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does the technique used for bladder irrigations make a difference?

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  • does the technique used for bladder irrigations make a difference?

    I've read on this forum some cautions against bladder irrigations and wonder if the reason for them is because of breaking the connection between the catheter and the drainage bag. I understand the reasoning, since you are possibly introducing more bacteria.

    however, my husband has an idea-why not use a sterilized syringe with needles cleaned in alcohol to simply inject the solution into the port (the area we also take specimens from)? the connection would not be broken (I have a SP).
    "courage is fear that has said its prayers"

  • #2
    Originally posted by jennypenny View Post
    I've read on this forum some cautions against bladder irrigations and wonder if the reason for them is because of breaking the connection between the catheter and the drainage bag. I understand the reasoning, since you are possibly introducing more bacteria.

    however, my husband has an idea-why not use a sterilized syringe with needles cleaned in alcohol to simply inject the solution into the port (the area we also take specimens from)? the connection would not be broken (I have a SP).
    I've had a supra pubic catheter for 7 years and have never had one with a specimen port. So, I've not experience with that system. My urologist instructed me to plug or clamp the catheter funnel, wait about 10 minutes, remove the plug or clamp and collect the specimen in a sterile specimen cup.

    While I understand the rationale behind a closed system, I've not had good luck in maintaining one. I clean the leg bag twice a day and the night drain bottle once a day. I instill HydroCleanse or Theracyn AH (Microcyn Technology) daily...very effective in killing bacteria. I instill through the catheter funnel.

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    • #3
      Some research shows less air exposure and therefore less infection. However, we see just as many infections with open and closed. However, you can't irrigate through a port and it be easy if you are using a 60 cc syringe. The pathway for bacteria is from around the catheter is still there.
      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
        Originally posted by gjnl View Post
        I've had a supra pubic catheter for 7 years and have never had one with a specimen port. So, I've not experience with that system. My urologist instructed me to plug or clamp the catheter funnel, wait about 10 minutes, remove the plug or clamp and collect the specimen in a sterile specimen cup.

        While I understand the rationale behind a closed system, I've not had good luck in maintaining one. I clean the leg bag twice a day and the night drain bottle once a day. I instill HydroCleanse or Theracyn AH (Microcyn Technology) daily...very effective in killing bacteria. I instill through the catheter funnel.
        just out of curiosity-what is a "night drain bottle"? also, where do you buy these products?

        I'm so grateful for your counsel and suggestions on this forum-I'm sure that you help many by sharing your experience!
        "courage is fear that has said its prayers"

        Comment


        • #5
          Here is a night drainage bag.

          https://www.healthproductsforyou.com...CABEgL5H_D_BwE

          Here is a night drainage bottle.

          https://www.medicalmega.com/medical/...SABEgLwcvD_BwE
          ^^(A)^^

          Comment


          • #6
            Originally posted by jennypenny View Post
            just out of curiosity-what is a "night drain bottle"? also, where do you buy these products?

            I'm so grateful for your counsel and suggestions on this forum-I'm sure that you help many by sharing your experience! Thank you.
            Yes, the second reference that "Darty" makes is the night drain bottle I use. Here is the reference at Urocare: https://www.urocare.com/EN/Products/4100EN.php
            The Urocare night drain bottle can be purchased at most urologic oriented medical supply outlets online.

            I set the bottle in a plastic shoe box, just in case there is a leakage problem. The shoe box sits on the floor for the lowest drainage position possible.

            Comment


            • #7
              so, you think it would take too long to inject this much liquid into the sample port. I've read that the CDC isn't in favor of irrigations-is this because of the research about breaking the connection that you mentioned, or another reason?

              I'm not understanding "The pathway for bacteria is from around the catheter is still there." can you clarify, please? thanks!
              "courage is fear that has said its prayers"

              Comment


              • #8
                I have never heard what you said but here it is on youtube with many other videos.

                https://www.youtube.com/results?sear...foley+catheter

                https://www.youtube.com/watch?v=eIh64la4hWI&t=249s
                Wish I didn't know now what I didn't know then.
                Bob Seger

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                • #9
                  An important distinction is the difference between IRRIGATION (flushing of the catheter using significant force) and INSTILLATION (putting chemical solutions into the catheter/bladder with low force).

                  While instillation of solutions is most safely done without breaking the system (ie, through the urine sampling port on a urinary drainage bag), effective irrigation (ie, to break up blockages due to either encrustation or blood clots) usually requires that you break the system and use a catheter-tipped syringe with some force to be effective.

                  (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


                  • #10
                    Originally posted by jennypenny View Post
                    so, you think it would take too long to inject this much liquid into the sample port. I've read that the CDC isn't in favor of irrigations-is this because of the research about breaking the connection that you mentioned, or another reason?

                    I'm not understanding "The pathway for bacteria is from around the catheter is still there." can you clarify, please? thanks!
                    Routine irrigation is not recommended by the CDC as there is no evidence that this prevents or effectively treats catheter clogging, and plenty of evidence that breaking the system to do so increases the risk for introducing bacteria into the catheter, even if done with "good" sterile technique. Irrigation should be reserved for emergencies where it is needed to open a catheter that is completely blocked by encrustations or blood clots.

                    Most bacteria enter your bladder both along the interior lumen and the external surface of the indwelling catheter, which is facilitated by the development of the biofilm that starts to develop along these surfaces within a day or two of catheter insertion. Biofilm is like mucous, and allows the bacteria to travel up these surfaces from outside your body to the bladder (and beyond).

                    (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


                    • #11
                      Originally posted by gjnl View Post
                      I've had a supra pubic catheter for 7 years and have never had one with a specimen port. So, I've not experience with that system.
                      Urinary sampling (and instillation) ports are found on most bedside drainage bag tubing immediately below the connector to the catheter. The port is not part of the catheter itself. This allows the collection of a urine sample with a syringe and not to have to break the system. Most modern ones do not require a needle, just a slip-tipped syringe to access.

                      Physicians are often not very up-to-date on standards for CAUTI (catheter associated urinary tract infection) prevention as established by APIC and the CDC.

                      In this example, the port is the blue "nub" on the side of the drainage bag tubing:


                      (KLD)
                      Attached Files
                      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


                      • #12
                        I have a very serious problem whenever I am hospitalized. I have an augmented bladder is very overactive, despite Botox, and there is no way I can reliably utilize a four hour cath schedule in a hospital, especially if one is on IV fluids. Once I start getting the signals that I do that my bladder is going to pop, it is may be 45 seconds to a minute before it comes shooting out the umbilical stoma. It has been quite disappointing.

                        To make matters worse, I still produce a tremendous amount of mucus, whether bowel mucus or inflammatory mucus. At home I irrigate twice per day to remove this mucus.

                        Whenever I am in the hospital my Foley plugs up at least every day, sometimes multiple times per day. The mucous plugs the catheter and perhaps the collapsing of the augment "tent" around the catheter also blocks it. However, hospital protocol dictates that they do not open the system to minimize infection. I understand that, but also cannot live in urine soaked sheets multiple times per day. That, hospital staff do not like to change. So I have them prophylactically irrigate the Foley twice per day, requires them to disconnect from the drainage bag and irrigate from the funnel end.

                        It's gotten so bad that I cannot leave the floor for tests without a couple of catheters, lube, and a urinal in case I have a problem somewhere in the hospital. Once the Foley is plugged I get hyperreflexic and my systolic blood pressure can go up to close to 200, when it is normally about 85.

                        I bought several dual balloon Poesis catheters and the next time I am hospitalized I want to have them use these. Is anybody brought their own sealed Foley to the hospital for them to use instead of their own?

                        Even when irrigating at home, I find that at least half the time when I go to pull the piston back out to withdraw the fluid and crud, the piston encounters resistance and I have to disconnect and let it run out the catheter. Obviously, the eyelet probably was jammed up against the bladder wall.
                        Does anybody with an augment experienced similar problems with a Foley?

                        Comment


                        • #13
                          Originally posted by crags View Post
                          I bought several dual balloon Poesis catheters and the next time I am hospitalized I want to have them use these. Is anybody brought their own sealed Foley to the hospital for them to use instead of their own?
                          I have found whenever I have brought something into a hospital that I use regularly, Magic Bullet suppositories, regular daily medication etc., the pharmacy department gets involved to check for expiration dates, dosage and strength, etc. Even once the pharmacy department has given its "blessing," the staff is reluctant to allow usage of things brought into the hospital. I can understand this to a point, liability and all of that, but what I have found works best is to have an order from your doctor. So, "crags" in your case you may want the order from the doctor to specifically state that he wants you to use the Poiesis Duette catheter in ___Fr. size with "xyz" brand leg bag, extension tubing and night drainage bag.

                          Comment


                          • #14
                            Originally posted by SCI-Nurse View Post
                            Urinary sampling (and instillation) ports are found on most bedside drainage bag tubing immediately below the connector to the catheter. The port is not part of the catheter itself. This allows the collection of a urine sample with a syringe and not to have to break the system. Most modern ones do not require a needle, just a slip-tipped syringe to access.

                            Physicians are often not very up-to-date on standards for CAUTI (catheter associated urinary tract infection) prevention as established by APIC and the CDC.

                            In this example, the port is the blue "nub" on the side of the drainage bag tubing:


                            (KLD)
                            I thought possible the poster was referring to one of these 3-way port catheters, which is specifically designed for irrigation:
                            Attached Files

                            Comment


                            • #15
                              Originally posted by gjnl View Post
                              I thought possible the poster was referring to one of these 3-way port catheters, which is specifically designed for irrigation:
                              Those catheters are designed only for continuous bladder irrigation, used after surgery on the bladder or prostate to prevent clots development when the surgical area is still bleeding. They are not designed for intermittent irrigation nor for use as a urine sampling port.

                              (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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