new self-cather - bladder spasm

[mishahu]

I have only one hand. L2 incomplete. I have areas of full feeling, dull feeling and no feeling in my groin. Enlarged prostate. Many years tap to release but increased retention was found and self-cath recommended.

I had my second try cathing last night.

First attempt was with coloplast speedicath flex. I had no sense of where the catheter was going, and had trouble holding it in place and feeding the cath in. Then it slipped out. After that I tried with a coloplast speedicath compact which was easier to manipulate but I also couldn't sense what was happening inside. It seemed to have gone a fair way in, but there was no urine. Withdrew it and there was a spot of blood on the tip. Call to the nurse consultant who said not to be too concerned about a spot of blood, and to try again.

Last night I used the flex again (this is recommended due to prostate). Again it wasn't easy to handle and sense, but I persevered and it went in. Urine flowed and I thought all is good.

After removing I had a feeling in the tip and head of my penis that I had to go which I assumed was just the remaining sensation of the cath. The feeling slowly increased during the next hour and extended throughout me penis and also in the lower abdomen, not quite pain but very uncomfortable. Lying down it was hard to find a position that reduced discomfort. I dozed and when I roused it had settled.

Dr Google tells me it was bladder spasm. Nurse consultant tells me not to over-worry but to talk to my urologist. Urologist has ordered a urine sample and to go on antibiotic.

I will try the speedicath compact again tonight which I hope will work as a long term solution.

So, the reason for writing is to seek input and other's experiences, and to share mine.

[mishahu]

Used the speedicath compact just now. Insertion is easier holding the casing and guiding the tip in. I definitely felt the resistance and cough/push it went in. I don't think I forced it but it did require more pressure than I liked using. Withdrawing was some resistance but cough/pull it released.

The flex I think is more comfortable but doesn't give the same awareness

The tip had a streak of blood and i noticed a small ball of dark coagulating blood, However there was no blood in the collection bag. Also no sign of blood in the normal pee-in-a-bottle during the day. Although I had little urge to pee during the day and did not produce much.

[mishahu]

Urine was a little cloudier this morning, started antibiotic (1 so far). During the day I noticed some white streak floating in the bottle. I think I'll hold off trying to cath again until this clears up. That should allow any trauma to heal in the meantime. Spoke to Hollister about their product and there are some VaPro Plus Pocket samples on the way that sound like they may be better for me.

[SCI-Nurse]

VaPro Plus Pocket -always good things to say about it. Are you using a lot of lubricant? CWO

[slow_runner]

Used the speedicath compact just now. Insertion is easier holding the casing and guiding the tip in. I definitely felt the resistance and cough/push it went in. I don't think I forced it but it did require more pressure than I liked using. Withdrawing was some resistance but cough/pull it released.
.........

To enable easier ingress of the catheter perhaps try introducing Lubri-Gel into the urethra first?
A friend and I were discussing the methods used for self cathing. He has some resistance so has resorted to introducing 5ml of gel via a 5ml syringe into his old fella first, followed by the catheter tube. He reports a much easier experience. Out of curiosity, I tried it and it was way easier. I haven't adopted this method though as it is no real gain for me and is another step that I do not want to introduce into my cathing routine.
Cathing one handed- impressive. Kudos to you.

[mishahu]

I don't think the problem is lube. Lube has been what's inside the sleeve of the flex or in the tube of the compact. That didn't seem to be the issue. Maybe my stress level was tightening the tubes.

I had another go with the flex before bed last night midnight, sitting on commode. All went well ... insertion successful. I didn't have much of a sense of resistance at the bladder.

The Flex doesn't have a bag, and I wanted to catch the urine in a bottle but couldn't hold it in place while attending to the business end, so I can't say what was in it. There was still some sediment in the bottle during the day.

A question, normally I wake in the night needing to pee (though as expected completely emptying made this not happen), and waking in the morning (which did the last days, except today not). This morning was a #2 day. Usually peeing triggers bowel and/or bowel triggers bladder but today I didn't pee through the whole process. I still had not peed at midday, so I cathed (quite easily but couldn't catch it). Will cathing reduce or stop my ability to tap/pee in the bottle?

The VaPros should arrive tomorrow or Tuesday.

slow_runner - cathing has proved easier one-handed than building the flat pack kithcen for my grandaughter

[Oddity]

I solved my biggest insertion issues with 2 changes: went to coude tip and starting using hydrophilic catheters. Occasionally I'll still have a spasm that, according to my Uro and ultra sounds, causes my bladder opening to shift a bit making it again impossible. He figured out that leaning back would sort that out and he was correct. If I sit on the leading edge of my cushion and lean back against the back rest, flattening out my abdomen, cathing under spasm becomes possible again. Not a great position for sheering type pressure but the Roho helps manage that better than most other cushions IMO.

The hydro-caths are quite good though. I found that external lube worked fine going in but there are a couple tight spots along the way that by the time the cath gets there didn't seem like enough lube was ever left at the tip by the time it got all the way there.

Also, it isn't uncommon for a deflating bladder to trigger a spasm at the very end of cathing. That began happening to me and doc isn't entirely sure why, but said it can be sediment or stones or tumor or bladder hitting the tip of cath, or just my new "normal", because for some folks that just happens. He suggested being back on meds or Botox injections to control the spasms (assuming the ultrasounds and scope on Tuesday don't find anything bad.)

Coude tips, hydrophilic caths, positioning, and Botox/Trospium are my go-to cathing related solutions for my issues of insertion, chronic infection (10+ years ago), and cathing related spasms/pain.

[SCI-Nurse]

So let me share... the first thing a urologist will do if difficulty cathing... instill a 60 mls. Syringe with lubricant in to the urethra-especially for possible prostate enlargement or other possible narrowing. Have been doing this for hundreds of years. Since it can be spasms of the sphincter-try using the 20 mls. Syringe called Uroject-put it in, squeeze top of penis as it will just run out right away, slowly put catheter in, when you come to the area of not going uneasy a minute or two because the lidocaine may not have gotten to that area then try again. The other suggestion-try a coude’ catheter-gas a little curve on the end, insert pointed upward towards your nose. If you don’t have you can try making a slight curve in the end of your catheter. And you can also try a smaller catheter -works for minor construction but if you are putting catheter in and won’t go in , you may have developed a false passage so try the coude’ but in a larger size-why? So it won’t keep going in the false passage. Once you get it in-if you think you might have a false passage-usually get blood/sometimes continues-so once you are sure you are in-blow up the balloon-or keep in -usually for a week or two for the false passage to heal. Or tape to your leg for At least 48 hours after blood tinge urine disappears-because once in-if that difficult, don’t remove it immediately without knowing the cause. And with a lot of manipulation-the urethral/ sphincter can swell because of the irritation. Sometimes scar tissue forms and you have to have it removed. And gentlemen, lubricant and more of it is your best friend. Sometimes just adding more gel to the tube for 8-10 inches over what is already provided us enough. Those kits provide the same amount of gel for women and men, and women don’t need that much. And sometimes there are defects and that that lot of catheters didn’t get enough gel! CWO

[mishahu]

I'm having no problem inserting the cooloplast flex.

Latest installment: after getting almost no urge to pee after the midday cathing, apart from producing about 250ml in the evening, I cathed at midnight. This time managed to aim into the bottle; 1 litre! This morning after no overnight production, I still didn't produce with tapping. Cathed , 400ml.

No sludge in urine, but last night there was a little blood in the tip, that fell on the floor before I could inspect it closely. This morning no blood.

[mishahu]

Sine the morning cath and no normal peeing and realised it was nearly 2pm at work. So, still with no caths with a bag transferred to toilet to cath. NOT EASY!!! Lucky I took two to work as one slipped and was unusable.


My new same old story. My 49 year bladder management practice appears to be no more. No pee and it’s 11pm so I cathed (850ml). Surprised to see I only have 1 size 12 Flex left and a few size 16 samples. And a stack of the Compact. (Hoping frantically that the Hollisters come in the mail tomorrow.) Decided to throw caution to the wind and chose Flex 16. Went in and came out ok. Only used the 12 til now so I was surprised by the speed of the flow.

[mishahu]

#2 procedure is bisalax suppository on waking, breakfast check email etc then on the commode. It takes some straining to make product. As I hadn’t peed and none was coming, I cathed with no issues. After that the next time I strained there was a drop of blood - just a litte ooze - sitting on my urethra. Subsequent strains produced a small ooze that became pinker and clearer. Waiting for a conversation with the nurse consultant about this.

[mishahu]

Everything has settled and cathing isn't such a scary thing any more.

The Hollister VaPro Plus Pockets came, but didn't work for me. The tube is too flaccid and in the very slippery sleeve is hard to control inserting. The collar of the point is narrow and pressed into penis. Ouch. Managed to get it in but too difficult. Flex is easier as the tube is firmer and maintains its shape to guide in. The tip goes in comfortably and to a length that it becomes steady and allows my hand to manipulate the rest of inserting.

I tried the Compact again as well and it worked fine. Was very nervous after the previous experience that set off spasm, but I need a solution when away from home as I have been using Flex sitting on my commode. It was so easy and the procedure was faster and no mess. Looks like that is what I will use long term.

Penis tip has been a bit sensitive since using VaPro … I hope that wears off soon.

So my panic at this change in my like has settled. Time for this thread to be laid to rest. Thanks for the advice above.