BPH and Catheters

[boxermom]

I posted this on the urology board, but it probably should be in Geriatrics.

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 member.

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:nurse:

[agnewRN]

Our doctors have evaluated some residents with recurrent UTI and put them on Ascorbic acid to help acidify urine . As much as I hate to see it, some residents are on prohylactic antibiotics to prevent recurrent infections.( I also have done infection control in our facility). Does Urology have any suggestion for these problems? Especially with the leaking catheter ?Leg bags- haven't worked much with them- CD bags are generally used. I know the legbag has antireflux valve but I 've only used legbags when the resident is up for the day.Guess I don't really trust it. If the resident goes to bed we change to CD bag. Our policy is pretty specific to rinsing our legbags with a vinegar solution each day after removed. Personally I think a new bag each day is safer but I know it's costly. For BPH there's a variety of meds- Flomax, Cardura(?) , these are the ones I see used more frequently . These are some significant medical issues- sounds like their doctors may need to look at this more if they haven't already. Don't know if this has helped. Good Luck!

[Catsrule16, RN]

I am not endorsing this product but I saw it in use at a LTC facility with a gentleman with some of the same history as you described. The facility also had him on the cranberry tablets. It's called "The Belly Bag" Here is the website.

http://www.originalbellybag.com/

Can be used with a suprapubic or an indwelling. The resident I saw it in use with had a history of pulling out his catheter with the balloon inflated and intact.

Check it out!

[boxermom]

One of my guys are going to Urology next week and I need to get some more ideas. The last time this guy was sent to urology, the MD just said to push fliuds.He has dementia and we feel like we are really "forcing fluids", to a sweet old man who kindly says I just can't drink anymore. the MD didn't even change the catheter. When the family , who were with him, questioned the MD, why he wasn't going to change the cath, he said he could go for months without changing it.

Good ideas.

I remember flushing a catheter with maybe citris acid and clamping it years ago. I also remember giving Vit C tabs po.This one guy hates to take any meds , but liquid meds he tolerates when he is on a ABO.

The bellybag may be a good option for the S/P cath guys who do drink a lot, and I worry what if the leg bag doesnt get emptied. We have used them before, but kind of forgot about them. Either the resident didn't like it or we thought the residents had more infections, but it's worth another try.

Thanks,

boxermom