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Thread: How often do you change your foley?

  1. #1

    How often do you change your foley?

    I have had a foley for almost 10 years now and until this past summer I changed my foley 3 times a week, along with my bowel program. This was done as the advice of my urologist at the time. Two years ago I moved and changed jobs and any and all opportunites for exercise went out the door. Needless to say I have gained about 65 lbs and my new urologist (as of two years ago) said this was a contributing factor of my cath coming out all of the time. That being said...he changed my foley schedule to once a month over the summer and it has seemed to work fine until now. Ive had some pain in my lower abdomen since Friday. My urine is great, only had a small temperature on Thurday, so I just figured either I had bad calamari and got the stomach bug OR somethings going on with my bladder. BTW I did an extra BP last night just to see if maybe that would help...still hurts..

    Now that Im winded from typing I will get to the point..
    1. How often should I change my foley?
    2. When I change it should I sit or lye down? ( I have bad AD when I change it)
    3. Should I drink alot before I change it (it seems to help if I change it with a semi full bladder)?

    Thanks,

    Ben
    C5-6 - 22 years

  2. #2
    Do you have a urethral indwelling catheter or a SP catheter? SP catheters should only be changed while laying flat. A urethral catheter can be changed in either a seated or laying down position. Have you tried using lidocaine jelly 2% in the tract or through your urethra prior to introducing the new catheter and as the lubricant? This helps many with AD symptoms related to catheter insertion. It helps to be well hydrated as it help to tell when you are in the bladder to see urine return. Be sure you are using proper technique to determine proper location of the catheter prior to inflating the balloon.

    Most people change theirs every 4-6 weeks. There is no good evidence that changing more often decreases complications such as UTI, stones or bladder cancer. The CDC says to change it prior to the time at which it usually starts to plug, and to avoid routine irrigations. Clean with soap and water only and only do it once daily.

    If plugging is a problem, requiring changing more often than twice monthly, then daily Renecidin instillations (not irrigations) should be considered.

    Anyone who uses a long term indwelling catheter and has used it for 5 years or more should discuss annual bladder cancer screening with their urologist. We start doing urine cytology tests (3 specimens, 24 hours apart) each year after 5 years, and include bladder biopsy annually after 10 years.

    (KLD)

  3. #3
    Quote Originally Posted by SCI-Nurse
    Clean with soap and water only and only do it once daily.
    I have an indwelling urethral catheter. I dont have too much trouble lately with clogging, as long as I drink enough water. What are you referring to in the above quote? I have never irrigated anything. My wife replaces the water in the ballon every morning so we are sure that it stays full. I get up a drink about 96 ounces of water a day...but I fell off the wagon this past week and dropped to about 32 ounces a day...That, and the pain, are whats giving me the idea that I may have a bladder infection. Arent there some sort of over the couter test kits for infections?

    Thanks for the quick response,

    Ben
    C5-6 - 22 years

  4. #4
    Do you use silicone catheters? If not, there is no reason to change the water daily. Even with a silicone catheter we recommend doing that only weekly.

    The cleaning is for the area around the catheter where it enters your body (penis and scrotum) and the catheter itself on the outside of the body.

    Over the counter UTI kits are totally worthless for you. If you have an indwelling catheter you are chronically colonized with bacteria. This will show up in the test kit as a UTI, but it should not be treated for you, and is insufficient information for treatment even if you have a true (symptomatic) UTI (fever, chills, AD, flank pain, etc.). If you have a true infection, you need to be treated based on a urine culture and sensitivity, and not just with a knee-jerk prescription for a broad spectrum antibiotic (like Cipro).

    With your drop in fluid intake, it is more likely that you have clogged your catheter (at least partially) rather than having a UTI unless you are also running a fever. A catheter change or irrigation should solve the problem if that is the case.

    (KLD)

  5. #5
    Thanks so much for your help...Im going to change the cath tonight along with my normal BP and see if that helps...again thanks so much for your help.....

    Ben
    C5-6 - 22 years

  6. #6
    I change my about every 5 or 6 weeks. I buy a box of 10 caths about once a year. I think I haven't changed it THAT often this year as I still have 5 left in the box<oops>. I just put the initial water to fill the ballon and have never changed it. Didn't know it was suggested.
    I WAS told to ic after my injury but they had me on a 40cc water restriction PER DAY! I said phooey to that and after a couple months of having to cath every two hours, went out and bought a foley and have used them since then. Like you a bit over 10 years.
    There is no way I would switch to ic, heck, I have a hard enough time remembering to empty my bag. I also drink large amounts of water. I'm colonized and only get 'symptoms' about twice a year now. And generally can get rid of it on my own.

  7. #7
    your situation sounds extremely similar to mine. I was in college at the time and couidnt go for more than 2 or 3 hours between caths and had constant UTIs. Thats why my doc suggested the foley. What type of symptoms do you have with colonization? Maybe thats whats wrong with me.

    thanks,

    Ben
    C5-6 - 22 years

  8. #8
    Quote Originally Posted by quartermile
    your situation sounds extremely similar to mine. I was in college at the time and couidnt go for more than 2 or 3 hours between caths and had constant UTIs. Thats why my doc suggested the foley. What type of symptoms do you have with colonization? Maybe thats whats wrong with me.

    thanks,

    Ben
    as for myself, i get flu like feelings of weakness when i start to get a UTI, ive been on an indwelling foley for 4 years.

    theres no way id do IC, getting up at night to do that nonsense, not a chance!

  9. #9
    just a quick update...I must have had a UTI....been on meds for three days now and Im feeling normal again...strange its never happened to me like that before...with weakness...
    C5-6 - 22 years

  10. #10
    yepper that was a UTI, with 'colonization' you have no 'symptoms' or sickness. It just means that you have 'bugs' living in your bladder that cause no real problems, aside from maybe smelly urine but no fever etc. Just drink plenty of water and real fruit juices and avoid sugar containg junk as much as possible. Processed sugar seriously reduces your immune system.
    Yeah Kenneth, after many months of waking and cathing every two hours, I was fed up. It was wonderful to sleep all night for the first time after all that!
    I'd PREFER not to have a foley and bag but it is a better solution for me than IC.
    I've gotten used to the ol 'radiator' over time, so used to it in fact, I really have to focus on emptying it in time,lol. Those lapses in memory have their benefit though. I can still hold 250-300ccs in my bladder when I back up.

    I personally change mine with an empty bladder. I flush with saline solution( fill bladder and as it drains I 'bounce the water around to stir up any sediment by gently pushing rapidly on the bladder as it drains). I flush it twice with about 60cc each time. Then I flush the urethra good, then I install the foley... I have always lubed it good, put it all the way in up to about an inch or two from the fork, fill the balloon which I emptied all the air BEFOREHAND. and pull it out til it stops(gently) then put the bag on which I have flushed with hot water from the sink just to make sure its flutter valve is open.
    No one told me these things I just devised it on my own, your mileage may vary.
    Last edited by CapnGimp; 01-05-2007 at 11:41 PM.

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