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Thread: Cathing Problems

  1. #1
    Senior Member MikeC's Avatar
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    Cathing Problems

    First a little background. I've had an enlarged prostate (BPH) for many years (before SCI). I still take 5 mg proscar daily. After trying several catheters I ended up using the Mentor Self Cath Coude tip because it's made with PVC. I still used a Bard red rubber coude tip at night because it is more flexible. I used this combination for about 6-8 months without any major problems.

    A few weeks ago I started having problems inserting the mentor cath. It would get completely stopped about 2 or 3 inches before urine started coming out. I assume this means it was getting hung up on my prostate. I tried the gentle pressure for a few minutes and it wouldn't go in (thinking maybe it was getting stuck at the bladder sphincter). Some times if I changed positions (usually I stand when I cath but if I would sit) it would go in. After about 10 minutes or so I'd give up and use a bard catheter and it would slide right in. This problem has gotten worse over time. I can hardly ever get the mentor to go in now (usually after I exercise it goes right in but forget about it first thing in the morning). Now the bard is also getting difficult to get in

    Wonder if anyone else has a similar problem and if anyone has any advice. I've got my annual exam at the VA on Dec 7 and I'll discuss it with the doc then but in the meantime I'd appreciate any advice. I'm on vacation now in NC and I didn't bring a lot of the bard catheters with me - so I'm cleaning them instead of using a new one every time.

    Thanks,
    Mike
    T12 Incomplete - Walking with Crutches, Injured in Oct 2003

  2. #2
    Senior Member mr_coffee's Avatar
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    Hey Mike, I have the same types of problems when trying to get cathers in, its gotten better ever since I switched to this astroglide lubercant, the KY wasn't doing it for me. Have you tried to add extra lube or change lubercants? I was using bard but stopped because it was actually cuttting my insides, blood would come out, i don't know if it was a bad batch or what but man it hurt, those bastards! I now just use mentor self cath straight caths and use a bottle to pee in or if a tiolet is near by just sit on it and then use it. I don't know about you, but if i hold the pee in there long enough it will start to come out, and this really makes it easy to get the cath in, do you have the same issue or will your bladder keep filling up? I also was sent samples of these one types of cathers, i will look for the name, but they are in their own packages and are in some type of lubericated water the whole time, they are only a one time use and are very expensive but wow those things go in with no problem, even right in the morning, those were the best i've had but couldn't afford them.
    Injured:10-16-04
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  3. #3
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    Well apart from your prostate problem, maybe you developed a stricture (an abnormal narrowing) of your urethra, something common after years of repetitive cathing. I had the same problem years ago and it was a stricture. The solution was a one-day surgery (in and out the same day). But I also agree with Mr.Coffee that the type of catheter will make a difference. Before surgery I had to use the coude type since the others would simply not go in anymore. Try any type of hydrophilic catheter (Mr.Coffee is referring to a type of those), they are covered with a salt layer that attracts water (hydrophilic) and make them extremely slippery, they will often work even with a stricture or prevent the development of a stricture when used on a regular basis. You need to add water to their packing and wait 30-60 sec for them to activate. As Mr.Coffee said, some are even packaged with the water in and they are the best (ex. Convene Speedycath) but also the most expensive ones, unaffordable unless you have a heck of an insurance. Those that I use are not as expensive, Self Cath hydrophilic from Rusch (LoFric is another brand and were the first marketed ones I think). Before anything else I would try hydrophilic catheters if you can afford it or just to try at least. Best of luck to you.
    Pharmacist, C4-5 injury but functional C6 (no triceps/flexors)

  4. #4
    Senior Member MikeC's Avatar
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    Thanks Cory and JGNI. I tried the hydrophilic catheters before I settled on the mentor caths and I couldn't find any coude tip. I couldn't get them in - even though they were supposed to be so lubed that you don't need a coude tip.

    Cory, where do you get astroglide lube? Can I get it while on vacation (Walmart, etc) or do you order it online? I've tried using a lot of lube and inserting very slowly but it doesn't help any more. Unfortunately if I don't pee I don't leak - I just continue to fill up. When I sit on the toilet for bowel movements and push I sometimes pee a little. I used to think that this helped lube things up too but lately it hasn't helped either.

    JGNI, how did they diagnose a stricture? Not sure if I should wait until my appointement with the VA on Dec 7 - if things continue to get worse I could have a problem. Do you know of any hydrophilic caths with coude tip?

    Thanks again for your help.

    Mike
    Last edited by MikeC; 11-21-2005 at 08:29 PM.
    T12 Incomplete - Walking with Crutches, Injured in Oct 2003

  5. #5
    Senior Member McDuff's Avatar
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    Mike,

    I don't remember if you were involved on the threads Jimnms and I have had talking about cath insertion problems before.

    My prob and others too, has been when switching between the "travel cath" or bag cath style, back to my home caths. Over the last year or so it has been getting worse. If I use a couple of travel caths, it is like my urethra gets glued shut. My home cath will go in a couple inches and stop dead. I have tried both different travel and home caths, as well as diff lube. Sometimes I wind up pissing on myself before I can get it in.

    As for the bard working when the mentor didn't, are you sure it's not just because it is the 2nd cath going in? I ask, because I have found that if I remove the cath and relube it up, it will usually slide in way easier, like the first shot got things started but needed a 2nd shot of lube.

    Hope ya find your solution.
    "a T10, who'd Rather be ridin'; than rollin'"

  6. #6
    Mike,

    The workup for a stricture usually involves a cystoscopy, which views the passageway into the bladder. A stricture is a abnormal narrowing of the urethra caused by inflammation or scar tissue from surgery, disease or injury.

    Here is a site that reviews uretral strictures:
    http://www.nlm.nih.gov/medlineplus/e...cle/001271.htm

    A Dec 7th appointment should be OK unless you develop a fever, sign of UTI, pain or have a significant decrease in the amount of urine you are passing, which could signal an obstruction.

    Keep us posted.

    AAD

  7. #7
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    The Speedicath are available with a Tiemann tip in sizes up to 14 FR. If sometimes you really cannot cath when you are full, then you could get yourself in trouble if you wait too long before having it checked. If you have a stricture and you are still trying to go against it, you could develop secondary problems like a "second passage" where the catheter will divert and dig some kind of another route. Have it checked whenever you can depending on how serious it is sometimes impossible for you to cath. The answer to the diagnostic is in the previous post.
    Pharmacist, C4-5 injury but functional C6 (no triceps/flexors)

  8. #8
    Hi Mike,

    LoFric makes a very good hydrophilic catheter with a coude tip.
    Millard
    ''Life's tough... it's even tougher if you're stupid!'' -- John Wayne


  9. #9
    Senior Member MikeC's Avatar
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    Thanks for all the replies. I'll definitely let everyone know what happens and will call uromed when I get home and see if they can send me some samples of the hydrophilic with coude tips.

    So far today as long as I enter the bard very slowly they go right in so I should be okay if it doesn't get any worse.

    McDuff - I did read the thread on the travel caths. At the time I wasn't having any problem using my 2 types of caths but was interested. At first when the mentor wouldn't go in I'd take a break and then try another mentor (I'm trying to avoid latex) and it still wouldn't go in. I'd grab a bard and it would go right in. I think that the bard are a little more flexible and are able to 'sneak' past the prostate. I'm a little afraid I'm getting second passages but since the bard goes right in I hope not. I'll see what they say at the VA in a few weeks.

    Mike
    T12 Incomplete - Walking with Crutches, Injured in Oct 2003

  10. #10
    Senior Member mr_coffee's Avatar
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    Mike, sorry about the delayed responce, you can by astrogluide at walmart, its 8 bucks a shot but worth it!!
    Injured:10-16-04
    C7/C8, T1 incomplete;


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