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Neobladder, Indiana Pouch and foley catheter

9 years 8 months ago #29790 by mmc
Interesting article.
I'm probably about 5 mins with a 14 and 2 mins with a 16.

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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9 years 8 months ago #29788 by Patricia
i think due to the difference in construction the Indiana is pretty quick to empty. I honestly donot spend any more time empting than i usually would.....5mins in and out. And i never have to flush anymore...after the first year even tho there is still mucus it is more like egg drop soup and comes out very easily.
Did you see my post on the new slings being made in Germany...both for male and female. Will be interesting to see if it gets over here.
http://www.urotoday.com/53/browse_categories/prostate_cancer/stress_urinary_incontinence_after_radical_cystectomy__neobladder_construction_and_placement_of_the_functional_retrourethral_sling__abstract06092009.html
pat

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9 years 8 months ago #29787 by mmc
I wonder if that's why Pouches need to flushed occasionally and Neos less so. I never need to flush but if use a 14, it could take forever to empty.

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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9 years 8 months ago #29785 by Patricia
Mike..as a female with an Indiana...a 14" french is all that will fit...16 will not go in.
And there were written instructions to watch the foley..problem is they didn't know what to expect and thought 70 cc's was plenty. For the next 3 days my output was over 3000 cc's a day..more than 1000 over what i usually put out...that IV was putting way too much into my body and i had a 24hr headache to prove it. I hate to think what my blood pressure was.
I've taken this up with the stoma nurses at Cleveland Clinic and hopefully maybe they can come up with a solution for other hospitals whose stoma nurses just never see much more than ileal conduits. I'm not sure about Hopkins but at Cleveland the stoma nurses have their own building and clinic and are well versed on all diversions.
Pat

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9 years 8 months ago #29781 by mmc
This has been discussed a bit in other forum threads but I thought it might be worth separating this out for posterty's sake.

Folks who have neobladders (and for that matter Indiana Pouches) has a risk of problems with Foley catheters for any subsequent surgery (or anything else that requires a Foley catheter).

Since the neobladder and Indiana Pouch create mucous, that mucous can clog up a Foley catheter. If it clogs, it can prevent any urine from coming out and cause stretching (and over-stretching) of the pouch. This is NOT a good thing. You can also have urine backing up into the kidneys and in at least one case I know of personally can get to the point of life threatening.

If you ever have to go into the hospital and will be getting a catheter for surgery it is critical that the doctors and nurses be made aware of the diversion you have and what to do.

In my case, by the time I discovered there was nothing in the catheter bag after my surgery, I had already retained over 1000cc of urine in my neobladder. I told the nurses to pull the foley and I did a straight cath myself. If you never have had to catheterize, that's ok because you still shouldn't have to. Tell the nurses they need to do a straight cath and suggest a 16 French. The 14 French has much smaller holes so the probability of it letting the mucous flow through it is reduced.

Whenever you get surgery, they are filling you full of fluids through the IV so you should have pretty good output and the nurses MUST monitor this closely. Keep on top of it yourself and ask the nurses about the output. If you are going to "out of it" for a while due to the nature of the surgery, then have somebody come with you who can be an advocate for you and keep an eye on the catheter bag. If output is low, they should do a straight cath.

You would be surprised how often this comes up as a problem and it is something that every RC with continent diversion patient should be told about so they can be on lookout and take the necessary precautions.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

Please Log in or Create an account to join the conversation.

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