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Medical Forum / Diseases and Disorders / Prostate BPH / November 2004Self Catheterisation and question for Zork and Daddyo
Zork - you mentioned in the post on Uroxatral that you are retaining 400ml without discomfort, so I guess you have a similar problem to me of an enlarged or floppy bladder. Have your doctors suggested self-catheterisation to you? I am doing this twice daily now, and passing about 75 to 150ml with the catheter during the day and about 200ml at night, after normal urination. The reason I ask is that I was put on this regime (together with Flomax) by the hospital doctors after total retention following an acute urinary infection (see My Story thread above), but when I discussed it with my GP later it was apparent that he didn't like self catheterisation except in extreme cases, and thought it's growing use is a fad. He feels that although there is some risk of infection in not doing ISC he believes that just taking care, together with the occasional ultra-sound scan of the bladder to check on retention levels is enough. I am in a bit of a quandary as to whether to continue, as my retention doesn't seem that severe. At the moment I thought I would keep doing ISC until I see the consultant in a couple of weeks and see what he has to say. Daddyo, I was interested to read your comments that PVP cured your retention. Were you retaining similar amounts to Zork and myself? Did you have a stretched bladder and if so how did the PVP help this? Like Zork, I am retaining without discomfort and am able to pass water normally without a problem, although that may be down to the Flomax. I intend to resist any suggestions of a TURP and go for the PVP if that course of action is suggested, but wasn't sure whether this would aid the floppy bladder retention problem. I'd be interested in any thoughts on this. Thanks Huw NB I must change this mail set up - although Dan is my first name I don't normally use it! We discussed self cath just a bit, he wants to give the Uroxatral a chance first. I have ISC before, its not a big deal at all. An inconvenience, but if it would lessen the chance of infection, would be an option. My URO does both TURP and PVP, he likes the TURP better. Before I would proceed with either, I would want to be resonably convinced that it would solve the retention problem. I not so sure it would. I have a good flow, it just doesn't empty the bladder. And again, no discomfort, no problems, just the darn infections. Maybe ISC would get rid of the urine, but introduce its own problems with infection (???) Probably no perfect solution, am not in a hurry and want to weigh all the solutions before proceeding. Zork ----------- >Zork - you mentioned in the post on Uroxatral that you are retaining 400ml >without discomfort, so I guess you have a similar problem to me of an [quoted text clipped - 25 lines] >NB I must change this mail set up - although Dan is my first name I don't >normally use it! Hi Zork My GP thought that there may be a slight risk of introducing infection with the catheters but I honestly don't think it's likely with the sterile single use catheters I've been given. He also thought that there may be a very, very remote chance of contracting bladder cancer through the long term use of ISC, but said that if I were to continue doing it then they would perform tests after about 10 years to ensure no problems were developing. I agree with you that ISC is not a big deal, in that it isn't even particularly uncomfortable to do, but if I can find a way to avoid the neccessity, preferably without surgery, than I would like to do so. I'm still harbouring a hope that my recalcitrant bladder will spring back into shape of it's own accord. I'd be very interested to hear if the Uroxatral helps the retention problem. Huw > We discussed self cath just a bit, he wants to give the Uroxatral a chance > first. I have ISC before, its not a big deal at all. <snip> Maybe ISC would get rid of the > urine, but introduce its own problems with infection (???) > Probably no perfect solution, am not in a hurry and want to weigh all [quoted text clipped - 4 lines] > >Zork - you mentioned in the post on Uroxatral that you are retaining 400ml > >without discomfort, so I guess you have a similar problem to me of an Huw, In the UK Uroxaltral is marketed as Xatral ( alfuzosin hydrochloride) and also has a modified release version Xatral XL. http://www.fda.gov/cder/consumerinfo/druginfo/uroxatral.htm Derek. > Hi Zork > My GP thought that there may be a slight risk of introducing infection [quoted text clipped - 31 lines] > 400ml >> >without discomfort, so I guess you have a similar problem to me of an Derek Thanks for this. Your message has just appeared but I see it's dated 8.11, goodness knows where ntl have been keeping it......! Huw > Huw, > In the UK Uroxaltral is marketed as Xatral ( alfuzosin > hydrochloride) and also has a modified release version Xatral XL. > http://www.fda.gov/cder/consumerinfo/druginfo/uroxatral.htm > Zork - you mentioned in the post on Uroxatral that you are retaining 400ml > without discomfort, so I guess you have a similar problem to me of an [quoted text clipped - 31 lines] > NB I must change this mail set up - although Dan is my first name I don't > normally use it! I believe that self catheterisation is not a FAD but NHS policy to reduce the workload in A&E. The Urology nurses when I recently went for a flow test suggests self catheterisation to all four of us who had just completed flow tests. Derek. Hi Derek Do you mean that if all these BPH sufferers are doing ISC they will be unlikely to go into complete retention and have to be admitted as emergencies? I guess that might help reduce the admittance rate and perhaps the cost of all these single use catheters on prescription would be balanced out against hospital in-patient care. Did any of you take up their suggestion?! Huw "Derek F." <Lordpilrig@NOXbtinternet.com> wrote in message > I believe that self catheterisation is not a FAD but NHS policy to reduce > the workload in A&E. The Urology nurses when I recently went for a flow test > suggests self catheterisation to all four of us who had just completed flow > tests. > Hi Derek > Do you mean that if all these BPH sufferers are doing ISC they will be > unlikely to go into complete retention and have to be admitted as > emergencies? That was what they were inferring and they also made the point of less bladder infections, less stretching of the bladder and kidney damage. They said that weekends are their busiest time as alchohol is a big factor in retention. > I guess that might help reduce the admittance rate and perhaps > the cost of all these single use catheters on prescription would be > balanced > out against hospital in-patient care. Did any of you take up their > suggestion?! It was given as a suggestion to think about before the next visit. My reaction was "Catheterise three times a day? I'd sonner have a TURP" Derek. > Huw > [quoted text clipped - 6 lines] > flow >> tests. >I believe that self catheterisation is not a FAD but NHS policy to reduce >the workload in A&E. The Urology nurses when I recently went for a flow test >suggests self catheterisation to all four of us who had just completed flow >tests. >Derek. If self cath turns out to be a good option what are the costs involved ? A one time cath I would assume needs a prescription. Are they normally covered ? (I know each health plan is different). Also, I have tried the caths that are 'plain' that have to be lubricated, but the Lofric which you just put water into the bag for 30 sec are really nice. Zork I am using Speedicath coated catheters, which are lubricated and sealed in a saline solution. This is what the urology department gave me and when I ran out I went to my GP and got a prescription for more. He gave me a prescription for 180 catheters, ie 180 for ?6.40, which I think is a pretty good deal for what is obviously a fairly expensive product. They are very easy to use but are in individually sealed containers 18" long which are not suitable for bending in half. So it's not something you can put in your pocket when you go to the pub, but if, like me, you only have to use it once or twice a day it's not so bad. See: http://www.coloplast.co.uk/ECompany/GBMED/Homepage.nsf/0/b578c79a5bc81c08002 56c1a00515810?OpenDocument Huw > >I believe that self catheterisation is not a FAD but NHS policy to reduce > >the workload in A&E. The Urology nurses when I recently went for a flow test [quoted text clipped - 9 lines] > really nice. > Zork Before you think that the NHS is completely mad I should add that I was catheterising 4 times per day until two weeks ago. Huw > I am using Speedicath coated catheters, which are lubricated and sealed in a > saline solution. This is what the urology department gave me and when I ran [quoted text clipped - 5 lines] > pocket when you go to the pub, but if, like me, you only have to use it once > or twice a day it's not so bad. See: http://www.coloplast.co.uk/ECompany/GBMED/Homepage.nsf/0/b578c79a5bc81c08002 > 56c1a00515810?OpenDocument > Huw [quoted text clipped - 14 lines] > > really nice. > > Zork >> I believe that self catheterisation is not a FAD but NHS policy to reduce >> the workload in A&E. The Urology nurses when I recently went for a flow [quoted text clipped - 10 lines] > really nice. > Zork I am using Mentor 16", #10 caths and they are about a dollar each. That could get expensive fast, but I have been reusing the same one for a week or two with no problems. After each use, I wash the cath in disinfectant soap and store it submerged in a jar filled with a bleach solution. To use, make sure to rinse the bleach off. I use a rubber syringe to force bleach and rinse water through the cath. For Lubrication I use Surgi-Glide. A $2 tube lasts for months.  SignatureNelson My retention was never "chronic" and never to the degree of many sufferers. It would occur after things like the ultrasound where a lot of water is taken in a short time and then held until the bladder capacity was measured. Then after the procedure it would never empty properly the first time. The Urologist called this retention and it varied over the years between 50cc and 100cc.I could feel it. Most of the time I had little or no retention,I believe. The other times it occurred were during and after a lot of drinking (of any kind) even peeing every 15 mins.I could tell that I was not empty. Post PVP I feel that I always empty. No hesitancy,no post-dribble and as I have no fat ,I can feel it's empty by pressing on the lower abdomen,just like the Uro's can feel.I have deliberately drunk a large amount of water in a short time to see what happened,with no apparent retention. I fully expect my next ultrasound to confirm this. My bladder capacity is not great yet,I guess about 25% improvement in 3 months up to say 400cc, but the stream is good and most importantly,always good. Richie |
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