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Thread: Considering bladder augmentation

  1. #11
    crags, metabolic acidosis can only be measured with a blood test. It has nothing to do with the acidity of your urine.

    There is little evidence that Hiprex or Mandelamine helps prevent UTIs in people with SCI/D.

    Gentamycin instillations are unlikely to effect your amount of mucous produced by the bowel patch in your augmentation.

    McDuff, the most common method for keeping mucous cleared is to do your cath, drain the urine, and then use a irrigation syringe (bulb or piston) to push about 40ml. of normal saline into your bladder, then suck it right out with the mucous, then remove the catheter and syringe.

    (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.

  2. #12
    How can one tell if the mucous one is producing is from the lining of the bowel and which is normal, or if it is inflammatory debris resulting from an infection or chronic colonization, as they both look quite similar?

  3. #13
    Senior Member McDuff's Avatar
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    gjnl - No, hadn't seen those before, could be interesting, thanks. The middle 2 links showed out of stock, don't know if that means they are popular or going the way of the wind.

    crags - Amazing the amount of trial and error we have to go thru to figure out what works, for us. When I do talk to my Uro, mucus will be a forefront question I ask.

    KLD - thanks for the explanation, hadn't thought of pulling a vacuum to get the mucus out.
    "a T10, who'd Rather be ridin'; than rollin'"

  4. #14
    Quote Originally Posted by McDuff View Post
    gjnl - No, hadn't seen those before, could be interesting, thanks. The middle 2 links showed out of stock, don't know if that means they are popular or going the way of the wind.
    Only used the sites I referenced as examples of products that are/have been available so you had the names of products. You may need to do your own research on these pouch products to suit your own needs. I've used a couple of these types of products, but can't be responsible for certain on line vendors being out of stock or not having product on hand.

  5. #15
    You definitely want to remove the mucus. I used to irrigate with just a small amount. Now I put in about 100 mL (1.5 syringes) to fully expand the larger bladder and loosen up any mucus. Your surgeon I doubt we'll be able to give you any feedback or assurance that it will be a problem. It's just the basic issue of the anatomy and that the bowel lining continues to produce its natural mucus. Unfortunately for me, it's over a decade and I still have a lot of it. I think for me that's the way it's going to be.

    One thing you can talk to him about, and this is extremely important, is the fact that open pelvic surgery will put you at risk for future problems, such as small bowel obstructions, due to surgical adhesions. I have had two of these, one of which required extremely involved surgery. The surgeon said my pelvic was chock-full of spiders web of surgical adhesions, which pulled my small bowel into a loop which restricted the natural flow and caused the obstruction. Several of us here have had them. As far as I believe, they do not occur if you haven't had open surgery. Mine occurred first six years post op and resolved with just and NG tube, which you will have the wonderful experience during your augmentation, should you have it. The second one occurred nine years post op and this one required surgery. Luckily, I haven't had one since.

    I believe there are now certain films they can wrap around the bowel to prevent them from developing scar tissue adhesions to prevent this problem. If there's anything else they can do that has come about in recent years, mention it to them that you consider it important.

    When the surgeon corrected my obstruction, it was infinitely more complicated due to the presence of an augmented bowel and the "chimney" leading up to the umbilical stoma. They had to call in a urologist just to make sure that none of this was accidentally nicked while they were dissecting out all of the adhesions. I believe they filled up my augmented bladder with methylene blue, a die, to let them know that there was any leakage into the pelvic cavity indicating that something may have been nicked.

    Anyway, sorry for the sobering news, but best to stress these things to the surgeon, as other patients have this type of surgery who are not SCI and their recovery and management is less problematic than for us.

  6. #16
    Senior Member McDuff's Avatar
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    gjnl - oh I know, that was just more of a jest post, about being out. Learning that that type of device exists at all was the benefit of your post.

    crags - thanks for the good write-up, definitely give me things to think about, and more importantly, things to bring up in discussions.
    "a T10, who'd Rather be ridin'; than rollin'"

  7. #17
    I use a baby diaper, the smallest size they sell, and just wrap it around my penis sort of like wrapping up a burrito and using the velcro tabs. It says on well and easy to change if I'm out and about and happen to leak. Plus they will absorb a lot.

  8. #18
    Senior Member ChesBay's Avatar
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    McDuff, have you ever tried just wearing a leg bag?
    In 78' they sent me home from rehab doing IC and taking Ditropan.

    I like my coffee in the morning and a beer when I want (especially back then) and lots of water. I found bladder kicking off to be way too unpredictable, 3-4 months out went to leg bag / eternal cath. I use Bard 32 oz. bag and Rochester silicon external male cath non-adhesive. I rotate usually 3 bags, cath when I want, wash external and leg bag with water, a little Ivory soap and then run 20- 30% bleach solution through and put on rack to dry out. I clean lube off with some warm water and alcohol then slip on 1 of the other 2 dry bags.

    One thing I do and don't know why it works ( friction?) I use 2 foam male external cath straps. Rochester or Urocare, for some reason 2 straps holds , I rarely blow a cath.

    I don't bother with the leg straps. I'll check my gear after a transfer but usually the way it sits is more than enough to hold.
    My bladder usually starts kicking off around 300 cc's if I am active. I do find IC a lot easier when bladder full so works well that way.
    I use the same methods at night and sleep through the night without cathing.

    I realize everyone's bladder is different but if "kicking off" is the only problem this may be something you want to try before going down the path of surgery.

  9. #19
    Quote Originally Posted by ChesBay View Post
    McDuff, have you ever tried just wearing a leg bag?
    In 78' they sent me home from rehab doing IC and taking Ditropan.

    I realize everyone's bladder is different but if "kicking off" is the only problem this may be something you want to try before going down the path of surgery.
    Reflex voiding was commonly used as the preferred method of bladder management for men with SCI in the 1960s and 1970s. In the mid-1980s we found that many men who were using this technique had unsafe high bladder pressures, and that these high bladder pressures were increasing their risks for upper UTIs, hydronephrosis, and kidney damage over the long term.

    Rarely is it appropriate now days for someone to use reflex voiding as a safe way to manage their bladder; certainly not without having urodynamics done on a regular basis to assure that high bladder pressures (over 40 cm. H20) are not occurring.

    (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.

  10. #20
    Bladder augmentation. At 67 now I rather go with a indwelling catheter the rest of my life. Bladder augmentation seems like a big deal with 2 problems or more to go wrong. Hate to have 2 weak spots rather than none. I know cancer is the one problem with indwelling catheter but at 67 if I get anywere close to another 10 years my shoulder will be shot by then as they are bothering me big time as it is. A person at a older age is a big question as what one should do. What do other think?
    Art

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