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Catheter Options?

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  • Catheter Options?

    After many years with ms (slow progressive), I am now a full-time wheelchair user and can no longer hop over to the toilet like I used to. Urgency and spasticity make intermittent catheterization not an option. So I need to get either an indwelling cath (ugh) or an sp. I'm still sexually active (female), so I think I want the sp, though my friend, a doc in Canada, consulted the ms society in Victoria and they preferred urethral caths.

    I would like to hear from others who've made transitions to THE DREADED BAG. I'm also interested in hearing from anyone who's not managed to wear a bag, but who's clamped the sp tube off and on. I've read about the risk of increased bladder pressure. I've had urodynamics and am retaining urine, but don't get UTI's for some magic reason.

    Would appreciate hearing other people's experiences.

  • #2
    Have you considered a Mitrofanoff procedure? This would allow you to continue to do intermittent cath (since you cath through your belly button or other small abdominal stoma), and requires much less hand dexterity, and is easy to do in your chair (no need to transfer to a toilet). Many women on this site have one. You can use the search function with that term to find many previous discussions of this.

    Are you using medications for both your spasticity and your bladder spasms/low capacity/high pressures? Is your urologist an expert in neurologic urology?

    Why does that clinic prefer a urethral indwelling catheter? While many women do use ann indwelling uretheral catheter, over time they can cause damage to the urethra (patulous urethra) and they can leak, esp. after menopause. It is not safe with a neurogenic bladder to clamp off either an indwelling urethral or SP catheter. You must wear a bag (either bedside or leg type) all the time.

    Please complete your profile. It makes it a lot easier if we know a little more about you to provide you the information and advice you are seeking.

    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.


    • #3
      Can't figure out

      how to add to my profile, sorry. I'm not sure why the Victoria clinic does not like SPC. My uro does work with a lot of m.s. patients. I think I need to make another appt with her once I've gathered information, since she seemed to think a valve was an option.


      • #4
        Click on "User CP" to see and revise your profile (after logging on). It is on the top blue bar toward the left.

        Ask your urologist if they are an expert in neurologic urology. Many are not.

        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.


        • #5
          looper here again

          okay, I added to my profile. The victoria ms clinic told my friend they didn't like sp caths because of risk of infection, stones, and bladder cancer, but on this site I've learned there are equal risks with any indwelling catheter.

          I believe my uro has expertise with neurological issues--she has a good reputation in the ms world. But I now see that I need to make an appt and bring in the information I've gleaned from this site.

          I've had a baclofen pump for 8 yrs to manage spasticity. I use the oxytrol patch for my bladder.


          • #6
            Hi there looper, i am a T7-L1 complete para from Transverse Myelitis. I have a supra pubic catheter, been in for two years, I have it changed by a nurse every 4 weeks. I use an on/off valve that I release every couple of hours. It works really well for me as I hate the idea of a bag. I use an overnight drainage bag though.
            I don't have any problems and I have a neurogenic bladder and none of my medical practitioners have advised against using an on/off valve. I have had a few minor UTI's but now take Vitamin C and Cranberry high dose tabs that keep my urine acidic so bugs don't grow. I am very happy with the supra pubic, it is good on car trips too as I empty my bladder into a bottle to save making toilet stops every couple of hours. The trick is to have a male cath as they are longer, I use a size 16 Releen foley.
            Hope this is helpful info for you.


            • #7
              Hi there Gang I had a supra pubic catheter quite a few years ago and IMOP it made life easier and the risks of infections with any surgery . Truthfully it wasnt bad also used a valve it was great on long road trips lol .

              Now I am older and just got lots on my plate so me and my urologist recently spoke about redoing the Supra pubic cath idea I may opt for it in the future because I am physically tired and weak comes with my age lol

              Being the neck surgery I had 2 yrs back made my throat different I cant drink lots of cherry flavor drinks but I will have A big glass of Cranberry juice the first thing Every morning

              For me Drinking lots of Water is good for the kidneys and thus IMOP beneficial with Non development of kidney stones which occur naturally from things like medications etc... Kidneystones usually are a byproduct of the kidneys overworking to breakdown Medications such as pills and things being Kidneys are our body's filters for urine , they are so painful lol

              I currently Self Cath
              and also I sometimes will have a normal female foley catheter inserted by my Urologist and he removes it every 2 weeks .
              Sometimes I may not have to cath at all depending on my bladder spasms etc...
              I give it all to God

              Beilieve in God and yourself and you can move mountains and overcome things that worry you .
              Hugs and best wishes Think positive When in doubt Consult your Dr


              • #8
                No Thumbs Down Gang
                Think Positive
                The Microfanoff procedure is something i'll speak to my surgeons and Urologist about
                I personally do not like surgical incisions because theres one more pathway for a infection to start .
                But i'll look into it

                No one is perfect but I taught myself how to self Cath and intermittent cath pack dressings , etc because I had to . I love to learn and do things on my own

                We as Humans always learn to adapt to our surroundings . Improvisation is the begginings of invention
                Now I am no Urologist or neuro urological specialist But I am a strong willed old country gal
                lives in a wheelchair and if I need A Dr or Urologist I make sure I get there immediately . I got A Urologist Dr appt the 9th
                Never Say Never


                • #9
                  I know from personal experence that sex is very possible with an indwelling cath, you just need to pull it up towards your belly & off to the side a little.


                  • #10
                    Sex with a catheter

                    Hi all, I have Spina Bifida (so not a spinal cord injury but a congenital abnormality of the spine). Sorry If i'm posting in the wrong spot, just not sure where to ask about this one.

                    I saw people talking about the Mitrofanoff procedure. I used to be able to self catheter but due to issues of being in hospital and in bed a lot, I have had to resort to an indwelling catheter on a leg bag. I was wanting to eventually get back to the self catheterisation but my bladder can't seem to handle it without the bag anymore and I'm not strong enough nor quick enough to get to the toilet in time. Also, given the bladder tone, I'd be there constantly.

                    I was talking to my urologist about the Mitrofanoff procedure a few months ago because it looked to me like the best option when it comes to sexual relations. I worry about the bag, either indwelling or Suprapubic because of the whole discreteness thing. My doc said that with the Mitronoff procedure, there's a 50 percent chance of bladder cancer. What have others heard about this? To me this would be the best option discreteness wise that I can find. I have read about having sex with the catheter I have, but I have no feeling from the waist down so would worry about it being budged, which it sometimes can do when I'm doing transfers.

                    Any advice would be appreciated, and maybe if anyone has heard of any other options? Thanks in advance, Serendipitious


                    • #11
                      The mitro would be best but if your disease is progressive, you may not be able to care for it later on. So then, the Sp is the way to go. TRUST ME, do not go the urethral route!


                      • #12
                        Go for SP made my life much better