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urethral catheter popping out: is suprapubic a good solution

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  • urethral catheter popping out: is suprapubic a good solution

    Hi all

    I am facing the decision to have a suprapubic cath inserted after the urethral one has begun popping out spontaneously on a semi regular basis ( 3 x this week) other times goes months in-between. but been happening for a year and drs were waiting for a systemic bug to clear out of my body before any surgery could be considered.

    The urologist recommends a supra because the balloon coming out will eventually damage urethra permanently.He also recommends botox at same time as believes leaking around cath and ejecting are from spasms and i dont tolerate oral meds well ( hazy thinking/blurred vision/ dry mouth etc)

    So i have some questions

    1 How fast do i have to make this decision i.e. long/ how many pull outs does it take to cause irreversible damage
    2 for those who have swapped did you get more or less UTI's ( I never get ANY)
    3 is my phobia of ripping it out of my belly if the tubing catches on something irrational?

    HISTORY

    I have been a complete t5 para for 34 yrs since accident when i was a kid. Self cashed until 5 years ago when I swapped to a urethral indwelling cath because an overuse injury to my arms caused my to shift to a powered wheelchair and also need to lay down to dress and undress/ toilet.

    Originally this was temporary till i had a total diagnosis/treatment for ams and knew what my new normal would be. I then thought either i would regain function to cath and b faced with the botox/ ditropan and leaking saga agin (which actually sucked having an indwelling has given me the BEST quality of life no leaks/puddles/ changing every few hrs and dry mouth from meds).

    Option 2 would have been a mitrofanoff and either botox or augment etc. but I'm presently in hospital receiving treatment for osteomyelitis on my heel when this occurred so surgeon is now looking for a short term fix as I don't want to damage my urethra permanently in the meantime with cath ejecting in hospital. The other surgeries are a big step require lots of tests finding a good surgeon and being sure- none of which i can do confined to bed with an elevated healing foot wound.

    So urology here suggested this interim measure

    Anyone gone through a similar desion or got feed back.

    I think my fears are silly

    - wanting to go swimming/ wear a bikini pants etc without the cath showing
    - scared of it pulling out through my belly
    - it freaks me out the idea of some permanent frankenstein tube ( i know i have a leg bag anyway but for meI'm used to that my whole life as useful during flights or travel to inaccessible areas, not permanent or disfiguring)

    thanks for reading this post

    and thanks for this whole community
    3
    Have suprapubic after urethral and hate it
    0.00%
    0
    Have suprapubic after urethral and love it
    66.67%
    2
    Had suprapubic and changed to mitrofanoff or mitrofanoff and augment or botox
    33.33%
    1
    Last edited by Jim; 08-05-2016, 07:41 AM. Reason: fixed title
    "The impossible is just that which hasn't been done yet.Impossible is nothing"

  • #2
    This was a symptom of rectal prolapse for me. I'd get a second opinion from a uro-gyne if you have them there.

    I'd also increase the balloon size.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

    Comment


    • #3
      IF it is popping out- instill more water in to balloon but this problem is common in women- as the indwelling shortens an already short urethra. Wha tis he planning to prevent leakage from urethra?
      CWO
      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


      • #4
        Thanks ladies for increase balloon size suggestio.

        CWO that was my question too- how ill it not leak from urethra. 1 urologist said just the botox would work by stopping spasms. I'm skeptical, as always leaked before i had indwelling urethral. . Another said a sling made from fascia may be needed. Today I had a 2nd opinion which was to postpone suprapubic and use ditropan patches in efforts to reduce pooping out and re visit this issue in 6 months when anticipated my foot will be healed and metro/sling/augment can be considered. This was largely because no dr available in this hospital to perform surgery soon= waiting list. I'm all for that as long as no long term damage to urethra in meantime.

        It has 10mm saline already and size 18 to stop leaking. Can it hold more in balloon?
        "The impossible is just that which hasn't been done yet.Impossible is nothing"

        Comment


        • #5
          I always go about 12-15.
          Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

          T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

          Comment


          • #6
            thanks lynnifer i shall discuss with hospital. I was started on oxytrol patches today after a bypassing episode. The instructions they left me say put on abdomen his high- nurse put on my shoulder. hope it doesnt matter. maybe this and more water will help
            "The impossible is just that which hasn't been done yet.Impossible is nothing"

            Comment


            • #7
              Suprapubic tube

              MISS SEPTEMBER: BY ALL MEANS - GET THE "SUPRAPUBIC TUBE PUT IN". Just like u, I too had the same decision to make (4) yrs. ago: I'VE got a BS in Kinesiology and if it's one thing I've learned it is: "Go on the attack". 1. The best catheter I've found is the: Poiesis Duette Dual-Balloon 2-Way Foley Catheter. 2. The best place to buy them is: (shop catheters.com)...I keep 2-18's, 2-16's and 2-14's on hand. D-10018...16...14...$12.99 ea. 3. Medicare will pay for 30 a month. 4. The best uirnary leg bag is: Bard Bedside Drainage from vitality medical.com...154002...single hook 2000 cc...$4.87 ea. 5. Leg bags (church-doctors-swimming Best is
              The (2) bulbs, with the slot in between, keeps the catheter from irritating the bladder wall. I've never had a urinary infection since I started using the POISES 2 Bulb Catheter's...fingers xxx..."PRAYING THIS HELPS" ))

              Comment


              • #8
                Originally posted by mrsea1 View Post
                MISS SEPTEMBER: BY ALL MEANS - GET THE "SUPRAPUBIC TUBE PUT IN". Just like u, I too had the same decision to make (4) yrs. ago: I'VE got a BS in Kinesiology and if it's one thing I've learned it is: "Go on the attack". 1. The best catheter I've found is the: Poiesis Duette Dual-Balloon 2-Way Foley Catheter. 2. The best place to buy them is: (shop catheters.com)...I keep 2-18's, 2-16's and 2-14's on hand. D-10018...16...14...$12.99 ea. 3. Medicare will pay for 30 a month. 4. The best uirnary leg bag is: Bard Bedside Drainage from vitality medical.com...154002...single hook 2000 cc...$4.87 ea. 5. Leg bags (church-doctors-swimming Best is
                The (2) bulbs, with the slot in between, keeps the catheter from irritating the bladder wall. I've never had a urinary infection since I started using the POISES 2 Bulb Catheter's...fingers xxx..."PRAYING THIS HELPS" ))
                My understanding and guidelines my catheter supplier follows is Medicare covers 1 (one) foley catheter per month whether for indwelling urethral or supra pubic use.

                All the best,
                GJ

                Comment


                • #9
                  Unfortunately for women, our bladder needs change over time as well. It really sucks.

                  After I deal with a bowel or rectum prolapse (colostomy), I'll be looking into bladder diversion or mitro as well. It may be something to look into. Keeping the foley in increases your chances of cancer.
                  Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

                  T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

                  Comment


                  • #10
                    I am not sure what the Australian guidelines on catheters are. Sorry that I can not be of more help on that one.

                    Good luck and let us know how you are doing.

                    ckf
                    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


                    • #11
                      Originally posted by SCI-Nurse View Post
                      I am not sure what the Australian guidelines on catheters are. Sorry that I can not be of more help on that one.

                      Good luck and let us know how you are doing.

                      ckf
                      I understand that the original poster on this thread is from Australia, but "mrsea1" is talking about using Poiesis Duette catheters, likely only available in the United States, referencing an online store that probably delivers only to the United States and references Medicare, that is only a United States government program.

                      That said, I will assert my premise again, my understanding and guidelines my catheter supplier follows is Medicare covers 1 (one) foley catheter per month whether for indwelling urethral or supra pubic use.

                      All the best,
                      GJ

                      Comment


                      • #12
                        Originally posted by gjnl View Post
                        I understand that the original poster on this thread is from Australia, but "mrsea1" is talking about using Poiesis Duette catheters, likely only available in the United States, referencing an online store that probably delivers only to the United States and references Medicare, that is only a United States government program.

                        That said, I will assert my premise again, my understanding and guidelines my catheter supplier follows is Medicare covers 1 (one) foley catheter per month whether for indwelling urethral or supra pubic use.

                        All the best,
                        GJ
                        Hi, I'm in the US and have medicare as my primary. I receive three catheters per month and change bi-monthly.

                        Miss September, I have similar issues and am contemplating making the same change. Very interested on what you decide.

                        Comment


                        • #13
                          This company will ship the Duette catheters internationally. http://www.discountcatheters.com/poi...catheter-16-fr

                          And, I found this to be cheapest, if in the U.S. They offer free shipping if you make a $25.00 purchase. http://www.shoplet.com/Poiesis-Medic...FUM9gQodm00P5A

                          Comment


                          • #14
                            Originally posted by Mikki View Post
                            Hi, I'm in the US and have medicare as my primary. I receive three catheters per month and change bi-monthly.
                            Here is the Edgepark statement of coverage at this website: https://www.edgepark.com/inc_cath
                            Did you doctor provide a statement of medical necessity to get extra catheters covered by Medicare for you?

                            All the best,
                            GJ
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