Why is catheter insertion sometimes easy and sometimes difficult?

[xsfxsf]

Usually intermittent catheter insertion is easy and straightforward. But sometimes it is more difficult and sometimes impossible. Maybe once every few months. Usually after it is impossible if I wait a while or try again after a few hours it is possible. What is the underlying reason for these changes?

[SCI-Nurse]

You could have scar tissue on the interior lining of your urethra after long term self cathing.- you can try a hydrophilic catheter that has a “slick” surface that eases the catheterization process
depending on the condition of your prostate you could be “bumping into” your prostate if it is enlarged - a coude (slightly bent) catheter could help with that.

SCI-Nursepbr

[endo_aftermath]

Catheter insertion is usually very easy for me, but it depends on how badly I need to drain my bladder. If the need is pretty urgent the catheter just falls in there. But if the need is not there, say I cathed recently but I'm just trying to get that last little bit of urine out before heading out for the evening, it can be very difficult (impossible). Of course, it's easy again if I'm willing to wait a while, but that's not always an option.

[Oddity]

I’m the same. Very hard to insert unless bladder is full. My Uro just said to wait patiently with mild pressure and it will eventually relax. That works most of the time. But when full and urgent to pee there is zero resistance.

[stephen212]

My bladder must have been manufactured in the Southern Hemisphere. :-)

[ChesBay]

I'm similar. When the bladder is full insertion is not a problem.
Sometimes if I know I've got volume in the bladder and I'm getting resistance will extend my legs and get all spasticity out of them.

[stephen212]

If the need is pretty urgent the catheter just falls in there. But if the need is not there, say I cathed recently but I'm just trying to get that last little bit of urine out before heading out for the evening, it can be very difficult (impossible).

It's exactly the opposite for me. When my bladder is sending SOS distress signals, it's MORE difficult for me to pass a catheter (LoFric), so there goes any thought on my part to offer an explanation as to what you're experiencing. The potential treatment, however, might be the same: Optilume® Urethral Drug Coated Balloon for the treatment of Anterior Urethral Stricture. My urologist has proposed the Optilume at the time of my next Botox procedure.

[endo_aftermath]

Reading that, I feel lucky.

[stephen212]

Lucky that there's a treatment??

[endo_aftermath]

Lucky that it's easy when I need to.

[August West]

If it was because of scar tissue, it would always be difficult. If it's sometimes easy and other times difficult, a more likely explanation seems to be muscle tone, for which the reason can vary from person to person and even for the same person, it can vary from time to time.

[Gordy1]

Our son has had problems inserting a catheter at various times in the last few years (he’s almost 20 now). He tried a coude tip one for a while, thinking it helped, but then had problems again. By chance found out that crossing his legs prior to inserting worked every time, so has continued to do that. (His leg joints are very flexible so he finds crossing them easy to do...I’m sure that won’t be the case for everyone.). And by crossing his legs I mean both legs crossed horizontally (like sitting on the floor cross-legged), not just one leg on top of the other.

Bladder drs here can’t explain why it works for him (or what the cause of the difficulty was).

[SCI-Nurse]

This may help to relax the pubocoxxygeal muscle, which forms both the anal sphincter and the external urinary sphincter. (KLD)

[SCI-Nurse]

First of all, are you using a hydrophilic (lubricious) catheter? Much easier to insert for males.

Secondly, do you have an enlarged prostate (ask your urologist)? If so, a Coude tipped catheter may be easier for a male.

Thirdly, you may have a condition call a false passage. Your urologist would have to diagnose this. Treatment is usually 3-4 weeks of an indwelling urethral catheter. This can occur in both passage of an indwelling or straight catheter, and is more common than a stricture.

Last, but not least, external sphincter spasm can be triggered by inserting of any catheter into the urethra. If this occurs, it is best to maintain firm but gentle pressure with the catheter for up to 2 minutes. Don't poke or try to force. The external urinary sphincter is striated (not smooth) muscle and will often fatigue with this procedure and you can feel it relax and the catheter slip through.

(KLD)