[boxermom]

I work in LTC. I have 3 men with BPH with either Supra Pubic Catheter or a regular cath. I need help. We routinely use leg bags 24/7, which I've been told have anti-reflux valves on them.

These poor guys, with the SP cath, continue to get UTI's. The guy with the regular cath won't drink enough, so his cath bag smells after a week or less after changing the collection bag. Due to pockets in his urethra the cath has to changed by the urologist, as do the SP caths since they are fairly new. I have not seen the benefit to the SP cath guys, in fact pain and healing complications have made their status unstable and have made a decline in their ambulation skills.

One of these guys, with the SP cath was started on Pyridium for the pain tid x7 days.We also got an order to flush the cath, cause he started urinating from his penis.

The guy that won't drink enough, with the regular cath, continues to leak urine, even with a larger diameter cath. We had to flush his cath last week x2, because it clogged up with sediment. He has dementia so he won't drink as much as he needs or eat enough.

Any meds out there that would help with BPH ?
Any good Internet sites ?
Cranberry juice?
Cath Policies? Right now cath care Q shift, empty bag q 4hours and prn.
Thanks,
boxermom

[sehbear]

Oh now that is a question with many different sub questions isn't it?
Firstly SPC's certainly do have a purpose in a certain case. Is the patient SPCed because of BPH? Because here we don't usually do that. SPC's are reserved for usually for long term catheterisation clients.
I would be intereseted to know what you areas protocol on leg bag and night bag changes is?
Cranberry juice is an option.. only 40mls a day is needed.
Current research does point towards flushing being detrimental to the lining of a clients bladder
Obvoiusly any patient with a catheter is at risk of infection and unfortunately it is expected to be infected with a certain level of bacteria.
There are also a number of drug trials at the moment hoping to decrease the size of the prostate but no results yet. There are a number of natural health alternatives, but my patients haven't had much luck with them.... one was bovine powder??? work that one out?!?!
Also as a urology nurse we do the first change of SPC when the tract is not formed very well and can close very quickly, but after a good twelve weeks the tract is well formed.
As for internet sites I don't know.. medscape have a good urology section.
Empty the bag every 4 hours will help with ambulation status but not with the infection status as such.
There are also some companies out there that do have anti bacterial catheters - I personally haven't had much experience with them but....

Hope I have been of some help....

Good luck.