Hi Bomm:
*How could you stand a full time foley for years? Ouch! I think if you go with the intermittent ones and do the following you will find this painfree. In particular if you've been stuck using a foley.
BTW for what its worth. I had prostate cancer which caused acute uninary retention and had to self cath. I had a radical prostectomy done to (God willing) remove all the cancer. Since then I've had light leakage (Pad level) and have had urinary retention problems. I think the bladder is just pooped out before its empty. Plus I notice when its full but I'm not getting a feeling when I'm not empty. +Small bladder for what its worth. Since cathing it does feel different in some subtle way to be fully empty.
I went with self cathing and that lets me empty the bladder fully which seems to be helping with leakage and I don't need to run back and forth to the bathroom.
What works for me has taken some serious time and more then one question to my Uro and her nurse. I'm just a patient not a doctor or expert of anysort so take this for what its worth.
So - thoughts. First I do this the 6 to 8 times a day and its pretty quick and painless. Getting to that point got confusing. If you look around for information you get all sorts of different comments on whats the right way to do it and which catheter is the best.
Picking a Catheter
First - what catheters are the worst? Dry catheters of all types where your supposed to lubricate them and then wash and reuse them. Anything where your handling the part that goes in the urethera is just an invitation to UTIs (I think) I couldn't ever get these to slide it without serious discomfort. You can cover every inch of these type with lube and still have dry plastic rubbing the urethera dry. Where I live and with the insurance I have I can use (And toss) the one time use catheters and this is the way I would go. I believe the "no touch" types will be of aid in avoiding UTIs.
Size
Get some samples from the Uro or one of the supply companies and get a variety of sizes so you can get the correctly sized ones. If its too big you are going to rub raw the urethera and if your doing it 8 times a day? Its going to suck. So start small and fit yourself. Don't expect a nurse to do this or the doctor to be able to guess. Also check out Coloplast (And others)they now have types that telescope out in size. The ones I use (And like) are the Speedicompact or the Speedicompact set. They start small (1st half is 12 French and the last half is 18 French) This way the small end is the part the goes into the bladder (Easier with the smaller tip)
Shape
There are straight catheters that most people use. If you have some sort of blockage a coude' type can more easily get by the obstruction (In my experience)
Slick
Hydrophilics are catheters where wetness reduces the friction by more then 90% (From what I see and have experienced) I'm not too keen on the ones you add tap water and the potential for UTIs based on funky water. Prelubricated is the way to go in my opinion. I think the goal of not touching the Catheter (Except for the Nozzle end) is made easier by pre lubricated Hydrophilics because I don't think anyone of us can get a grip on this type them being so slippery.
UTIs
Wash your hands every single time you cath. After this clean the head of the penis with a Benzalkonium Chloride antiseptic towelette. Start at the tip (Urethera) and wipe around and away. Hygea is one brand that I've used. It helps keep anything on the skin from being pushed in with the cath. One time use (hydophilics) don't get touched except for the actual nozzle. My opinion is you have a lot less chance to give yourself a UTI if your not handling anything that goes internal. If your sexually active and don't use condoms cath before and right after you have intercourse.
Catheter Insertion
See the attached image. The whole idea is to insert the catheter and have it get into the bladder with the least amount of radical bends. My Uro said hold the penis straight outward. This way you have one gradual turn. If your head is zero degrees hold the penis so that its 90 degrees or at a mild up angle. Don't hold the penis straight up against your belly. *I've seen that suggestion on an educational video and this sharp U turn seems like a surefire way to injure the urethera. There are going to be times that your catheter slides right in and your good to "go" Then there are other times you hit the valve for the bladder and it feels stuck. Never Ever "jab it in." Instead close your eyes and wiggle your toes (No kidding) Force just damages tissue. And if your doing this 8 times a day? I've seen an awful video that has an "expert" saying you should insert the cath until urine flows then when the flow stops to?? push the rest of it in as far in as you can??? <-THIS IS WRONG. The whole idea is to get the cath in just far enough for the eyelets to let all the urine empty out of the bladder. Shoving it in beyond that point is going to stab the top of your bladder or God knows what. Put it in just enough to get flow then maybe a fraction of an inch more (Watching to see if the flow increases) then stop. When the flow stops slowly remove the Cath to see if that restarts urine flow. Repeat this a few times until your sure you got rid of all of the urine remove and trash it.
For incidental leakage its good (I think) to have a pad. Or at least have some handy. I've found that cathing on a regular basis seems to have slows (Stopped?) the small amount of leakage I have experienced. My Uro said that if I'm down to one pad a day thats a win. I think so too.
