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Issues with Mitrofanoff catheter causing terrible stress

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  • Issues with Mitrofanoff catheter causing terrible stress

    Hi Everyone,


    I am looking for some advice on behalf of a client on mine; he has cerebral palsy and I provide home care for him several days a week. He has a mitrofanoff catheter and the past few months it has been more and more difficult to insert the catheter, particularity first thing in the morning when his bladder is very full. Here is what we have been doing so far:


    I have him pee into his diaper, several times and so far this has always worked, eventually. However, my client has some behavioral issues and some very understandable anxiety issues and he has built a phobia around anything to do with this catheter, so this process is becoming very stressful and difficult for everyone involved. By the 2nd or 3rd attempt to insert the catheter he is usually very distressed and upset, which of course only causes muscle tension and makes things more difficult. I would love to find some tricks to make this a bit easier on him.


    I have tried applying slight pressure on his abdomen with my hand
    I have tried "twisting" the catheter a bit and have tried using different angles.
    I have also tried re-positioning a bit and having him lie back to relax his abdomen.


    as I said, we always figure things out but what was once a 5 minute process is now bordering on close to an hour and I feel absolutely horrible fro him having to start his day like this. I am wondering if anyone has any tips or words of wisdom? It could make a huge difference for my client!
    Thank you so much to everyone in advance!

  • #2
    How many times per day are you cathing him?

    if the stoma opening is tight for the mitrofanoff? if so you would do well to return to the urologist or talk to his/her nurse who can provide direction.

    You may need some therapy for visualization from a licensed therapist to help the anxiety also place a local anesthetic to the area like lidocaine preparation

    pbr
    Last edited by SCI-Nurse; 09-11-2015, 07:50 AM.
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


    • #3
      Thank you so much for your response. He has a team of caregivers and the schedule generally calls for him to be catheterized 5 or 6 times a day. The longest gap is of course overnight, which is why the first catheterization of the day seems to be the most difficult. I know his Mother is considering doing an early morning (2 or 3am) catheterization, but of course she would like to avoid that if possible. The stoma opening itself isn't tight, the catheter slides in smoothly for the first couple of inches, however when the bladder is very full it just hits resistance. It used to be possible to alter the angle and with gentle persistence the problem would be solved but lately it just seems to hit a wall. And again , it doesn't help that he is experiencing such anxiety which creates muscle tension.
      I like the idea of a therapist, I will mention that to his mother and see if she would consider that.

      Thank you very much for the advice.

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      • #4
        I've had that issue also especially when my bladder is full. My uro told me the channel can kink when the bladder is full. He also gave me a couple of coudae catheters to try. They have a curved more flexible tip. They work.

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        • #5
          Have you tried using a lubricious (hydrophilic) catheter? What size are you using? Type (PVC, latex, silicone)??

          It is not unusual for a Mitrofanoff stoma to require revision, esp. if the person tends to have excessive scarring for wounds on your body.

          (KLD)
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment

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