Other than UTI, any other reasons foley leaks?

Published

Specializes in BNAT instructor, ICU, Hospice,triage.

Does long term use cause leaking? Bladder spasms are somewhat controlled with pyridium.

Up Vote Up Vote ×
Specializes in ER, progressive care.

Improper catheter size, balloon not being inflated all of the way, weak bladder sphincter muscles. And to my understanding, pyridium is used mainly for the symptoms of UTI and not the drug of choice for bladder spasms.

Up Vote Up Vote ×

Balloon being inflated ON the sphincter.....:eek: But there would be c/o constant pain...

Pyridium does help with the pain of bladder spasms and mucosal irritation.

Long term use does tend to require larger sizes as time goes by. It wasn't unusual to see 22FR and 24FR with LTC residents.

Up Vote Up Vote ×
Specializes in Peds/outpatient FP,derm,allergy/private duty.

Ouch xtxrn! Let's hope they can verbalize the pain! ! Over a long period of time with an indwelling catheter the urethra loses tone and can leak around the catheter. Assuming you've ruled out more serious causes a step up in tubing size should help.

Up Vote Up Vote ×
Ouch xtxrn! Let's hope they can verbalize the pain! ! Over a long period of time with an indwelling catheter the urethra loses tone and can leak around the catheter. Assuming you've ruled out more serious causes a step up in tubing size should help.

Yep......it hurt. A lot. I rammed it up myself, since the dynamic duo who left it there on my sphincter were clueless as to why I was nearly in tears. pee'd me off :D

Up Vote Up Vote ×

Pyridium is an analgesic. Ditropan, or oxybutynin, controls bladder spasm.

Up Vote Up Vote ×
Yep......it hurt. A lot. I rammed it up myself, since the dynamic duo who left it there on my sphincter were clueless as to why I was nearly in tears. pee'd me off :D

:eek::eek::eek::eek:Ouch

Up Vote Up Vote ×

There are numerous reasons for leaking around an indwelling catheter, bladder stones, urethral and or sphincter erosion, small spastic bladder to name a few. It is not good practice for the doctor and nurses to try to blindly fix the problem, the better practice is to refer the patient to urology, for a cystoscopy to determine the cause of leaking.

Up Vote Up Vote ×

Are you changing the cath q month?

Up Vote Up Vote ×
Specializes in ICU, Telemetry.

dishes, the only problem is, in our hospital, we have 1 -- count'm, ONE -- urologist. And he's supposed to be retired ( he's about 105, we joke, "gee, were there kidneys when you went to medical school?"). You call him about a leaky foley, OMG, it doesn't bear thinking about.

What I'd do: First, first, first is the catheter actually in the urethra? Yes, I've had a prior shift try to drain a uterus. Not pretty.

1) check the balloon. How much water's in there, deflate, advance, reinflate to proper size. Look it over from one end to the other. Is it kinking? Are the person's thighs so big they are occluding the catheter? Try to flush it and see if you get back what you put in, or if it shoots out -- if it does, the catheter may be "U" shaped, holding the urethra open enough to leak, enough to catch a little urine, but not doing the job.

2) What's the size? Is this a woman who's had 10 kids, a guy with a long standing catheter? Go up a size if it seems appropriate.

3) Get a bladder scan. We actually had a shipment of bad catheters, and they just weren't draining because the holes were too small. If the person's got 800 in their bladder, that's a good reason for it to leak.

4) Is it really urine? Where's it coming from? I had a patient who actually was "double barrelled" -- she had an opening in the lady parts, and one in the bladder. Somehow, thru the gift of some seriously weird anatomy, she could "pee" out of her lady parts, despite the presence of the catheter.

5) tell the person to relax their bottom like they were going to urinate. I've had folks who must have been doing the "sphincters of steel" videos, because they could clamp down and completely occlude the catheter. When I got them to relax, the urine flowed like a river.

Up Vote Up Vote ×
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Yep......it hurt. A lot. I rammed it up myself, since the dynamic duo who left it there on my sphincter were clueless as to why I was nearly in tears.

Not that it's fun to be sick, but being a patient tells you a ton of information about discomforts our patients feel, and would have no idea how to express. I can't really stop the way my mind works when I am a patient. I keep a mental list of "do this" and "don't do that" for my future patients as I am the patient myself. . . and I must say, my restraint is admirable. :)

. . . .pee'd me off :D

:lol2:
Up Vote Up Vote ×

Yeah. Since I've been disabled, the only thing I can contribute currently is my experience as a patient....I will always have my 19 years of working and what I learned there, but the last 7 years with various problems (from looking for what part of my brain can be hacked off to stop seizures...nothing found that i could do without, to the learning curve of starting insulin (it's not as easy as some pre-fab sliding scale), PEs, TKR, AML, etc....)....my only hope in posting any of my personal info is that someone can use it to make things easier for one of their patients :)

Gotta be useful somehow :)

(and humor helps :D)

Up Vote Up Vote ×
+ Join the Discussion