female cathing

klcmacjac · 10-17-2003, 05:17 PM

I am a T6 complete. I am not able to cath myself from my chair. Any helpful hints anyone can give me? Also what is the difference between a supra pubic and cathing from the belly button. What is cathing from the belly button really called? What are your thoughts on these types of cathing?

SCI-Nurse · 10-18-2003, 10:32 AM

A suprapubic catheter is a type of indwelling catheter (usually a Foley) that is inserted permanently through a stoma make in your lower abdomen just above your pubic bone into your bladder. The catheter stays in all the time. The advantages of this are similar to a urethral indwelling catheter: you do not need to do any caths other than periodic changes (usually every 3-6 weeks), and you do not need to limit your fluids. There is also less risk of urethral damage than with a urethral catheter. You can still leak, and the risks of infections, stones, and bladder cancer with long term use is very real. You must wear a leg or bedside bag all the time. This is minor surgery.

The procedure for cathing through your belly button is a surgery called a Mitrofanoff. Your appendix, or a small section of small bowel is used to connect your bladder to a small stoma made in your belly button. It is fashioned so it does not leak. You do intermittent cath through the stoma every 4-6 hours just like doing intermittent cath through your urethra, but it is much easier, especially for females. It does require surgery, and a period of healing and learning to do the procedure. The stoma barely shows, and it is easy to cath in your chair, even with limited hand function.

Many women do learn to cath in their chair though. What technique are you using now? Were you taught some of the "tricks" when you were in rehab?

Here are a few previous posts about techniques that others use for this:

http://carecure.org/forum/showpost.php?p=14464

http://carecure.org/forum/showpost.php?p=11385

http://carecure.org/forum/showpost.php?p=8090

(KLD)

Karen M · 10-20-2003, 08:10 PM

Try using the Asta-Cath. It was difficult for me to learn but it was the biggest "life changing" function that I have yet mastered. It allowed me to go from 24 hour care to 7 hours a day.
I use a 6 in catheter because it is stiff and easier to insert. I attach it to tubing that connects to a urine collection jug that I keep hidden in a drawer in my bathroom. I scoot down in my chair, in front of a large mirror attached to the wall to insert the Asta-Cath and catheter. I need the mirror on the wall because I don't have very good sensation in my hands/fingers and my propreoception isn't normal either. Also, feet touching wall/mirror secures me from slipping out of my chair, in case I scoot too much. Of course, I do clean my hands, use a wipe, dry KY Jelley off after with a tissue. It took me a while to make my system work for me but I encourage you to try and find what will work for you. Oh, I don't wear undies and when I wear jeans (all fall and winter)they have a cut-out in the crotch. It opens when I scoot out and tucks in nicely when I push back up. No one would ever guess.

Maybe you could get out of jeans but I have limited arm movement. Good luck!
Karen C 3-4 central cord inc.

Karen M

[This message was edited by Karen M on 10-20-03 at 11:18 PM.]

SWEETIEheart · 10-21-2003, 03:18 PM

Hey! I'm T6, and like you, I dont cath out of my chair. There's no reason for you to have a supra pubic or mitrofanoff. You have full hand function.
Check out this post at New Mobility on how I cath. I tell pretty much everything from how my clothes are altered to how I get on a toilet. Look for "sweetieheart" posts there.
http://newmobility.com/ubbcgi/ultima...c;f=7;t=000437

klj · 10-21-2003, 10:07 PM

Hi just a quick question for the nurse. I currently have an IDC and block this several times during the day allowing the bladder to fill. I'm looking at getting a SP and was told I could still block this off as well. Is this not possible?

klj · 10-21-2003, 10:12 PM

Some more info, I can tell when my bladder is fill and then drain into a bag. Looked also at the mitrofanoff option but not many doctors here do this!

SCI-Nurse · 10-22-2003, 07:12 PM

klj - Blocking or clamping a foley catheter is not recommended. Why are you clamping your foley? This can lead to overdistention of the bladder, contribute to UTIs and could precipitate autonomic dysreflexia. Have you had urodynamic studies done to determine the pressures within your bladder? Do you have sphincter spasms? A good urological workup should be done to determine the most appropriate bladder management program for a person living with SCI.

A suprapubic catheter is managed in the same way that one manages a foley (IDC) I would urge you to go to the University of Alabama, Spain Rehab Center site; review their resources on bladder management, in particular, InfoSheet #11: http://www.spinalcord.uab.edu/show.a...1&return=21828 CRF

klj · 11-01-2003, 06:42 PM

Why is this not recommended?

I know when my bladder is full and unclamp when need to so it can flow. I haven't had an UTI for over 2 years now (touch wood). I do this so to maintain my bladder capacity so it is not free flowing constantly. I use to be able to block off for up to 3 hours now can only go about an hour depending on intake of fluid, but this also shows that the capacity has decreased significantly. I have had an urodynamic study done also, and my uroglosit sees no problem with what I'm doing and says the same methods should work with a suprapubic.

klj

SCI-Nurse · 11-01-2003, 07:24 PM

klj - You say that you can tell when your bladder is full. How much urine do you usually expel when it is "full"? One of the reasons for not blocking is that generally, due to the deficits with a SCI, one could easily have a distended bladder. Do you have an indwelling catheter since you have not been able to cath from your chair? It seems, from the information provided, that you could manage with intermittent catheterization. Have you had either a nurse or occupational therapist work with you to help you learn to catheterize?

You have noted that your bladder capacity has diminished. Has there been any discussion of the option to do an augmentation (enlargement) of the bladder?

Let me get some further clarification about blocking from other members of the SCI Nurse team. CRF

klj · 11-02-2003, 05:05 PM

Thanks for your reply.
At present I don't have sufficent hand function or control to self catheterize. I currently have a IDC and after blocking off about 125ml comes out. Looked into mitrofanoff but there are very few doctors who have previously performed this op before. Thought I should at least try a suprapubic first.
What exactly is involved with an augmentation? Is this a major op?

klj

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10-17-2003, 05:17 PM	#1
klcmacjac Member Join Date: May 2003 Location: Missouri Posts: 69	female cathing I am a T6 complete. I am not able to cath myself from my chair. Any helpful hints anyone can give me? Also what is the difference between a supra pubic and cathing from the belly button. What is cathing from the belly button really called? What are your thoughts on these types of cathing?

10-18-2003, 10:32 AM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,516	A suprapubic catheter is a type of indwelling catheter (usually a Foley) that is inserted permanently through a stoma make in your lower abdomen just above your pubic bone into your bladder. The catheter stays in all the time. The advantages of this are similar to a urethral indwelling catheter: you do not need to do any caths other than periodic changes (usually every 3-6 weeks), and you do not need to limit your fluids. There is also less risk of urethral damage than with a urethral catheter. You can still leak, and the risks of infections, stones, and bladder cancer with long term use is very real. You must wear a leg or bedside bag all the time. This is minor surgery. The procedure for cathing through your belly button is a surgery called a Mitrofanoff. Your appendix, or a small section of small bowel is used to connect your bladder to a small stoma made in your belly button. It is fashioned so it does not leak. You do intermittent cath through the stoma every 4-6 hours just like doing intermittent cath through your urethra, but it is much easier, especially for females. It does require surgery, and a period of healing and learning to do the procedure. The stoma barely shows, and it is easy to cath in your chair, even with limited hand function. Many women do learn to cath in their chair though. What technique are you using now? Were you taught some of the "tricks" when you were in rehab? Here are a few previous posts about techniques that others use for this: http://carecure.org/forum/showpost.php?p=14464 http://carecure.org/forum/showpost.php?p=11385 http://carecure.org/forum/showpost.php?p=8090 (KLD)

10-20-2003, 08:10 PM	#3
Karen M Senior Member Join Date: Aug 2001 Location: Roseville, CA Posts: 217	Try using the Asta-Cath. It was difficult for me to learn but it was the biggest "life changing" function that I have yet mastered. It allowed me to go from 24 hour care to 7 hours a day. I use a 6 in catheter because it is stiff and easier to insert. I attach it to tubing that connects to a urine collection jug that I keep hidden in a drawer in my bathroom. I scoot down in my chair, in front of a large mirror attached to the wall to insert the Asta-Cath and catheter. I need the mirror on the wall because I don't have very good sensation in my hands/fingers and my propreoception isn't normal either. Also, feet touching wall/mirror secures me from slipping out of my chair, in case I scoot too much. Of course, I do clean my hands, use a wipe, dry KY Jelley off after with a tissue. It took me a while to make my system work for me but I encourage you to try and find what will work for you. Oh, I don't wear undies and when I wear jeans (all fall and winter)they have a cut-out in the crotch. It opens when I scoot out and tucks in nicely when I push back up. No one would ever guess. Maybe you could get out of jeans but I have limited arm movement. Good luck! Karen C 3-4 central cord inc. Karen M [This message was edited by Karen M on 10-20-03 at 11:18 PM.]

10-21-2003, 03:18 PM	#4
SWEETIEheart Senior Member Join Date: Oct 2002 Posts: 175	Hey! I'm T6, and like you, I dont cath out of my chair. There's no reason for you to have a supra pubic or mitrofanoff. You have full hand function. Check out this post at New Mobility on how I cath. I tell pretty much everything from how my clothes are altered to how I get on a toilet. Look for "sweetieheart" posts there. http://newmobility.com/ubbcgi/ultima...c;f=7;t=000437

10-21-2003, 10:07 PM	#5
klj Senior Member Join Date: Aug 2001 Location: New Zealand Posts: 181	Hi just a quick question for the nurse. I currently have an IDC and block this several times during the day allowing the bladder to fill. I'm looking at getting a SP and was told I could still block this off as well. Is this not possible?

10-21-2003, 10:12 PM	#6
klj Senior Member Join Date: Aug 2001 Location: New Zealand Posts: 181	Some more info, I can tell when my bladder is fill and then drain into a bag. Looked also at the mitrofanoff option but not many doctors here do this!

10-22-2003, 07:12 PM	#7
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,516	klj - Blocking or clamping a foley catheter is not recommended. Why are you clamping your foley? This can lead to overdistention of the bladder, contribute to UTIs and could precipitate autonomic dysreflexia. Have you had urodynamic studies done to determine the pressures within your bladder? Do you have sphincter spasms? A good urological workup should be done to determine the most appropriate bladder management program for a person living with SCI. A suprapubic catheter is managed in the same way that one manages a foley (IDC) I would urge you to go to the University of Alabama, Spain Rehab Center site; review their resources on bladder management, in particular, InfoSheet #11: http://www.spinalcord.uab.edu/show.a...1&return=21828 CRF

11-01-2003, 06:42 PM	#8
klj Senior Member Join Date: Aug 2001 Location: New Zealand Posts: 181	Why is this not recommended? I know when my bladder is full and unclamp when need to so it can flow. I haven't had an UTI for over 2 years now (touch wood). I do this so to maintain my bladder capacity so it is not free flowing constantly. I use to be able to block off for up to 3 hours now can only go about an hour depending on intake of fluid, but this also shows that the capacity has decreased significantly. I have had an urodynamic study done also, and my uroglosit sees no problem with what I'm doing and says the same methods should work with a suprapubic. klj

11-01-2003, 07:24 PM	#9
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,516	klj - You say that you can tell when your bladder is full. How much urine do you usually expel when it is "full"? One of the reasons for not blocking is that generally, due to the deficits with a SCI, one could easily have a distended bladder. Do you have an indwelling catheter since you have not been able to cath from your chair? It seems, from the information provided, that you could manage with intermittent catheterization. Have you had either a nurse or occupational therapist work with you to help you learn to catheterize? You have noted that your bladder capacity has diminished. Has there been any discussion of the option to do an augmentation (enlargement) of the bladder? Let me get some further clarification about blocking from other members of the SCI Nurse team. CRF

11-02-2003, 05:05 PM	#10
klj Senior Member Join Date: Aug 2001 Location: New Zealand Posts: 181	Thanks for your reply. At present I don't have sufficent hand function or control to self catheterize. I currently have a IDC and after blocking off about 125ml comes out. Looked into mitrofanoff but there are very few doctors who have previously performed this op before. Thought I should at least try a suprapubic first. What exactly is involved with an augmentation? Is this a major op? klj