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Effects of long term foley use on bladder capacity

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    Effects of long term foley use on bladder capacity

    I just spoke with my physiatrist and I am kinda freaked out because he gave me a big lecture on how if I continue using an indwelling I'll never be able to I/C or have a Mitrofanoff unless I get a bladder augumentation. Anyone been in a similar situation?

    "Learn from yesterday, live for today, hope for tomorrow"
    ~ Anon
    Emily, C-8 sensory incomplete mom to a 8 year old and a preschooler. TEN! years post.

    #2
    I know there have been some good posts on this forum concerning this topic, but I'll be darned if I can find them tonight. I think it is possible for some people to go back to an IC program after having a foley, but it may take some time to get your volumes back to where they were. I don't think it is accurate to say you will "never" be able to go back. Everybody's bladder is different. (EMK)
    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.

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      #3
      i have a super pubic

      i cant remember specifics but you start clamping off catheter and gradually build up bladder capacity over 2 or 3 months to whatever is a reasonable amount then do away with indwelling.

      urology seems to be a very opinionated occupation, ask ten urologist same question get ten differant answers

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        #4
        One of the reasons we recommend that everyone using an indwelling catheter stay on an anticholergic drug (Ditropan, Detrol, etc.) is that this will reduce the natural bladder shrinkage that accompanies constant drainage of urine with a catheter. (this will also reduce your risks of both reflux and leaking around the catheter).

        Even with the use of these medications though, over time the bladder with get contracted. Any muscle that is not stretched and exercised with do the same. I would not recommend clamping the catheter on your own without working closely with a good urologist. Clamping of the catheter can cause serious reflux of colonized urine to your kidneys, resulting in kidney damage and/or infection, and clamping can also cause very serious AD.

        If someone wants to go to intermittent cath after years of using an indwelling catheter often this will require a procedure such as an augmentation to be fully successful.

        In addition to the above, we are very reluctant to have younger people use indwelling catheters due to the significantly increased risk of bladder cancer with long term use. For someone who starts using one in their 70s or 80s this is probably not much of a concern as we know that the risk stays fairly low until after 10 years of use, but it is a concern for someone in their 20s, 30s, or 40s (and sometimes beyond this).

        (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.

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          #5
          good advice nurse

          i went for annual check up and had not been taking any daricon, and my bladder had shrunk a lot urologist told me i better start taking meds etc.

          the whole next year i took daricon & purposely would not drain leg bag until ad was more than i could stand. the next year they were surprised how much larger my bladder was.

          they did tell me when i first got the super pubic that it was possible to switch back later?

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            #6
            I've been using an indwelling foley catheter ever since my injury (14 years) and I HATE it cuz I get full blown UTI like once every month, but I haven't really got much choice due to my level injury. Recently I had testing done and been told my bladder's basically shrunk down to the size of a walnut by now. Now the doc is recommending I get bladder augmentation surgery and switch to a suprapubic catheter.

            My question is that if they had known this was going to happen, couldn't they have prescribed a course of action beforehand to prevent this from happening? And how necessary would the surgey be if I still end up with an indwelling catheter?
            "The only true currency in this bankrupt world...is what you share with someone else when you're uncool." - Almost Famous

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              #7
              I agree with KLD (as always)

              Having a good urologist involved in the process is essential. Also, in my opinion Starlight Angel, there is always going to be something that probably should have been approached differently in order for things to work better later. When I was at the last open house Dr. Young said something to me that may explain things...clinicians just don't always know every way to handle sci issues. They often do not read journals and can not know what is the best possible approach for all things. I can't criticize....I have a year of journals sitting here unopened too. Yeah yeah yeah... I will get to it! Take care Angel stay well!!!

              Mary

              ...and she lived happily ever after...
              1FineSpineRN

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                #8
                "Now the doc is recommending I get bladder augmentation surgery and switch to a suprapubic catheter."

                This is not correct procedure. If you get augmentation, you don't continue with an indwelling catheter such as a suprapubic. The two treatments are not consistent with each other in terms of objective. You get augmentation to get rid of the indwelling.

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                  #9
                  I agree. I don't see what would be gained by a bladder augmentation with a suprapubic catheter. Because a piece of bowel is used to create the augmentation, it secretes mucous which can plug indwelling catheters. In my experience, augmentation is usually a part of the Mitrofanoff procedure or used when a person is able to void volitionally. (EMK)
                  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 SCI-Nurse:

                    I agree. I don't see what would be gained by a bladder augmentation with a suprapubic catheter. Because a piece of bowel is used to create the augmentation, it secretes mucous which can plug indwelling catheters. In my experience, augmentation is usually a part of the Mitrofanoff procedure or used when a person is able to void volitionally. (EMK)
                    That's what I thought. With my level injury doing IC of any sort isn't really an option.
                    "The only true currency in this bankrupt world...is what you share with someone else when you're uncool." - Almost Famous

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                      #11
                      So what steps are appropriate for someone who has used an indwelling cath for over three years and now wants to start IC? My husband can IC but has to do it every two hours or he wets himself. We figured it was because his bladder cannot hold very much urine. How can he go about stretching the bladder again? Is it even possible to stretch it?

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                        #12
                        sci-nurse...today a urologist told me indwelling catethers destroys the urethra and should not be used long term. he said extra bad in males. i ask how long on average does it take before damage. he said as soon as 1 year.

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                          #13
                          JJS

                          i think if he takes daricon or some sort of bladder relaxant it would help?

                          try talking to differant urologist, i have seen probably 30 and they all have there own idea of best way to handle bladder problems?

                          the only thing urologist seem to have in common is they never want to hear what another urologist suggested

                          Comment


                            #14
                            Indwelling catheters

                            DA, there are two types of indwelling catheters: urethral and suprapubic. It is the urethral indwelling catheter than runs the risk of damage to the urethra. The most common problems seen in men who use these are urethral fistulas and strictures due to pressure and scarring, especially if there is traumatic insertion or removal. In women, the risk is overstretching of the urethra creating what is called a patulous urethra that no longer seals around the catheter. The risk for this is highest after menopause.

                            Use of a suprapubic catheter will minimize the risk of any urethral damage, but runs the same risk of bladder shrinkage with time. Suprapubic catheters also have advantages for sexual activity, especially for men.

                            (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


                              #15
                              emi...

                              you have a indwelling?!? get that thing out! unless its for the duration of your pregnancy but if i recall you shouldnt be having a problem IC'ing yet. my urologist warned me about the serious dangers of keeping the indwelling. the funny thing is... the 2-3 years i was an outpatient at kessler it was never mentioned. not until i started seeing my current urologist did i know i even
                              had other options besides indwelling. other than a situation such as starlight i dont quite understand why anyone would use an indwelling... [img]/forum/images/smilies/confused.gif[/img]

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