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  • Neobladder Self-Cath & Irrigation – For how long?

    Posted by Dan366 on April 21, 2008 at 1:24 am

    I’m five weeks past surgery–three weeks past foley removal. The last time I saw my surgeon, he said to continue the self-cath and irrigation at least once a day. Here is what I’m experiencing:

    When I insert the catheter, I experience a stinging sensation after about 3 inches of insertion. The stinging sensation continues for another five inches, and then subsides. I don’t experience any stinging except during self-cath. Urine is not cloudy. When I mentioned this to the surgeon a few weeks ago, he said that he expected the stinging would stop. I’m not seeing any change.

    I usually get only a few cc’s of residual urine. I seem to void most of the mucus during regular urination.

    Questions:
    1) Do you experience stinging?
    2) How long is self-cath usually done?

    Thanks in advance,
    Dan

    mikeg replied 16 years, 9 months ago 10 Members · 12 Replies
  • 12 Replies
  • mikeg's avatar

    mikeg

    Member
    May 15, 2008 at 12:35 pm

    my husband got his neobladder on nov. 5, 2007. when they removed his foley he had to self-cath once in the doc’s office just so he knew how to do it. he has never had to do it since. i can’t imagine why your doc is making you do that. good luck!

    eileen, mike g’s wife


    Michael
    Age 58
    Stage T2-T3, muscle invasive
    Married to Eileen
    2 sons, ages 20 and 23
  • leigh's avatar

    leigh

    Member
    May 11, 2008 at 5:50 am

    Hello Dan,

    I too was advised to self cath once all cathethers had been removed after RC.

    At first it was twice a day to flush my bladder with saline solution. In the beginning I was prescribed a numbing gel to insert in my penis before cathing which did help with insertion of the cath.

    Most of the time I had little mucus or urine being retracted from the cath as like you I could pee it out naturally.

    After a few weeks it also became painful to cath and stung inside my uretha after a 3-4cm and once passed a certain point became easier. I guess regular self cathing makes it sensitive inside with the insertion of a tube a few times a day.

    On my follow up exam one month later at my Urology office I was then advised to reduce cathing to once a week which was great news. My Urologist insisted that I kept up this weaning off schedule. The cathing for me was not to urinate as this could be done naturally but only to flush and cleanse the new bladder to prevent mucus build up in the beginning when production is at it’s highest.

    Three months after my RC and cathing was stopped and since that time I have had no problems that have required me to self cath.

    Many fellow patients of RC are advised not to cath unless having problems with urination. I suppose it depends totally on the type and size of new bladder made for you and if the diversion was successful in all areas and connections.

    Good luck to you and hope that cathing ends soon for you too….

    All th best
    Leigh…


    Leigh, 39
    Dx July 2007
    TURBT July 2007
    RC/Neobladder ,Studer Pouch, September 2007
    Erasmus Centrum Rotterdam
    TNM Classification: pT4 N2 Mo
    4 cycles aduvant chemo Gemzar & Cisplatinum
  • dan366's avatar

    dan366

    Member
    May 9, 2008 at 7:41 pm

    Thanks for the info Carolyn,

    I’ve cut back to once a week, and will probably continue to reduce the frequency.

    Best wishes,
    Dan

  • carolyn-king's avatar

    carolyn-king

    Member
    May 9, 2008 at 4:02 pm

    I would question why you need to continue self cathing. The whole purpose of self catherizations is to drain any residual. If you have less than 60 cc then I think you are doing a good job draining your neo. I was told not to self cath after my neo and I’m 4 months out and never have had an infection. As a nurse also I was curious to see if I was draining well so I did it once and got 20 cc after voiding. I guess it is up to your doctor but why go through the pain, discomfort and the chance to give yourself an infection. DR Koch at IU told me it was not necessary from the beginning. Good luck to you! Carolyn King

  • timb's avatar

    timb

    Member
    April 29, 2008 at 6:29 am

    I agree. your residual sounds the same as mine. and wendy’s point about infection is also worth noting. I only self cathed a couple of times and each time experienced infections a few days after.

    Tim

  • Dmartin12358's avatar

    Dmartin12358

    Member
    April 29, 2008 at 12:04 am

    Hey Dan,

    It doesn’t make sense to cath each day to check for residual post-void urine. That can be done much less frequently. You might consider asking your doctor if it is acceptable to cath once a week this week, then every other week beginning next week, then every three weeks, then once a month…

    Based on my personal experience with my RC 2 1/2 years ago (and what is standard practice at USC/Norris), regular cathing should not be necessary, assuming no problems. Mucus should exit the neobladder when you void. You seem to have minimal residual urine post-void, which is great.

    I cathed twice only, both times to check post-void volume – and that was over two years ago. There was a stinging sensation, pretty painful. Lube helped.

    Where did you have your surgery?


    Dx 7/04, CIS + T1G3, Age 50
    2 TURBTs
    12 BCGs
    Cystectomy 8/05 USC/Norris
    So far, so good (kow)
  • dan366's avatar

    dan366

    Member
    April 26, 2008 at 12:07 am

    Hi Wendy,

    Yes I do use Surgilube lubricant. I’m not sure how long the doctor will require me to continue the self-cath. The next time I talk with him, I will ask.

    He said that the primary reason for self-cathing is to measure the residual urine in the neobladder–I always have only a trace amount (so far).

    I’m also required to measure (intentional) urine output. The purpose being to determine the capacity of the neobladder. Three weeks ago when the Foley was first removed, the amount was only 100cc, with major incontinence. Now it’s up to about 200 (three weeks after Foley removal), with moderate incontinence day and night.

    Things are slowly improving.

    Thanks very much to all for your input.

    Dan

  • wendy's avatar

    wendy

    Member
    April 25, 2008 at 10:48 am

    [quote author=Dan366 link=topic=2148.msg15886#msg15886 date=1208741051]
    When I insert the catheter, I experience a stinging sensation after about 3 inches of insertion. The stinging sensation continues for another five inches, and then subsides. I don’t experience any stinging except during self-cath.
    [/quote]

    Dear Dan,

    Could it be that you need lubricant? What about a smaller cath, even pediatrician size? There are no indications of a stricture, right? Were you instructed to measure output during these early post-op days?

    It’s weird reading how people’s doctors differ on their post-op instructions! I guess there are reasons, like different styles and types of neo-pouches, different sections of the ileum or whatever…but I want to know if you are going to be able to stop with the cathing like these other guys! You aren’t hypercontinent, or experiencing blockage, and cathing is a bit invasive and increases risk of infection, so if should be serving a clear purpose, no?

    I’m not a medical professional and don’t have the answer, the responses only gave me more questions. I’m used to hearing guys say they self cath after RC but not for so long unless there’s an indication.
    All the best,
    Wendy

  • Dave's avatar

    Dave

    Member
    April 25, 2008 at 5:49 am

    HI Dan,

    I also experienced the pain you describe when self cathing, and for a couple of months I was hyper continent and had to cath several times a day. I found that a coude tipped rubber catheter was the easiest as it has a smaller blunt end on it. It is also curved to help go through the prostrate area, which sounds like where you are having the pain. I tried some other catheter samples that were not coude tipped and found them rather painful. Now, nine months after cystectomy, I no longer cath and find that it all flows out quite well. I have one in a backpack I keep with me along with a change of underwear and a couple of pads (just in case)…I haven’t used any of that stuff for months and life is pretty much back to what is typically abnormal.

    Dave S

  • Dale50's avatar

    Dale50

    Member
    April 24, 2008 at 6:45 pm

    I had my neo on 12-2-07 and never did I have to self-cath, my foley was removed at three weeks post surgery and I have been fine since with no problems.

    Dale

  • timb's avatar

    timb

    Member
    April 21, 2008 at 7:35 am

    dan

    I only ever self-cathed a couple of times just so I knew I could in an emergency (blockages etc). My docs advised me against it and said they didn’t want me to cath unless I thought it was necessary. so I never have and I don’t think it’s been a problem. I guess all docs have different ideas and techniques. Maybe you should ask your doc if you can stop. Unless your neo is very different to mine (a W pouch). On the few times I did cath, though, I definitely experienced the stinging sensation you mention. I asked my medical people who didn’t have much of an answer. It never seemed to get better. If you end up having to cath often, you should seek out some of the gels and suchlike that provide an anaesthetic effect. I believe there’s also a variety of different catheters with different coatings to experiment with. I remember someone talking about it somewhere on the forum so have a rummage round!

    Tim

  • skypilot's avatar

    skypilot

    Member
    April 21, 2008 at 1:34 am

    For me it was 2 months once a day after the removal of foley. Then for 3 weeks once a week. I had surgery on Dec 21,07 Since then I just did it once the other day, To make sure I was geting it all out, I was just a few drops left. I did have a spot hurt about 3 inches in for a little distance . It also felt kind of bad on the way out. It was still tender the other day, But not as bad. So every case will be diferant but that is what my Doc had me do. As I understand it to much cathing or to long can be harmful. Don


    Hanging in there!

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