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Thread: Problems inserting Duette

  1. #1

    Problems inserting Duette

    Haven?t been here in a couple years and a search didn?t show this having been discussed, so my apologies if this has been asked and answered repeatedly...

    I?ve been using 16fr Duettes in my SP for 6 months and they?re miracles. But last month it was a bear to get in. This morning it wouldn?t go in AT ALL. I fought with it for 15 minutes and it?s like the tip is bigger than 16, and it just won?t fit. I had some regular latex caths in the house thankfully, and that slid right in. It?s driving my bladder nuts already, though, and I want it out ASAP.

    Are there variances with some some of the Duettes? Why is it suddenly so hard to put in? Is there a trick to it?

  2. #2
    Quote Originally Posted by CornFedUp View Post
    Haven't been here in a couple years and a search didn't show this having been discussed, so my apologies if this has been asked and answered repeatedly...

    I've been using 16fr Duettes in my SP for 6 months and they're miracles. But last month it was a bear to get in. This morning it wouldn?t go in AT ALL. I fought with it for 15 minutes and it?s like the tip is bigger than 16, and it just won't fit. I had some regular latex caths in the house thankfully, and that slid right in. It's driving my bladder nuts already, though, and I want it out ASAP.

    Are there variances with some some of the Duettes? Why is it suddenly so hard to put in? Is there a trick to it?
    Difficulty inserting Duette catheters has been addressed here a couple of times, but not recently. I talked to the President of Poiesis about this difficulty and was told:

    • Regarding the insertion, yes this can be a difficult item to address with 100% confidence. Each individual can present with their unique situation so as to providing assistance (other than mentioned) would be of little use I am afraid. We have heard that there are stoma plugs out on the market. One user stated he employs a slightly larger plug then the catheter during each change. He pulls the cath then inserts the plug which is slightly larger, then comfortably prepares the new catheter for insertions. He seems to appreciate the relaxed nature of the change. Again each person has their own method for their own individual situation.

    I've posted a picture of the types of plugs to which he was referring.

    Other ideas:
    It helps to know the direction of your stoma. You might think that a stoma is a straight shot into the bladder, so you may be inclined to push the catheter straight down. In fact, your stoma is probably biased in one direction or another. I found that insertion is easier, in my case, when the catheter is angled down toward my pubic bone. If you have difficulty getting the Duette in, try upward toward the navel or downward toward the pubic bone or even to one side or the other.

    Some people have used a 4Fr stylet, usually available where you purchase urinary supplies. The stylet slides down into the catheter and stiffens the tube, making insertion easier. Stylets are tricky to use and can cause injury or perforation of the bladder wall. You should have the advice and consent of your physician before using a stylet.

    Some people say putting the catheter in the freezer for a couple of hours before trying to insert it can help.
    Attached Images Attached Images  

  3. #3
    Yowza! That plug looks a bit draconian!!! My stoma does slope down and I do install any cath in a the direction of the channel, rather than just smashing it in. Up until this last order if caths, I’ve never had an issue. But No amount of lubricant or force could get it in farther than the very tip. It just seems larger than 16fr. I guess I’ll try the freezer, and see what happens. Thanks for your response.

    My my apologies for not finding the answer in search.

  4. #4
    Quote Originally Posted by CornFedUp View Post
    My my apologies for not finding the answer in search.
    No worries.

  5. #5
    Senior Member
    Join Date
    Sep 2001
    Location
    middle georgia
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    2,267
    most of the time it goes in easily then boom I can not so care giver will put in for me I just thougt my be the way sitting or...

  6. #6
    I'm using Duette for past two years. Even though Duette is 100% silicone, it is not rigid and stiff like most catheters. Its softness and pliability may cause trouble at times. One technique that works for me every time is to keep my bladder full during the replacement. Therefore, I first irrigate my bladder with 30cc saline before removing the old catheter. Also, it's essential to insert the new catheter as soon the old one is removed even without a split-second delay.

  7. #7
    Senior Member
    Join Date
    Aug 2007
    Location
    upstate NY in summer, Ft Myers in winter
    Posts
    127
    Softness and pliability in silicone can be influenced by temperature. To make the catheter a bit more rigid, try refrigerating it for 15-20 minutes.

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