Catheters!!

Some of the reasons that we saw in our office were usually caused by a neurogenic bladder. Sometimes this can be caused by diabetes, spinal cord injury, or occasionally just by the bladder muscles getting worn out over time for unknown reasons. Some people could not handle leaving a indwelling foley in all the time, and not really a great solution for long term. Other people were not candidates for an Suprapubic cath. So we would teach them to do the Self Cath, usually QID, so they could completely empty their bladders without having to deal with the collection bags. Oh, and occasionally we would see men with urinary strictures that could be kept open by doing self cath. I am sure that there are other reasons, but those are the most common ones that we saw.

Multiple sclerosis

Bladder dysfunction most commonly results from neurological damage, structural outflow problems, and neuromuscular diseases. Examples are the individuals with spinal cord damage, sacral disc compression, benign prostatic hypertrophy,and MS. It safer for patients to do intermittent self catheterization every 4-6 hours using the same catheter. They are trained to cleanse the catheter with soap and water after each use. The patient is exposed to their own normal bacteria. A catheter can be used a day or a week. Conversely, an indwelling catheter is a constant opening for infection to occur. Unfortunately i know this from sustaining multiple back injuries and developing bladder dystonia-lazy bladder. I have a normal lifestyle as a nurse.

Hope this helps,

Skip

My aunts bladder was knicked during a hysterectomy and caused a neurogenic bladder which required self cathing. She could have had an indwelling cath but works and that is a QOL decision she made

I do straight caths on two students every day. One has spina bifida, and the other has a neurogenic bladder of unknown etiology. The 10 year old self caths and I just supervise, and I cath the 7 year old.

Interstitial cystitis is one condition where a person may have to straight cath themselves on a regular basis.

pregnancy with a tilted uterus...not fun, but having a foley wasn't what i wanted. This was only needed for a few weeks and only used if unalbe to void after a few hrs.

Paraplegic.

Spina Bifida. Or any condition that causes trouble with voiding. The cathing wouldn't be SHORT term as most of the conditions that cause voiding troubles are LONG term.

An indwelling catheter presents a high risk of infection.

I'd like to thank you all for your responses! I learned a few new things. :thankya

Thanks, I learned a few things as well. I didn't realize there were so many people who self cathed.

It safer for patients to do intermittent self catheterization every 4-6 hours using the same catheter. They are trained to cleanse the catheter with soap and water after each use. The patient is exposed to their own normal bacteria. A catheter can be used a day or a week.

This is incorrect. While it is not necessary for those doing intermittent self-cathing (IC) to use sterile technique (clean is fine), it is NOT safer to reuse catheters than it is to use a new, sterile catheter each time. The high rate of UTIs among those reusing catheters is why Medicare changed their rules to cover a new sterile catheter for each use (up to 200/month) instead of only providing 4-8 catheters per month.

For some people with neurogenic bladders like Me, IC is simply not an option. I use an indwelling cath 24/7. I am far from alone in preferring to use a Foley rather than having a suprapubic catheter. And while I am colonized with bacteria, I actually have very few actual UTIs because I drink at least 3-4 liters of water every day, use D-Mannose to prevent e. coli. infections, and do prophylactic bladder washes with a product called Microcyn.

(I'm an incomplete quad wheelchair user with spinal cord damage from C2-T4 resulting from the excision x 3 and radiation of an anaplastic astrocytoma.)