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Thread: A lot of leakage..

  1. #1

    A lot of leakage..

    Can anyone tell me if urine leakage around the catheter from the stoma/supra pubic area is a common/typical symptom of a UTI/bladder infection I’m currently being treated for? Just wondering if there can be other causes then I should be aware of. We of course make sure of the catheter is changed enough and the stoma sp area is kept clean and I drink a good amount of fluids.

    Maybe this is an obvious answer, that it is a usual symptom, but other than the leakage problem that soaks my pants when I’m sitting in the wheelchair, I’m not having other major symptoms like pain or a fever or feeling crappy. The leakage doesn?t happen while I am in bed laying flat probably because less pressure is put on my bladder from my abdomen.
    Over the 23 years since I had a c4/5 spinal cord injury I?ve never quite had this leakage problem and wanted to find out if there could be any other cause. Four days ago i had a urine culture tested at my urologist?s that initially looked clean but was found to have bacteria and be positive for an infection. Tomorrow will be my third day on antibiotics so hopefully this leakage problem goes because until it stops I can?t work or really do very much beside stay in bed.

    My new urologist is doing urinalysis and botox injections in two months from now... wondering if I should ask the urologist to move that date to up.
    Last edited by KyleP2112; 12-07-2018 at 07:59 PM.
    C4/5 incomplete, 17 years since injury

    "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

    "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

  2. #2
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    every so often I will for no reason nota lot jut leak . did he do a clean culture could you have kink the tube I have done that good luck

  3. #3
    I always make sure the catheter is not kinked... urine is pushing out around the catheter, at the supra pubic spot while I’m sitting in my wheelchair at a 90? angle. The same leaking from the suprapubic side around the catheter doesn’t seem to happen nearly as much when I’m laying in bed
    C4/5 incomplete, 17 years since injury

    "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

    "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

  4. #4
    Quote Originally Posted by KyleP2112 View Post
    Can anyone tell me if urine leakage around the catheter from the stoma/supra pubic area is a common/typical symptom of a UTI/bladder infection I?m currently being treated for? Just wondering if there can be other causes then I should be aware of. We of course make sure of the catheter is changed enough and the stoma sp area is kept clean and I drink a good amount of fluids.

    Maybe this is an obvious answer, that it is a usual symptom, but other than the leakage problem that soaks my pants when I?m sitting in the wheelchair, I?m not having other major symptoms like pain or a fever or feeling crappy. The leakage doesn't happen while I am in bed laying flat probably because less pressure is put on my bladder from my abdomen.

    Over the 23 years since I had a c4/5 spinal cord injury I've never quite had this leakage problem and wanted to find out if there could be any other cause. Four days ago i had a urine culture tested at my urologist?s that initially looked clean but was found to have bacteria and be positive for an infection. Tomorrow will be my third day on antibiotics so hopefully this leakage problem goes because until it stops I can't work or really do very much beside stay in bed.

    My new urologist is doing urinalysis and botox injections in two months from now... wondering if I should ask the urologist to move that date to up.
    Leakage around the stoma can be a symptom of an infection, but it can also be a symptom of excessive sediment clogging the eyelets, possibly stones, or the eyelets can embed themselves in the wall of the bladder and becomes occluded. Positioning (lying down vs sitting in your chair) may have something to do with leaking and not leaking in all those instances.

    What catheter are you using. Changing to a Poiesis Duette catheter may help. In this catheter there are two balloon, with drainage eyelets between the balloon. One balloon serves as a retention balloon and the other balloon serves as a cushioning balloon to keep the catheter from irritating the bladder wall and prevent the tip of the catheter from embedding itself in the bladder wall and occluding the eyelets. Poiesis will send you free samples. http://www.poiesismedical.com/products/duette/

    Your urologist may not understand the difference between a urinary tract infection and bladder colonization. Only true urinary tract infections, with symptoms should be treated with antibiotics and then only in a urinalysis (UA) and a culture & sensitivity (C&S) have been done. The course of antibiotics should be prescribed for 12-14 days and then several days later, another UA and C&S performed to make sure the infection has been successfully treated.

    Your urologist may not want to do the Botox injections, if you have a urinary tract infection or if his perception is that you have one even though you may not. When I have had Botox injections, I've been given Cipro (500 mg) before the procedure and one to take home and take 8 hours later.

  5. #5
    This is helpful information. To be more precise, I was having some UTI symptoms like urine w/ an oder and not feeling so good. My urologist did do a urinalysis and culture/sensitivity and then recommended antibiotics.

    I’m using a Band 22fr, 10cc balloon (we fill it to 5cc). Would you suggest flashing it more with sterile saline? We have sterile saline here in could definitely flush it more.
    The catheter you suggested looks promising. Do you know how much they are per catheter?

    If this leaking/training around the stoma doesn’t stop over the weekend I’m going to requesting a ultrasound or scope from my urologist to see if there are bladder stones causing this.

    Thanks for your help.
    C4/5 incomplete, 17 years since injury

    "The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves happy. The amount of work is the same.” - Carlos Castaneda

    "We live not alone but chained to a creature of a different kingdom: our body." - Marcel Proust

  6. #6
    Quote Originally Posted by KyleP2112 View Post
    This is helpful information. To be more precise, I was having some UTI symptoms like urine w/ an oder and not feeling so good. My urologist did do a urinalysis and culture/sensitivity and then recommended antibiotics.

    I’m using a Band 22fr, 10cc balloon (we fill it to 5cc). Would you suggest flashing it more with sterile saline? We have sterile saline here in could definitely flush it more.
    The catheter you suggested looks promising. Do you know how much they are per catheter?

    If this leaking/training around the stoma doesn’t stop over the weekend I’m going to requesting a ultrasound or scope from my urologist to see if there are bladder stones causing this.

    Thanks for your help.
    If you want to flush the catheter more, I would suggest using Microcyn Technology and you can start here to read about it and then branch out to other threads by doing a search on "Microcyn." http://sci.rutgers.edu/forum/showthr...light=microcyn

    Right now, I think the Duette catheters only go to 18FR, but many who have tried the Duette catheter have found they can scale down from a 20 or 22 FR to the 18FR without any problem, because the stoma adapts and closes to accommodate the smaller FR size in a very short period of time.

    When my supra pubic stoma was place, it was a 16 FR. That was about 8 years ago, and there has been no need to use a larger FR size, I am still at a 16 FR.

  7. #7
    Quote Originally Posted by KyleP2112 View Post
    I?m using a Band 22fr, 10cc balloon (we fill it to 5cc). Would you suggest flashing it more with sterile saline? We have sterile saline here in could definitely flush it more.
    Are you sure your Bard foley catheter has a 10cc balloon? A chart from Bard (http://m.bardmedical.com/media/18135...guidelines.pdf) shows that Bard indwelling catheters have 3, 5, 30, and 75cc balloons. If your catheter has a 3cc balloon, the capacity of that balloon 5cc. If you have a catheter with a 5cc balloon, the capacity of that balloon is 10cc. If you have a catheter with a 30cc balloon, the capacity of that balloon is 35cc, and a 75cc balloon has an 80cc capacity.

    It is possible that your balloon may not be inflated enough to keep urine from leaking around the balloon. I've read the you can reduced the amount of inflation by a 1, 2, or even 3cc, if you find you are more comfortable with less inflation, but generally following the inflation recommendations will give you maximum protection against leaks and accidental removal of the catheter.

  8. #8
    Rarely is leakage around a catheter due to too small of a catheter or balloon. Bladder spasm can actually be increased by using a bigger catheter or balloon. Is the leakage improving with treatment of you UTI? If not, you may need to increase anticholinergic meds until you can get your Botox injections.

    (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.

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