Supra vs ileovesicostomy

cydnight · 04-24-2012, 08:54 PM

Had a sp put in oct 2011 have had nothing but pain changing requires holding the stomach down after twisting the catheter and pulling it out blood coming from inside as well as outside. Before. Sp had an in dwelling for 30yrs. 2nd urologist suggested ileo loop or ileovesicostomy?Do I keep the SP? To see if it gets easier? But it's added 1 more problem autonomic Disreflexia. I have days where bp goes to 170/105 talk about a headache I am usually 97/64. I am a c5/6 incomplete quad. Does anyone have any suggestions or has any had an ileovesicostomy? Thank you Cyd

gjnl · 04-24-2012, 10:18 PM

Are you deflating the balloon of the foley catheter before you attempt to remove it from the suprapubic stoma? You need to use a slip tip syringe, attach it to the inflation port and allow the back pressure to fill the syringe. Then, take the plunger out of the syringe tube and once again (a couple times) attach the slip tip to the inflation port and drain what ever fluid comes into the tube of the syringe, before trying to remove the catheter.

Have you been trained by your urologist how to change these catheters. If you have, maybe you need to have a refresher on how to change the catheter or you should have your urologist change the catheter a time or two to see if he has the same difficulty you are having.

All the best,
GJ

SCI-Nurse · 04-24-2012, 10:54 PM

Can put some lidocaine jelly around stoma and inject a small amount and wait two to three minutes before insertion . Do you have a hypersensitive area in abdomen?
CWO

RAFS · 04-24-2012, 11:50 PM

Quote:

Originally Posted by cydnight

Had a sp put in oct 2011 have had nothing but pain changing requires holding the stomach down after twisting the catheter and pulling it out blood coming from inside as well as outside. Before. Sp had an in dwelling for 30yrs. 2nd urologist suggested ileo loop or ileovesicostomy?Do I keep the SP? To see if it gets easier? But it's added 1 more problem autonomic Disreflexia. I have days where bp goes to 170/105 talk about a headache I am usually 97/64. I am a c5/6 incomplete quad. Does anyone have any suggestions or has any had an ileovesicostomy? Thank you Cyd

I have had an sp catheter since 2/05 and never had any problems or experienced any discomfort while the nurse is changing my catheter that was up until several months back. Every 4 weeks I go to the VA to get it changed and I've been experiencing discomfort. If lidocaine jelly is used first and allowed to take affect before the catheter is pulled it makes it a lot less uncomfortable for me. I know SCI Nurse has mentioned this also in a post below. I just wanted to let you know that it helps to make the sp catheter change so much more comfortable. I wish you the best during future changes.

Cheers !

cydnight · 04-26-2012, 03:17 PM

Hi I first use sterile jelly to soften any crust then wash with the cleansing swaps from insertion kit then apply lidocaine wait 5 min then deflat with syringe and just to make sure I cut it do slow twist then try to pull-out. That doesn't work so I hold the stomach down turn it again and till it comes out. Tried sucking my stomach in while he pulled and tried pushing it out when pulled. Asked Dr he had no suggestions. Going back to let him change it. Don' think he believes me. The other two urologists suggested ileal conduits and had no suggestions how to make the SP work . I can tolerate pain but keeps triggering my blood pressure. I am normally 96/64 some days I wake at 3:30am with headache and bp of 177/95 I am at a loss. Thank you for ant feedback.
Cydnight

gjnl · 04-26-2012, 03:37 PM

What size is the foley catheter in your suprapubic stoma? Maybe that has something to do with it.

Do you have "rescue medications" on hand for the autonomic symptom of high blood pressure, i.e., nitropaste to decrease blood pressure and therefore decrease the headache or Nifedipine-sublingual to decrease the blood pressure?

Take a look at this link to find threads on the Care Cure Community on ileovesicostomy: ileovesicostomy site:sci.rutgers.edu

All the best,
GJ

gjnl · 04-26-2012, 03:42 PM

What size is the foley catheter in your suprapubic stoma? Maybe that has something to do with it.

Do you have "rescue medications" on hand for the autonomic symptom of high blood pressure, i.e., nitropaste to decrease blood pressure and therefore decrease the headache or Nifedipine-sublingual to decrease the blood pressure?

Try using the search feature to find threads that have been written about ileovesicostomy. There is quite a bit of information on Care Cure Community about this subject.

All the best,
GJ

04-24-2012, 08:54 PM	#1
cydnight Junior Member Join Date: Oct 2011 Posts: 4	Supra vs ileovesicostomy Had a sp put in oct 2011 have had nothing but pain changing requires holding the stomach down after twisting the catheter and pulling it out blood coming from inside as well as outside. Before. Sp had an in dwelling for 30yrs. 2nd urologist suggested ileo loop or ileovesicostomy?Do I keep the SP? To see if it gets easier? But it's added 1 more problem autonomic Disreflexia. I have days where bp goes to 170/105 talk about a headache I am usually 97/64. I am a c5/6 incomplete quad. Does anyone have any suggestions or has any had an ileovesicostomy? Thank you Cyd

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04-24-2012, 10:18 PM	#2
gjnl Senior Member Join Date: Jun 2005 Posts: 5,048	Are you deflating the balloon of the foley catheter before you attempt to remove it from the suprapubic stoma? You need to use a slip tip syringe, attach it to the inflation port and allow the back pressure to fill the syringe. Then, take the plunger out of the syringe tube and once again (a couple times) attach the slip tip to the inflation port and drain what ever fluid comes into the tube of the syringe, before trying to remove the catheter. Have you been trained by your urologist how to change these catheters. If you have, maybe you need to have a refresher on how to change the catheter or you should have your urologist change the catheter a time or two to see if he has the same difficulty you are having. All the best, GJ

04-24-2012, 10:54 PM	#3
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,341	Can put some lidocaine jelly around stoma and inject a small amount and wait two to three minutes before insertion . Do you have a hypersensitive area in abdomen? CWO

04-26-2012, 03:17 PM	#5
cydnight Junior Member Join Date: Oct 2011 Posts: 4	Hi I first use sterile jelly to soften any crust then wash with the cleansing swaps from insertion kit then apply lidocaine wait 5 min then deflat with syringe and just to make sure I cut it do slow twist then try to pull-out. That doesn't work so I hold the stomach down turn it again and till it comes out. Tried sucking my stomach in while he pulled and tried pushing it out when pulled. Asked Dr he had no suggestions. Going back to let him change it. Don' think he believes me. The other two urologists suggested ileal conduits and had no suggestions how to make the SP work . I can tolerate pain but keeps triggering my blood pressure. I am normally 96/64 some days I wake at 3:30am with headache and bp of 177/95 I am at a loss. Thank you for ant feedback. Cydnight

04-26-2012, 03:37 PM	#6
gjnl Senior Member Join Date: Jun 2005 Posts: 5,048	What size is the foley catheter in your suprapubic stoma? Maybe that has something to do with it. Do you have "rescue medications" on hand for the autonomic symptom of high blood pressure, i.e., nitropaste to decrease blood pressure and therefore decrease the headache or Nifedipine-sublingual to decrease the blood pressure? Take a look at this link to find threads on the Care Cure Community on ileovesicostomy: ileovesicostomy site:sci.rutgers.edu All the best, GJ

04-26-2012, 03:42 PM	#7
gjnl Senior Member Join Date: Jun 2005 Posts: 5,048	What size is the foley catheter in your suprapubic stoma? Maybe that has something to do with it. Do you have "rescue medications" on hand for the autonomic symptom of high blood pressure, i.e., nitropaste to decrease blood pressure and therefore decrease the headache or Nifedipine-sublingual to decrease the blood pressure? Try using the search feature to find threads that have been written about ileovesicostomy. There is quite a bit of information on Care Cure Community about this subject. All the best, GJ