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Thread: prostate infection?

  1. #21

    Other issues of concern??

    To Bob ---

    Wow, thanks for all of the details. I have a few reservations though.

    1. Are there that many people who simply won't go no matter how full their bladder gets? Out of all of the paras I've talked to like me they only get to a certain point and then go.
    2. How long does that take to run through the procedure. If I had to guess it already takes me 5 mins or more to cath and I don't follow any of those. I'm probably the opposite of you in many ways. Not saying I'm good for not being as clean but just that I can't imagine spending that much time every single time I have to go.
    3. Lastly, when I spoke with my urologist and told him I was glad that I was now not feeling the extreme urge to go (I feel some but can't go on my own) until about 500cc. He acted as if this is getting on the high side. I would think that 1000+ cc is WAY too high for maintaining your bladder for the long run. I know in my early years when I did drink some I would seem to extend my bladder due to waiting until around 900 to 1000cc. Isn't this bad for the bladder?

  2. #22
    Yes, current research indicates that the maximum you should hold in your bladder is in the range of 425-450 cc. (in an adult). Above that, not only is leakage more common, but also reflux of urine from the bladder up to the kidney, AD, and high bladder pressures. In addition, volumes larger than this have been shown to cause decreased blood circulation to the wall of the bladder, increasing the risks for development of symptomatic UTIs.

    (KLD)

  3. #23
    Hi Jay,

    Some people, I for one, can't leak a drop. This can be surgically "corrected" with a sphincterotomy. http://sci.rutgers.edu/forum/showthread.php?t=110905 They can cut away some sphincter or prostate tissue and perhaps place a stent in the urethra so the obstruction is relieved or removed. Sometimes this can cause you to constantly drip or void so you need to wear an external catheter and leg/bed bag all the time. I don't like wearing that "ball and chain" stuff.

    Everyone's bladder is a bit different. And since most SCI's bladders are always colonized with different types and strains of these bacteria it's difficult to say with certainty at what volume a bladder will reflex or spasm at. These colonizations effect the bladder in different ways for different people but usually cause the bladder, due to irritation, to spasm sooner than normal or usual. Meaning if your bladder normally spasms or reflexes at 400ccs, if it's colonized or if you have a full blown UTI, it may spasm or reflex at 100ccs and then of course you wet yourself.

    So most people, barring certain bacterial colonizations and UTIs, can hold about 400ccs before they reflexively void. It's recommended to have less than 400ccs in you at any given time but more importantly to have the proper pressure in your bladder. You don't want the urine, due to high pressure, to reflux into your kidneys. I was that way 30 years ago when I was newly injured but over the years, perhaps because of abuse or neglect of my bladder, that's to say overly high volumes and high pressures in my bladder, it's become what's called "decompensated". So my bladder, over the years, has become stretched out and can now easily hold 1000ccs before I even "feel" the urge to urinate. The urge is the bladder stretching beyond its "comfort" level causing slight AD (Autonomic dysreflexia) or if it gets really outta whack, severe pain and headache. A normal bladder shouldn't get close to holding 1000ccs... 400ccs should be your limit.

    The downside to having a large, stretched out decompensated bladder is that the walls of it can more easily become infected. Or so I've been told. But like I said before, I haven't been colonized or had a UTI in over 3 years using my cathing technique. I just keep the bacteria from getting into my bladder instead of dealing with it once it's taken up residency in there. Either as multiple types and strains of colonizing bacteria or until one of them turns into a full blown UTI. I don't know if UTIs are caused by very determined or certain types of bacteria or a bacteria that mutates into a strain that can cause a full blown febrile UTI.

    If your urine has a foul odor to it then you are bacterially colonized and that usually shouldn't be treated with antibiotics. Only UTIs that cause high fever, aches and pains and spasms galore should be treated. Personally, I don't like any bugs at all in my bladder! Even with the large capacity of my decompensated bladder, if I were to become bacterially colonized or worse yet, get a UTI, my bladder would start to spasm at 100ccs. That's how much effect those nasty bacteria can have on a bladder.

    About the concept of time. Good handwashing only takes about a minute or two. Would you rather spend a minute washing your hands or spend countless days and nights like LeeThompson84 suffering from a UTI and perhaps even dying from it after it's progressed into sepsis?! Draggin' your ass to the doctor with a fever of 104*F so he or she can prescribe you some damn antibiotics? I remember when I used to get UTIs and I didn't have any antibiotics (personal emergency stash!) on hand... I sure as hell didn't feel like going to the doctor or the damn ER. Grrrr... Anyway, I finally got sick and tired of constantly being sick and tired from UTIs so changed the way I cathed.

    The Nurses here say you shouldn't cath like I do. And they are probably right. My technique involves cathing with clean hands, storing the catheter in a bottle of hydrogen peroxide and inserting it dripping wet and squirting the head of my dick with the HP and then squirting some of it inside the meatus/urethra where the bacteria begins its colonization of the bladder. There... all in one sentence! I'm hoping that my body can repair whatever damage the use of hydrogen peroxide does to it. And that it can keep up these repairs over and through the ravages of aging and time. Fingers crossed.

    It boils down to choosing between the best (or worst) of two evils. One being the caustic nature of antiseptics like hydrogen peroxide and the possible or perhaps even likely harmful effects they may have on the lining of our urethras. Or two, the harmful effects of constant bacterial colonization/infection and the "caustic" nature of antibiotics and the certain harmful effects they have on our whole body. If we only had an antiseptic that could kill bacteria but not harm our urinary tracts. It sounds like such an impossibility. Just think, we're waiting for these geniuses to cure our spinal cord injuries with all of its many challenges (just read the "Cure" forum) but these geniuses can't create a simple antiseptic that's kick ass on bacteria but harmless to mucous membranes. Don't hold your breath for either. In a sentence, do your best to keep bacteria out of your urinary tract.

    Bob.
    Last edited by bob clark; 12-03-2008 at 05:53 AM.
    "Be kind, for everyone you meet is fighting a great battle." - Philo of Alexandria

  4. #24
    Thanks once again for your reply.

    Here is my situation. I work full time and a technique like that would be just about out of the question. I TOTALLY agree with you about being cautious although I must admit that I'm far less than cautious.

    I would like to hear the nurse/Doc on the site chime in on some info in my situation.

    After I was injured insurance paid for everything. You know, the good old days when insurance actually PAID for things. At that time I was using the sterile technique with new cath, gloves and lub for each time.

    About 3 years or so ago the insurance companies stopped paying for 99% of the things I need. Up until that point I was managing to get everythign I needed including enemeez and not pay anything to the vendor. Suddenly I was looking at spending a small fortune to continue that way. This made me think back. My original urologist said that he had MANY patients who carried around a single catheter in a small skoal type can (clean can) and they would go and then simply wash the catheter out in the sink when done.

    Due to money issues I started doing this. My body seemed to retaliate the non sterile technique for about 9 months or so but then I got it under control. The key for me is simply drinking a LOT of water. As long as I have a lot out then my system is constantly being flushed out. I don't use gloves and rarely wash my hands unless they are dirty but I'm careful not to touch very low on the cathter before inserting. I carry a ziplock back of about 10 caths in it in case I'm in a situation where I can't wash one. I wash and use again.

    Anyway, I would have never done this unless I had to (get away from sterile technique) but I have found success even without long routines. The KEY for me is the drinking of a lot of water. I do get bladder infections several times a year but they are always when I have neglected to drink a lot of water for a couple of days or more. My catheters are cleaned in a sink with regular soap or no soap at times with hot water. If I drink enough water I have no problems at all. After reading some things here I'm taking my Vit C and cranberry pills to help. Tons of water!!

    Now, after saying this I do wake EVERY morning with a lower abdominal pain which my doctors have not been able to figure outwhat it is but that is for another topic.

    Any comments, thoughts, suggestions?

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