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Supra pubic cath

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    Supra pubic cath

    This is a question for (mainly) for SCI nurse/s but any input from users is very welcome too. I am female incomplete T 5 para, 40+post and up untill a year ago I have used the "valsalva" method to empty my bladder. Essentially I can feel when I need to void and my bladder also spasms, which I use to void by leaning forward onto my knees (while on toilet) and pressing on my bladder to initiate voiding. I sometimes need to do this several times(in one session) to empty my bladder. I dont have leaking, or accidents unless I have a uti. Take no meds.

    Issue now is that I have had an indwelling cath for over a year, due to wound on r ischial area and need to be on bed rest 24/7 to heal. My concern is that once wound is closed and I am able to start sitting again, will going back to my old valsalva method put undue pressure on the healed wound? Aside from the leaning forward, holding my breath, straining type pressure there is also the issue of side transfers to toilet several times per day. I also know that it will be another year before the wound, tho closed, is fully "healed" . I've never intermittent cathed, but my understanding is I would need to transfer to toilet for that anyway.

    So, im thinking about an SP, instead of indwelling, for at least a year or so after wound closes. My under standing is that I can change caths w an SP myself, whereas an indwelling needs to be changed by nurse, which I wont have after home health stops.

    So these are my questions:
    1. Would valsalva method be safe to use again?
    2. If not, SP, indwelling or IC?

    BTW, I dont have a urologist with any experience w female SCI in Colorado Springs. Thanks for your input!

    Have you had urodynamics studies to determine bladder pressures and retention? That is a good starting point to help you decide if you should or can go back to the valsalva method of bladder management you were using before the wound and the indwelling urethral catheter. Indwelling urethral catheters in a woman can result in a stretched urethra over time. Intermittent catheterization is definitely an option for a T5 para.

    I think getting some information from the urodynamic studies is your first step and then you can go from there.

    All the best,
    Last edited by gjnl; 3 Dec 2016, 12:31 PM.


      Hi GJ, appreciate your reply. You are of course right, I should see urologist and get the tests done. Its been a while. Finding a doc who knows SCI is a challenge here, but will try the Craig SCI nurse line in Denver and try to get a referral. Thanks!