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Thread: Effects of long term foley use on bladder capacity

  1. #1

    Effects of long term foley use on bladder capacity

    I just spoke with my physiatrist and I am kinda freaked out because he gave me a big lecture on how if I continue using an indwelling I'll never be able to I/C or have a Mitrofanoff unless I get a bladder augumentation. Anyone been in a similar situation?

    "Learn from yesterday, live for today, hope for tomorrow"
    ~ Anon

  2. #2
    I know there have been some good posts on this forum concerning this topic, but I'll be darned if I can find them tonight. I think it is possible for some people to go back to an IC program after having a foley, but it may take some time to get your volumes back to where they were. I don't think it is accurate to say you will "never" be able to go back. Everybody's bladder is different. (EMK)

  3. #3
    Senior Member
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    i have a super pubic

    i cant remember specifics but you start clamping off catheter and gradually build up bladder capacity over 2 or 3 months to whatever is a reasonable amount then do away with indwelling.

    urology seems to be a very opinionated occupation, ask ten urologist same question get ten differant answers

  4. #4
    One of the reasons we recommend that everyone using an indwelling catheter stay on an anticholergic drug (Ditropan, Detrol, etc.) is that this will reduce the natural bladder shrinkage that accompanies constant drainage of urine with a catheter. (this will also reduce your risks of both reflux and leaking around the catheter).

    Even with the use of these medications though, over time the bladder with get contracted. Any muscle that is not stretched and exercised with do the same. I would not recommend clamping the catheter on your own without working closely with a good urologist. Clamping of the catheter can cause serious reflux of colonized urine to your kidneys, resulting in kidney damage and/or infection, and clamping can also cause very serious AD.

    If someone wants to go to intermittent cath after years of using an indwelling catheter often this will require a procedure such as an augmentation to be fully successful.

    In addition to the above, we are very reluctant to have younger people use indwelling catheters due to the significantly increased risk of bladder cancer with long term use. For someone who starts using one in their 70s or 80s this is probably not much of a concern as we know that the risk stays fairly low until after 10 years of use, but it is a concern for someone in their 20s, 30s, or 40s (and sometimes beyond this).

    (KLD)

  5. #5
    Senior Member
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    good advice nurse

    i went for annual check up and had not been taking any daricon, and my bladder had shrunk a lot urologist told me i better start taking meds etc.

    the whole next year i took daricon & purposely would not drain leg bag until ad was more than i could stand. the next year they were surprised how much larger my bladder was.

    they did tell me when i first got the super pubic that it was possible to switch back later?

  6. #6
    I've been using an indwelling foley catheter ever since my injury (14 years) and I HATE it cuz I get full blown UTI like once every month, but I haven't really got much choice due to my level injury. Recently I had testing done and been told my bladder's basically shrunk down to the size of a walnut by now. Now the doc is recommending I get bladder augmentation surgery and switch to a suprapubic catheter.

    My question is that if they had known this was going to happen, couldn't they have prescribed a course of action beforehand to prevent this from happening? And how necessary would the surgey be if I still end up with an indwelling catheter?

  7. #7

    I agree with KLD (as always)

    Having a good urologist involved in the process is essential. Also, in my opinion Starlight Angel, there is always going to be something that probably should have been approached differently in order for things to work better later. When I was at the last open house Dr. Young said something to me that may explain things...clinicians just don't always know every way to handle sci issues. They often do not read journals and can not know what is the best possible approach for all things. I can't criticize....I have a year of journals sitting here unopened too. Yeah yeah yeah... I will get to it! Take care Angel stay well!!!

    Mary

    ...and she lived happily ever after...

  8. #8
    "Now the doc is recommending I get bladder augmentation surgery and switch to a suprapubic catheter."

    This is not correct procedure. If you get augmentation, you don't continue with an indwelling catheter such as a suprapubic. The two treatments are not consistent with each other in terms of objective. You get augmentation to get rid of the indwelling.

  9. #9
    I agree. I don't see what would be gained by a bladder augmentation with a suprapubic catheter. Because a piece of bowel is used to create the augmentation, it secretes mucous which can plug indwelling catheters. In my experience, augmentation is usually a part of the Mitrofanoff procedure or used when a person is able to void volitionally. (EMK)

  10. #10
    Originally posted by SCI-Nurse:

    I agree. I don't see what would be gained by a bladder augmentation with a suprapubic catheter. Because a piece of bowel is used to create the augmentation, it secretes mucous which can plug indwelling catheters. In my experience, augmentation is usually a part of the Mitrofanoff procedure or used when a person is able to void volitionally. (EMK)
    That's what I thought. With my level injury doing IC of any sort isn't really an option.

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