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Thread: Female with cath questions

  1. #1
    Junior Member fillmore's Avatar
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    Female with cath questions

    I am a C4-5 female with an indwelling foley. I have had it for four years with limited complications. Within the last six months I've had so many leaks from sediment and bladder spasms. I have never taken meds for the spastisity because I did not want to put any more medication into my body. I recently went to a urologist and discovered after 30cc my bladder spasms. Also, I have two tiny bladder stones and calcification build up around the bladder wall. Lastly, the doctor highly recommend me getting a suprapubic. The thought of something surgically coming out of my body is almost too much for me to consider. The doctor kept stressing to me that if I don't do this surgery the indwelling Foley that I use now will act as a saw at some point and cut my ureter away from my bladder leaving me incontinent. Is this true? And... is the medication a necessity in order to keep a healthy bladder? Any information and words of advice is greatly appreciated!
    kd

  2. #2
    It has been 21 years for me with a foley and I have not had too many problems. I do take ditropan though. Are you using one of the brands of catheters that are "hard"? If I don't use a soft one I do get spasms and leaks.

  3. #3
    We do recommend the use of anticholenergic meds like Ditropan or Detrol for those with indwelling catheters. It helps to prevent leakage, and also helps to prevent reflux of urine up the ureters, which can happen even in indwelling catheter users. It is unlikely after this amount of time that anything medical can be done to increase your bladder capacity.

    For women, long term indwelling urethral catheter use is associated with the development of a "patulous" (stretched out) urethra. This often occurs at about 20 years post injury. It is made worse by menopause, which also makes the urethra less pliant and moist (just like the vagina), causing less ability of the urethra to seal around the catheter. For this reason, many urologist recommmend that females consider a SP catheter.

    Of course using a urethral catheter that is as soft as possible, and staying with a small size (14-16 Fr.) will help with some of this, but it may not prevent it entirely.

    I am sure you will hear from others here who have SP catheters. While it is a surgery, it is a relatively minor one, and many people find it is an improvement over a urethral indwelling.

    (KLD)

  4. #4
    What about how much of an activity level can you do with one of those? Like can you still throw with one in without bothering it? And can you do activities that require a lot of twisting motion from the torso?

  5. #5
    There are no activity restrictions with either a urethral or SP indwelling catheter. With both you need to be sure they are secured so they don't get tension on the balloon (or get ripped out accidentally) but other than that, just do what you want.

    (KLD)

  6. #6
    Junior Member fillmore's Avatar
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    First off, thanks for your help.
    I have been using a 16Fr silicone catheter from Rochester medical. It does seem rather stiff. The reason I chose this one is because it is latex free and see-through. I will try a more flexible one now. Are there other see-through catheters that are flexible? As far as my activity level... it has gotten to the point that any time the catheter is even moved a little (i.e.: during pericare or leaning forward in the chair) I get a bladder spasm.
    Also, in the past my bladder did not leak until maybe 80 cc of fluid. Is it because of the lack of ditropan that it now holds so much less fluid? of course, I don't want it to continue to shrink. This may be a silly question but, are there drawbacks in waiting until the urethra expands before getting a suprapubic cath?
    Lastly, the urologist did mention I am not a candidate for kidney damage because my urine leaks before it backlogs to my kidneys.
    Thanks again for your help!
    kd

  7. #7

    fOLEY OR SUPRA?

    Female C4/5 complete quad here. 27 yrs post injury.

    I have had an indwelling Foley catheter for 27 years. All of that time I have been on 5 mg of Diropan twice a day. But at some point I remember hearing that it was prescribed not so much for the bladder spasms but for very mild dysreflexia. I found this to be true when I tried getting off of it about five years postinjury.

    I have never been pressured by any doctor [urologist or otherwise] to have a suprapubic done instead. I have considered it, though, several times.

    The thing in this... it is still an indwelling catheter because it still goes directly into the bladder!!! I have talked to so many people who have them and who did not have them. Some have just as many problems and some do not. So there is no easy answer.

    In 1989 I began to have a lot of sediment and sludge and it was constantly plugging my catheter. I went to a urologist in Syracuse New York and he thought that women should have a larger sized catheter and especially for those who have sediment problems. The reason being... there is more room for the sediment to travel through the larger catheter.

    Ever since then... I have been using a 20F, 5cc silicone catheter. Prior to that... I was using an 18F, 5cc. For the longest time I have been putting 7.5 cc into the balloon.

    I am 27 years postinjury and just began to have some leaking problems but ONLY when I am sitting up in bed and it is only a very little bit. Not even enough to change the sheets, etc.. And it only happens once or twice a week. One suggestion was to put a little bit more sterile water into the balloon. So I increased it to 10 CCs. But that has not made a difference so it is only a minor inconvenience that is a mystery.

    Thank goodness that it only happens in bed!

    Two years ago I began having UTI's every single month. A year ago this past October I was diagnosed with having very large bladder stones. I had them removed this past May but it has not resolve my UTI's.

    It is always a trial and error SCI experience!

  8. #8
    I do find the Rochester catheters to be hard. I also find the Bard catheters to be hard. My preference is the ones from Mentor.

  9. #9
    Junior Member fillmore's Avatar
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    Thanks for the info. It is Very helpful.
    kd

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