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Thread: Bladder Spasms!

  1. #1

    Bladder Spasms!

    I'm not a new injury, but I'm somewhat new to dealing with a suprapubic catheter. I've pretty much gotten all the kinks that happen worked out except the bedtime spasms. I drain just fine all throughout the day, but all that changes when laying down. It doesn't matter in what position either.

    My bladder spasms randomly all throughout the night, especially the early part. My catheter drains fine (slower but fine), but my bladder spasms as it fills to drain. It spasms so hard that it causes leakage through my urethra.

    Any suggestions on how to remedy this problem. As most of you know, it's so painful. Then, there's the additional problems it causes. I'm already taking the max dose of oxybutynin.

    Thank you,
    Karen

  2. #2
    You may find the Poiesis Duette catheter more comfortable. It may be that the tip of the catheter is irritating the bladder wall causing spasms. This catheter has two balloons, a retention balloon and a cushioning balloon with the drainage eyelets positioned between the balloons. http://www.poiesismedical.com/products/duette/

    I believe they are still providing free samples of this catheter. It comes in French sizes 14, 16, and 18.

  3. #3
    I already use the duette catheter, and we've experimented with the 2 bulbs being at different volumes. It's helped tremendously while sitting up, but only a slight bit laying down.

    Thanks for for trying to help though gjnl. I'm willing to try almost anything.

  4. #4
    I would just try other catheters. For me 100% silicone ones are problematic.

  5. #5
    As said above, try different catheters? Do you have a urologist? Usually they have all kinds and you can try them (coude, larger, smaller, even different brands may make a difference). I found that the cheapo blue silicone caths just never drained for me, the clear coude ones drained better, and so on. When it really wouldn't drain sometimes rotating the cath a bit would let things drain - I think it was getting caught on bladder wall/spasms worsened it and it caused spasms, sort of a vicious cycle. It's been suggested to me that you could cut the tip extending past the balloon in some caths. Never tried cutting them but I found variations that have shorter/different tips, not sure how you would go about doing that (could work with an SP? I'd let urology try that first though). I had the opposite problem - it would only drain properly (sometimes) laying down. After trying just about every catheter out there (including the Duette) I found something that worked.

    My problem was really weird though, the length of catheter was the problem. I only figured that out after the tip started lodging itself down my urethra - you'd try and flush it and it would completely bypass my bladder ha! My doc had never heard of that before but hey. Doubt that's your issue but there might be something to you laying down, maybe things shift a certain way inside. Who knows. Can you try putting the bag lower? Actually, have you tried different bags too? What if it was a nightbag that isn't draining properly, not the cath? I've had a few bad bags that just didn't seem to want to work properly.

    Maybe Botox for spasms? Even simpler first there's Myrbetriq which is a completely different bladder spasm med than all the others (on its own or with oxybutinin). Myrbetriq is the only one of the bunch that didn't give me side effects too so that's cool. It's expensive though, ask for samples if you can!
    Last edited by twistties; 10-27-2017 at 12:00 AM.

  6. #6
    It drains by gravity and when you are lying in bed the position of the bladder/tube changes.
    The tube will empty continuously as a drain however if lying down the urine must be able to reach the tube. Do you take the anticholinergic at bedtime?
    CWO
    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.

  7. #7
    What is your night drain set up? Do you lay your leg bag on the bed, switch to or attach to a night drain bag that hangs on the side of the bed, other?

  8. #8
    Quote Originally Posted by Rustyjames View Post
    I would just try other catheters. For me 100% silicone ones are problematic.
    I've tried a few others, but it's worth trying even more kinds to try and get this issue fixed. Thanks!

  9. #9
    These are what I've been using for 17 years: https://www.vitalitymedical.com/bard...-catheter.html

  10. #10
    Quote Originally Posted by twistties View Post
    As said above, try different catheters? Do you have a urologist? Usually they have all kinds and you can try them (coude, larger, smaller, even different brands may make a difference). I found that the cheapo blue silicone caths just never drained for me, the clear coude ones drained better, and so on. When it really wouldn't drain sometimes rotating the cath a bit would let things drain - I think it was getting caught on bladder wall/spasms worsened it and it caused spasms, sort of a vicious cycle. It's been suggested to me that you could cut the tip extending past the balloon in some caths. Never tried cutting them but I found variations that have shorter/different tips, not sure how you would go about doing that (could work with an SP? I'd let urology try that first though). I had the opposite problem - it would only drain properly (sometimes) laying down. After trying just about every catheter out there (including the Duette) I found something that worked.

    My problem was really weird though, the length of catheter was the problem. I only figured that out after the tip started lodging itself down my urethra - you'd try and flush it and it would completely bypass my bladder ha! My doc had never heard of that before but hey. Doubt that's your issue but there might be something to you laying down, maybe things shift a certain way inside. Who knows. Can you try putting the bag lower? Actually, have you tried different bags too? What if it was a nightbag that isn't draining properly, not the cath? I've had a few bad bags that just didn't seem to want to work properly.

    Maybe Botox for spasms? Even simpler first there's Myrbetriq which is a completely different bladder spasm med than all the others (on its own or with oxybutinin). Myrbetriq is the only one of the bunch that didn't give me side effects too so that's cool. It's expensive though, ask for samples if you can!
    Thank you for the suggestions. Im going to try more different catheters. As far as the bed bag goes, I switch over to the Bard brand bed bag. I understand what you're saying...some of them don't drain as well.

    I actually have a sci urologist. We have talked about trying Botox, but I'm hesitant about it too. I like the idea of trying Myrbetriq. She hasn't mentioned this option, but I'm going to talk to her about it. I'm taking 30mg ER oxybutinin a couple of hours before bedtime as of now.

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