about it in the past. I'm on immunotherapies to keep my immune system low. He said he thought it would complicate things and was not too interested.

    I have terrible anxiety and the thought of this happening has sent it into overdrive

    And what's worse is I've read they can't even repair it

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    WOW - sorry to hear about the immune thing. The wrecking of the urethra was the main reason my urologist went SP. Hope you and your doc can come up with something to stop/prevent what's happening.

  5. #5
    Since you don't have urethral erosion right now, there are some steps you can take to help prevent erosion. These suggestions are from a New Mobility article: http://www.newmobility.com/2011/08/p...e-and-erosion/

    Securing a Foley Catheter
    A
    2005 article in Spinal Cord Journal points out that urethral erosion also occurs in women that use indwelling catheters ? most often from improperly secured extension tubing. The catheter can get inadvertently tugged and pull the Foley balloon against the bladder neck.
    Bricker explains the proper technique for securing a Foley catheter is to use a leg strap to secure the extension tubing from the Foley to the upper thigh and make there is enough tubing leading to the Foley to allow it to move freely and avoid any pulling or tugging. Journal articles explain that men need extra extension tubing to allow for penile movement and erections. Bricker says at Craig they also recommend alternating the tubing placement from leg to leg every other day so the bulb inside the bladder and the Foley are not always pulling on one side.
    Size Matters
    Another important step to help avoid urethral erosion is working with your urologist to make sure you are using the proper size Foley for you. ?Although 16 FR is the standard size Foley, everybody has different anatomy, and different people require different size catheters,? says Bricker. ?I?ve had patients that would get a lot of blood every time they inserted a catheter, and the reason behind it was they were using a too-large catheter. When they went to a smaller catheter, that solved their problems.? In addition to bleeding, discomfort or autonomic dysreflexia are other indications that the catheter may be too large.
    A 2008 article in Ostomy Wound Management is right in step with Bricker and explains the prevailing guideline for Foley catheter size is to use the smallest diameter that will provide good drainage, typically a 14 to 18 FR ? unless the catheter user has blood clots or sediment that occlude the lumen (eyelets that urine drains into), in which case a urologist may suggest a larger size. The article further confirms that catheters that are too large can contribute to urethral erosion.
    Foley Material Types
    Journal articles also point out the importance of using a Foley catheter made out of a soft material. A
    2010 article in Ostomy Wound Management discusses a facility that, as part of creating a latex-free environment, replaced their (softer) latex-containing Foley catheters with silicone catheters that were stiffer. The use of stiffer Foley catheters was associated with urethral erosion in four elderly men. Major catheter manufacturers offer Foley catheters in a variety of soft materials. If there is a concern that the Foley you are using is too stiff, your catheter supplier should be happy to send you samples of different Foley catheter options. However, it is important to discuss any change in a Foley with your urologist.

    Exams Are Key
    If you suspect your urethra is damaged or suspect you have urethral erosion, it is important to seek help from a urologist versed in physical medicine and rehabilitation as soon as possible. Although the articles I mentioned discussed a few of the different options for dealing with urethral erosion ?such as having a caregiver do intermittent catheterization, or switching to a suprapubic catheter (see August 2008 Bladder Matters) ? that will be something for you and your urologist to decide together.

    All the best,
    GJ

  6. #6
    Are you using a cath-secure? That's a MUST along with always check and supervise the position of your boy with the catheter. This way you won't have any issues, but still I'd get rid of the indwelling catheter asap. I had one for 6 months while in hospital just because I was dreading the thought of getting a whole for the suprapubic cath, but after getting it I realized how much better this is. But you should definitely consider looking into getting the SP and you won't believe the difference

  7. #7
    Senior Member PC720's Avatar
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    I hadn't thought to check the position. When I first got it I did have problems. Since I have been taping it to my Beltline so it stays secure when I'm in bed I have had very little problems. Unfortunately it took me a nearly a year to figure that out. I guess I need to talk to my neurologist first to figure out what to do about the complications

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    Thanks GJ

  9. #9
    Traumatic hypospadias is the problem where an indwelling urethral catheter causes erosion and tearing of the urethra. It can be prevented by being sure that the catheter is secured to prevent tension on or pistoning of the catheter, both when you do and do not have an erection. There are basically two main advantages for changing to a indwelling SP (suprapubic) catheter for men who use an indwelling catheter long term. One is to prevent urethral damage such as hypospadias, strictures, or fistulas, and the other for genital sexual activity.

    I am puzzled about why your urologist is reluctant to do a SP, as the risks for infection, stones, and other complications is the same compared to a urethral indwelling catheter.

    (KLD)

  10. #10
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    Quote Originally Posted by SCI-Nurse View Post
    Traumatic hypospadias is the problem where an indwelling urethral catheter causes erosion and tearing of the urethra. It can be prevented by being sure that the catheter is secured to prevent tension on or pistoning of the catheter, both when you do and do not have an erection. There are basically two main advantages for changing to a indwelling SP (suprapubic) catheter for men who use an indwelling catheter long term. One is to prevent urethral damage such as hypospadias, strictures, or fistulas, and the other for genital sexual activity.

    I am puzzled about why your urologist is reluctant to do a SP, as the risks for infection, stones, and other complications is the same compared to a urethral indwelling catheter.

    (KLD)

    My best guess is the fact that I am on immunosuppressants and I have multiple sclerosis. Mycase is pretty severe. I have declined significantly since the first time I saw him. Any kind of new infection seems to be traumatic. Other than that I don't know.
    I guess for the time being I'll try to keep it as immobile as possible.

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