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Thread: pre cath care

  1. #31
    last time i had urodynamics done was probably 2012 i would think, it was a long time ago, went with botox and dont remember the out come of that test apart from he cut me and i bled badly from it. i go to the toilet usually when i have no problems every 5 hrs and output can range from 500ml - 750ml but its always been like that also i get no symptoms of needing to go like when ive got a uti and cant hold much or botox has ran out i get symptoms, like years ago i used to void alittle bit but it was like overflow blut left too much in so had sheath and legbag while still doing ic's i would get sweaty around my waist etc and red in the face and for some reason my balls would be tight so to speak.
    prostatitis has never been mentioned to me by the urologist or gp, where do i go with all this information? do i just tell them i want this done or do i just mention it to them?

  2. #32
    You need urodynamics done again. Likely the Botox is no longer working, and you have a high pressure bladder. Prostatitis is diagnosed by lab work (elevated PSA) and a rectal prostate exam, and is usually diagnosed and managed by a urologist. Your high volumes are also very likely a factor in your UTIs, esp. if you also have a high pressure bladder. Try to cath more often, or limit your fluids a bit.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #33
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    I'm not a urologist or an SCI-Nurse but, from what I understand, you really should do a new urodynamics whenever you change anything that has to do with your bladder care. New med, new urodynamics. Switch to botox from drug, new urodynamics, etc. Urodynamics tells you the maximum safe volume your bladder can handle specific to your current bladder care. If you change the dose of Oxybutynin then you've changed the pressure as a function of volume in your bladder.
    T3-T7 complete since Sept 2015

  4. #34
    atm the botox has ran out and im waiting for my appointment in september to get it done again as they are behind or else it should of been done back in june, no one has mentioned my output is too high its always been like that even when i was in hospital and i had limited input then as well, if i cath more often arnt i making it easier to get another uti by introducing the catheter more often, like putting some foreign body in my bladder more often sounds worse to me?
    so if i cath every 3 hrs but drink the same then that will help? i really hate having to limit any intake as i like to drink and dont want a restriction on what i can and cant do, i mean i get 500ml out from drinking 1 mug of tea and the milk in my cereal! thats not alot of intake in my eyes :/
    what would be cool if it were invented would be like a kind of stent that is remote controlled that way when my bladder fills up the pee would drain out like normal flushing the urethra then close it off when done, no indwelling things or pushing catheters in all day and night.

  5. #35
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    So you might want to try tracking intake of water, salt, caffeine and alcohol relative to your cath volumes. It took me some time but I'm better at anticipating my 4-4.5 hour IC volumes after doing this. Both salt and alcohol postpone urine production, but it's going to come through within 2-3 caths for alcohol and 2-5 for salt. Caffeine will boost volumes enough that I drop my interval to 2.5 hours after 2 cups of coffee in the AM. I haven't had a UTI yet as I approach my 2 year anniversary so increasing my frequency doesn't impact my UTI rate.
    T3-T7 complete since Sept 2015

  6. #36
    all i drink is decaffeinated tea and water, i can roughly work it out that drinking 2 mugs of tea within the 4hr window depending on when i drink them ofc i usually get 500ml out, as for salt ive got no idea i guess thats really down to food, im not really aware of the ingredients of what i eat tbh.
    back to the whole holding too much urine causing uti's how is that possible what happens to cause a uti just because theres more of it or its under pressure?? i thought uti's were caused bacteria being introduced to the bladder via the catheter, or pushing bacteria down the urethra??

  7. #37
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    Volume doesn't cause UTIs. High volumes alone aren't a risk factor unless they result in unacceptable pressure.
    High pressures are the dangerous thing because they can cause backflow into the kidneys and because they can lead to bladder stretching and contraction atrophy.

    The former is very dangerous if you already have a UTI since this can push the infection into the kidneys which can then lead to sepsis and death.

    The latter is dangerous because it leads to retained urine in the bladder which can allow a slight infection to take hold and become a serious UTI.
    T3-T7 complete since Sept 2015

  8. #38
    Quote Originally Posted by Mize View Post
    Volume doesn't cause UTIs. High volumes alone aren't a risk factor unless they result in unacceptable pressure.
    High pressures are the dangerous thing because they can cause backflow into the kidneys and because they can lead to bladder stretching and contraction atrophy.
    Actually, volume IS important, and not just in high pressure bladders. This has been shown in several research studies, which is why it is included in the clinical practice guideline about bladder management in SCI. Over-distention (overfilling) of the bladder causes decreased blood flow to the bladder wall and decreased resistance to infection (conversion of colonization to UTI usually):
    http://www.pva.org/CMSPages/GetFile....b-9c557bc21b34

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  9. #39
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    I'm confused. Bladders vary in size so how does one determine safe volumes other than by pressure?
    T3-T7 complete since Sept 2015

  10. #40
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    I know an sci who just got rid of their suprapubic and now has a 150 mL bladder. So how can his safe volume be related to someone with a 600 mL bladder?
    T3-T7 complete since Sept 2015

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