Catheter advice needed

[YogaLite]

A family member had a catheter inserted yesterday due to difficulty passing urine.

Told that's for 2 weeks initially but when I read on line I can see that it could well be nigh on impossible to wean off after 2 weeks.

I was shocked that no other method was suggested and now I am worried it will be here to stay.

Anyone with positive experience? Should they consider earlier removal? Anything else worth trying after coming off it?

Help!

In what context were they given a catheter? I was given one for three weeks after childbirth as I had bladder retention (I would do wees but had a good litre still left in there) it was to give my bladder a rest. It was attached to my leg. A bit grim at first. After three weeks everything had settled down and I did some tests with the ultrasound to makes sure I was emptying properly. All fine.

Just need to keep an eye out on UTIs as I ended up with one afterwards.

Thank u for responding @steponthetightrope

Oh God, yes, the infection is a major worry. And u say that happened even after just 3 weeks :( I hate to think of a potential vicious circle now :(

It was semi-similar scenario for a bit random inability to pass urine despite urgency - but in a male.

Yes, attached to a leg and they are desperately unhappy and would consider removing earlier. But what other options will they be left with?

Did u have any incontinence immediately after removing it?

Urinary retention isn’t uncommon in men, especially if they’re a bit older. Management depends a bit on the cause. The risk of infection has to be balanced against the risk of irreversible kidney damage and infection caused by the retention. Hope it turns out well.

There's loads of options, don't worry.

Depending on the type of management the medical professionals do, to wean him off he will either:

• Have a catheter toggle attached. That means keeping the catheter bout not having a bag. Just a tap at the end of the tube, so he goes to the tiolet and opens the tap to wee.

• He will be taught to self cathetrerise. So no perminant catheter in place. He will be prescribed packs of disposable ones. He inserts when he needs a wee, empties bladder and throws it away.

The person could call there gp practice or the urology department and ask for a flip flow valve. As long as the person has the dexterity to operate the valve and the capacity to remember to empty their bladder every few hours it’s usually given. Most doctors would prefer the catheter to stay in as it’s there for a reason so if the leg bag is making it unbearable then a valve is a good compromise.
It’s totally standard for patients who have gone into acute urinary retention to go home with a catheter, the majority of them will have the catheter removed and have no further problems

Thank you so much for mentioning those other options Fate & Florence and giving us some hope.

I am surprised the options were not mentioned and they went for the bag straightaway.

The tap/toggle could be a sensible idea, will definitely suggest prior to the review.

They could operate the tap/toggle but fixing the bag is such a crude faff, especially at night that the guy needs help with it which makes it so much worse.

The use of a flip flow valve (which is the proper name of the tap/toggle) depends on what issue the catheter is to solve.

If his only issue is retention (ie the bladder is not emptying fully), then the tap thingy or self catheterising could well be offered quickly. But sometimes a catheter is used to allow the bladder to "rest" - in which case they do not want it to hold any wee at all. So a bag is needed then, so that urine can empty out as soon as it enters the bladder.

It's therefore important to listen to medical advice, rather than just assuming you can go straight to the flip flow valve.

Close member of family older male
After radical prostectomy men have catheter for a few weeks than normally it is removed & they check they can pass urine
Sometimes -because of blockage they cannot & need to continue & maybe have a small surgical procedure to clear it
In this case there was an issue which meant they were shown how to self catheterise but after op they were fine
It isn't pleasant to have a catheter but its there for a reason & they need to talk to doctor & ask what is planned

@FATEdestiny, really appreciate your explanation.
The issue is/was not able to empty fully and almost constant urge so I am hoping the valve alone might work otherwise there would be a risk of losing the use of the bladder altogether.

@mumwon, he can't self catheterise at the moment, the bag keeps slipping down and we are trying to work out a more practical positioning method for it.

Human body is so complicated :(

Following this with interest. DH recently had acute urine retention and ended up with a catheter and bag. Hated it! Failed his first attempt to go without it and was given the tap instead of bag. This was better but still not straightforward. He got lots of problems with wee coming out around the catheter and spraying everywhere. Fortunately after 6 weeks he's been able to get rid of it. But has an enlarged prostate and won't be properly ok till that's fixed. He's needing the loo so often!

@Catsrcool69, I fear my relative is heading that way. We have asked for urgent appointment for him to try the tap which might be easier to use daytime.

Before catheter he used to spend ages in the toilet straining but unable to do it. I don't want him to lose use of the bladder so hope the tap would give him a feel he needs to go rather than someone reminding him/checking the bag.

@FATEdestiny, I wonder if u can help me more to understand it.

In case of the family member (in his 30s), it looks like the problem is possibly neurological rather than obstruction.

Maybe our understanding was incorrect, I had always thought that if signal is "lost", the problem would be incontinence rather than inability to get urine out?

His other muscles are not that much affected, I really don't understand what's going on there, I would have thought that human body would try to preserve basic bodily functions as far as possible, eg heart, digestion etc

He hates it and I am not surprised and it would be horrendous if that was now for life.

Any other options/treatments available?

The neurological control of the bladder is quite complex (I’m a doctor and I can’t remember it all!) and involves the bladder muscle and sphincter, spinal cord, brain and peripheral nerves, and also has unconscious and conscious elements. Neuro problems can therefore cause both retention or incontinence depending on where the problem is. Examination and history will probably suggest where the problem is and there are investigations can also help diagnosis. There really isn’t enough in your posts to suggest what the most likely problem is and the best people to advise him are the urologists. Treatment options will depend on what the actual problem is. The meantime, if the only way his bladder will empty is with the catheter then it’s really important to stick with it to avoid infections and damage to the kidneys. HTH.

@Greybeardy, you are awesome, thank you for replying. The uro X neuro appointment is next year, such a long wait :(

I am tempted to pm you with more details but I can see how complicated all this is, not sure if that's ok?

[quote YogaLite]@FATEdestiny, I wonder if u can help me more to understand it.

In case of the family member (in his 30s), it looks like the problem is possibly neurological rather than obstruction.

Maybe our understanding was incorrect, I had always thought that if signal is "lost", the problem would be incontinence rather than inability to get urine out?

His other muscles are not that much affected, I really don't understand what's going on there, I would have thought that human body would try to preserve basic bodily functions as far as possible, eg heart, digestion etc

He hates it and I am not surprised and it would be horrendous if that was now for life.

Any other options/treatments available?[/quote]
Is it Cauda Equina Syndrome (which is nerve damage to the lower spine due to a prolapsed disc)?

Mine was, the symptoms sound similar. Be assured that nerve damage does heal, it just is slow.

With me, the nerve to my sphincter muscle of my bladder stopped working. So I felt the urge to go, but was unable to send a nerve message to the ring of muscle at the opening of my bladder and bum. So nothing could come out- hense retention.

There is no element of protecting bodily functions - it is literally pot luck which nerves are damaged, and how much they are damaged.

My nerve damage did heal. I had the catheter bag for about 6 weeks. Then was taught to self catheterise (which is the best option, and not as hard/scary as you might imagine). I self catheterised for about 7-8 months, by which time the nerve controlling the sphincter was working again and I was back to normal.

I echo what Greybeardy said, that if he needs a catheter then he just needs to accept he does and get his head around it. It is the only way he can empty his bladder, so it's important

I was 29 years old when this happened (16 years ago).

@FATEdestiny
Really grateful, pm'd you

OP, I have nerve damage in my bladder (to the point where, when having a urology investigation, the technician said they wouldn't fill my bladder any further - I'd previously had urine retention and ultimately had over 2 litres of urine drained). It's not always incontinence. It can also be not being able to sense when your bladder is full to 'bursting'.

I am very grateful for all comments, advice/recommendations/physio ideas...etc.

So far all I have seen is kegel recommendations but with the catheter it's probably not that effective.

Oh, and another question, apart from obviously keeping everything clean, is there anything else he needs to do/not do to avoid infection or is that inevitable sooner or later.