Page 2 of 2 FirstFirst 12
Results 11 to 13 of 13

Thread: I need advice from the sci nurse!

  1. #11
    Agreed, CWO. Here are the posts I was reading in that other thread regarding using a indwelling catheter in this situation. I found it realistic concept, even though the the person they're talking about is dealing with kidney stones.

    #3:

    http://sci.rutgers.edu/forum/showpos...01&postcount=3

    Quote Originally Posted by SCI-Nurse
    I suspect his nearly constant AD is because he is voiding with excessively high bladder pressures, which can cause recurrent UTIs, AD, and, long term, kidney damage. If so, intermittent cath or even an indwelling catheter would possibly be safer methods of bladder management than reflex voiding with a condom catheter.
    (KLD)
    #26:

    http://sci.rutgers.edu/forum/showpos...4&postcount=26

    Quote Originally Posted by Cory-M
    I think this has been mentioned before but I didn't see a direct answer from you. The AD he is experiencing is most likely from high bladder pressure, because his bladder is not emptying completely with the method he is using. Even though this method worked in the past, things may have changed and the infection he has may be causing extra bladder spasms and pressure.

    I would seriously consider an indwelling catheter or Intermittent Cathing, atleast try it or discuss with the Dr., maybe until he gets the infection cleared up.

    Normally a UTI itself does not cause AD, but a full bladder/high bladder pressure is a primary cause.
    #32:

    http://sci.rutgers.edu/forum/showpos...0&postcount=32

    Quote Originally Posted by ouch
    I'm a c6-7 quad. I wore a leg bag and condom cath for ten years and had a TON of utis. I was on meds every other week.

    I finally asked to have a bladder pressure test done.. was too high.

    I nows straight cath every 4 hours..sleep thru the night, and most importantly.. GET NO UTIS.

    I would bet the quad in question has a residual amount in the bladder that is acting as a breeding ground for those nasty bugs.

    Dump the condom cath.

  2. #12
    I was agreeing with you. But each person is a little different.
    A UTI is a not common cause of AD, but any irritation below the level of injury can cause AD. I had a pt who we tie dhis sheostrings to tight & he had AD. And a UTI can be irritating.
    A while ago I had a pt. having AD, he had a bladder infection but the volume obtained was small, on fluoro he had an outpouching of the bladder, a diverticuli, or we call it a tic.-that was holding about 65 cc of very funky thick urine. He had the AD until I crede' d his bladder tic and emptied it- ony 65 ccs but it was some thick foul urine. And the AD was gone. The AD did not return when his bladder was filled over 500cc with sterile water.
    Also there are many causes of high pressures. One cause is the high pressure of the bladder filling and trying to empty- the bladder contracts & tries to empty. At this time, the sphincter should relax and let the bladder empty-but it doesn't so the bladder pressure gets higher & higher trying to empty. & force th esphincter open -sometimes this works. This is called detrusor sphincter dysnergy- DSD.
    Due to the SCI, the bladder is a little "confused" and tries to empty with low volumes in it or due to irritation, as with a UTI.
    You can only tell this from Urodyanmic Studies-cystometrogram with EMG and fluor is helpful. And these realy need to be done and are the only way to tell exactly what is going on.
    But the treatment for high pressures is catheterization when volumes are below 400cc, usualy at least eveyr 4 hours, and Oxybutynin(an dother meds) can help. An indwelling catheter will keep the bladder from fillling but it has its disadvangtages. Botox is another possibility.




    CWO

  3. #13
    Quote Originally Posted by SCI-Nurse
    I was agreeing with you. But each person is a little different.
    A UTI is a not common cause of AD, but any irritation below the level of injury can cause AD. I had a pt who we tie dhis sheostrings to tight & he had AD. And a UTI can be irritating.
    A while ago I had a pt. having AD, he had a bladder infection but the volume obtained was small, on fluoro he had an outpouching of the bladder, a diverticuli, or we call it a tic.-that was holding about 65 cc of very funky thick urine. He had the AD until I crede' d his bladder tic and emptied it- ony 65 ccs but it was some thick foul urine. And the AD was gone. The AD did not return when his bladder was filled over 500cc with sterile water.
    Also there are many causes of high pressures. One cause is the high pressure of the bladder filling and trying to empty- the bladder contracts & tries to empty. At this time, the sphincter should relax and let the bladder empty-but it doesn't so the bladder pressure gets higher & higher trying to empty. & force th esphincter open -sometimes this works. This is called detrusor sphincter dysnergy- DSD.
    Due to the SCI, the bladder is a little "confused" and tries to empty with low volumes in it or due to irritation, as with a UTI.
    You can only tell this from Urodyanmic Studies-cystometrogram with EMG and fluor is helpful. And these realy need to be done and are the only way to tell exactly what is going on.
    But the treatment for high pressures is catheterization when volumes are below 400cc, usualy at least eveyr 4 hours, and Oxybutynin(an dother meds) can help. An indwelling catheter will keep the bladder from fillling but it has its disadvangtages. Botox is another possibility.




    CWO
    CWO, I surely didn't mean to disagree with you, sorry. I hope frwheel16 reads this and takes your advice to request urodynamics study. I only pointed out those posts to save him some searching, that other thread is so long.

    Would be interested what you do with Botox? Thanks.

Similar Threads

  1. HGH & testosterone
    By Varian in forum Cure
    Replies: 2
    Last Post: 06-04-2004, 11:42 PM
  2. DIRECTORS’ SUMMARY Miami Project
    By chastev8 in forum Cure
    Replies: 2
    Last Post: 04-28-2002, 10:50 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •