Male Catheter Problems

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I need some opinons. I have a male patient that we do weekly wound care and monthly foley changes on. We have been having problems with his cath leaking off and on for months now, despite going up in foley size. But the past 2 weeks, even more problems. It has come out 3 times, and he and the staff (facility patient) state he is not pulling it out. Monday when I reinserted it, I met resistance when I got to the sphincter, but he eventually relaxed and I was able to finish inserting it. Well, out it came again today? The balloon was deflated, no obvious s/s of trauma, etc. Again attempt to reinsert, only this time, met lots of resistance and he was complaining of lots of pain. I left it out and got an order for a urology consult. I wasn't sure what could be causing the resistance and recent rash of problems with catheter. Prostate problems maybe? I'm at a loss. I've been a nurse for 12 years, but have never run across a catheter that gave me such a fit until now. But I'm also not a urology expert. Ideas?

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Have you tried increasing the balloon size to 30cc? The leaking may be due to bladder spasms, might request Urispas or something equivalent.

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Yes, that is what we were using the last few times. The leaking doesn't concern me as much as why it was suddenly difficult (no, impossible) to get another in. I guess the urethra could be swollen/irritated from all the reinsertions, but it literally felt as if I was hitting a brick wall. I've had them do that with me before at the point of the sphincter, but usually it will eventually relax and allow you to continue advancing the foley. But this one was not budging, and he was clearly in a lot of pain.

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Specializes in LTC/hospital, home health (VNA).

I agree with HmarieD. It could be bladder spasms..numerous meds to try. Maybe a neurological problems starting...or as you mentioned, BPH or uro problems?

I had a patient who had their 6yo brother (I know!!!) straight cath him and he (not surprisingly) received a tear in his urethra. SO difficult to cath after that.He even needed scoped a time by the doc or 2 because you couldn't pass a catheter at all! I'd say let uro have a go at it!

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Specializes in ER.
I need some opinons. I have a male patient that we do weekly wound care and monthly foley changes on. We have been having problems with his cath leaking off and on for months now, despite going up in foley size. But the past 2 weeks, even more problems. It has come out 3 times, and he and the staff (facility patient) state he is not pulling it out. Monday when I reinserted it, I met resistance when I got to the sphincter, but he eventually relaxed and I was able to finish inserting it. Well, out it came again today? The balloon was deflated, no obvious s/s of trauma, etc. Again attempt to reinsert, only this time, met lots of resistance and he was complaining of lots of pain. I left it out and got an order for a urology consult. I wasn't sure what could be causing the resistance and recent rash of problems with catheter. Prostate problems maybe? I'm at a loss. I've been a nurse for 12 years, but have never run across a catheter that gave me such a fit until now. But I'm also not a urology expert. Ideas?

you're right with the Uro consult. Let them investigate, sounds like you did all that you could and was appropriate.

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