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Thread: INCONTINANCE/BLADDER CATH QUESTION

  1. #1
    Senior Member kngtreeman's Avatar
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    INCONTINANCE/BLADDER CATH QUESTION

    since my accident leaving a t-8 2.8 years ago, this has been the biggest hurdle for me.it seems that my body has these cycles.i go 3-4 weeks without any trouble having to many accidents.i still do but not to often as long as i cath every so often during the day.i dont need to wear anything to bed.but then without any couse or reason that i can see,i start having accidents constantly.these accident times continue for several weeks.then stop just as quickly as they started.ill cath and their will hardly any pee and 5 minutes later my pants are soaked.or ill cath get a lot of urin and in minutes im soaked again.ill tell about yesterday thruout the night and thismorning for example.yesterday i woke and the condom cath stayed on thank god.i emptied the bag and it smelled so strong.i drank my coffe ,took kids to bus.getting outta van the condom came off soaked my pants.i showered and changed.cathing before i put my pants on.i pissed all over myself minutes later putting my pants on.out in my shop later,at my bench i thought "i better go cath".i am dry at this moment.before i can even move,just the thought of cathing i start peeing.this happens all the time.or ill think i better cath,remove the leg bag and put the cath down inside of the condom cath no point in removing the condom as they cost so damb much.biggest problem cathing this way is getting the cath in the hole at the end of my pecker.cant feel the cath or see inside wile i try.but just trying somhow my body knows its time to pee and i pee before the cath is in..in the morning my urin really smells strong and then as the day progresses the odor and strong collors fades.i drink lots of water.drink the cranberry juice.stay away from soda pop and acidity drinks as much as possible.take vitamin c regularly as i read somwear it helps with odor in urin.if it is a urinary infection is it possible for the body the get rid of the infection on its own and this is whjat is cousing my problems.i went to the doctor for a urinary infection one time i was in this pissin cycle and i was clean.i woke thismorning couse my condom come off during the night and i pissed all over the bed.i felt cold wear i was all wet as though i had peed on myself.but of cours i had no sensation of hot or cold down their.i lifted the sheet and smelled strong urin.i new exactly what happened.got up got in shower cathed and wile getting clean i started peeing again.wile i cath ive tried running water over my handf,pulling pubic hair,pressing my guts.nothing i do creates more urin to be expelled.i have wile in the shower put my finger up my bung hole and pressed on my prostate this does expell urin at times,but does not empty my bladder.if i go out and tie one on it will start my peeing cycle.i havnt had a beer now though in quite a wile.sexual contact in the past has stopped these pissin on myself cycles.i am at the moment trying to find a doctor at the university of miami for physical workup.but till i find one any suggestions would be helpfull.anyone else experiance what ive described.any exercise i can do that will strengthen my bladder to hold rather then let go.

    scott r

  2. #2

    Recommendation

    Scott, have you had recent urodynamics? Your bladder tends to change a lot in the first 1-2 years after injury. Are you taking any medications to help keep you dry (Ditropan, Detrol, etc.) between caths?

    I would strongly recommend that you see a urologist who is experienced in SCI and get a complete GU work-up, including urodyanamics (minimally a CMG with sphinter EMG). This test should be done at least every 2 years...more often if there are problems. You definately have problems.

    Strong concentrated urine is not abnormal in the morning. Strong urine has a different odor than infected foul urine and it is important to differentiate the two. You say you drink "plenty" of water. How much is this? Generally on intermittent cath you want a balance between not enough and too much water...about 2 1/2 quarts daily is often recommended.

    What type of external catheter are you using? Perhaps you should try a different brand that stays on better until you can get yourself dry again with your urologist's assistance.

    (KLD)

  3. #3
    Senior Member kngtreeman's Avatar
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    i havnt had any of those test.i wrote the info down so as i can ask when i go to the doc.i drink about a half gallon water a day mabee a bit more.as far as catheders and condom caths i use mentor brand.with the condoms i find the large ones stay on best.and the catheders are mentor self cath.long catheder.14fr whatever that means.on another note thismorning has been better.but jkust as soon as i went to the bathroom to cath,i look down and im soaked again.literally piss me off.

    scott r

  4. #4

    Brand and type

    Scott, which type of Mentor external are you using (there are several). The size should be such that you have no wrinkles along the long axis of the external (when the penis is flaccid). If there are any, this indicates the size is too large for you. Most Mentor external catheters come in 5 sizes. Try some other brands. The adhesive on the Mentor catheters has undergone some changes, and may not be the best for your skin.

    In addition, tell me how you clean and prepare your skin under the external when you apply it. This can make all the difference in how well the external stays on.

    (KLD)

  5. #5
    Senior Member Jeff's Avatar
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    Scott

    As the man with the most neurogenic bladder on the planet let me assure you, you are having bladder spasms. I suggest you try BioDerm external catheters. They allow you the health benefit of self-cathing while on, but also afford you the dignity of catching urine in between caths. Are you on Ditropan or anything similar? I think it will help you.

    ~See you at the SCIWire-used-to-be-paralyzed Reunion ~

  6. #6
    Hey Scott! Ditto to the ditropan, I was always having accidents many years ago, as soon as I started taking ditropan, I've had like two accidents in 10yrs, and it was cause of bad infections. So hang in there, I know it really sucks, hopefully it will be as simple as medication, it's worked for lots of us, so it probably will for you too!
    Oh PS. Jeff; No way man! My bladders the worsed! So there!

  7. #7
    Senior Member Jeff's Avatar
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    Monkeygirl

    Thanks for making me smile.

    I've tried taking the max dose of ditropan on two occasions. Both times the result was the same. At about 250cc my bladder would begin its normal spasms. The difference was that they were too weak to expel urine for about twenty minutes, but eventually would. So I could either try to ignore the sensation of my bladder constantly contracting and then have an accident, or I had to cath every 1 to 1.5 hours.

    Anyone who can be successful with ditropan prolly has a less neurogenic bladder than me. But I understand exactly how you feel. So there!

    ~See you at the SCIWire-used-to-be-paralyzed Reunion ~

  8. #8

    Bladder of the Gods

    I might take exception to Jeff's claim that he has "the most neurogenic bladder on the planet." For the first 10 years post-injury I opted for condom catheters and leg bags, but increasingly higher bladder pressures compelled me to begin taking all sorts of anticholinergics in all sorts of combinations. My bladder pressures did come down, for a while, but accidents were none too infrequent. With time, however, my bladder pressures climbed back up and I was staring down the barrel of needing an augmentation cystoplasty when I suggested to my urologist that I try infusing Ditropan directly into my bladder.

    Intravesicle Ditropan instillation has changed my life! My particular regimen consists of emptying my bladder, and with the catheter still in place, instilling 10 mg of generic oxybutynin disolved in 30 cc of distilled H20. I do this 3x/day.

    Urodynamic studies proved what I was already experiencing: greatly enhanced bladder capacity and very low pressures.

    I've also begun taking cranberry extract supplements and drinking much more H2O. In the past I couldn't drink plain H2O because it would go through me like H2O. On this new regimen, my bladder takes on the extra volume without so much as a cough. While I prefer not to let my bladder get too full, I've had residuals if 500 ccs without feeling that I was at imminent risk of having an accident. That's a very dramatic improvement from where I was when taking oral anticholinergics (as much as 40mg Ditropan XL).

    Certainly, this is an approach that every SCI struggling with neurogenic incontinence should at least investigate. It's also a great benefit not having anticholinergics swimming throughout my entire body.

  9. #9

    Anticholergics

    Anticholergics are most probably needed here, but urodynamics should be initially done without these meds on board, then added and urodynamics repeated to see the effectiveness.

    Not everyone responds the same to these meds. Many do well on Ditropan. Some do better on Ditropan XL (extended release), while others do worse. Some do better on intravesicular Ditropan bladder instillations. Some do better on Detrol or Detrol extended release. Others need to add a tricyclic antidepressant to this (such as imipramine).

    Some also have bladder neck dysynergia (where the bladder neck does not relax when the bladder contracts), and then alpha sympathetic blocker drugs may be needed (Minipress, Dibenzyline, etc.). This condition can only be diagnosed with videourodynamics.

    The external urinary sphincter is less managemable with drugs, but its activity can really only be assessed by the EMG portion of urodynamics.

    The bladder is complex as its function includes innervation from somatic (voluntary) nerves (sphincter), parasympathetic (autonomic) nerves (bladder muscle) and sympathetic (autonomic) nerves (bladder neck).

    (KLD)

  10. #10
    Senior Member Jeff's Avatar
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    Holy Cow

    I didn't know that was even available, Stephen. I thought only Capsaicin was available for that. Are you also saying you only cath 3x/day, or only use Intravesicle Ditropan 3x/day but might cath more often?

    My goodness, I feel like running out and getting some. Oral meds never worked well enough for me but maybe this will! Free Willy from condom caths and contact with urine! Let him make love without urinating half way through! Rid him of that attached leg bag! Oh man, I am excited...


    ~See you at the SCIWire-used-to-be-paralyzed Reunion ~

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