The MTG catheter.
They come with lot of names and the one I was sent was the folding pocket one which also has a bag. Now it is possible that there exists later types which improve on this one. I am sure since I send this link to all those who sent me samples, that all manufacturers will start changing their products seeing that now people will know that better ones exist. I suppose they pay the hospitals to train them on their own products but people wont be satisfied with that anymore and will request the best one. Now this catheter tries to get away with the fact that one has to hold the limb tight to stop the catheter falling out. Since it is made to fit in the pocket it is made of very very soft plastic which is no good for this since one can only put in a bit at time according to the video one and a half inches and therefore takes very long. They claim that it is made for those whose hands are not dexterous. You can see the video how they go about it. Basically they have a cap on the tip to make sure catheter can only go one way as you hold it to the limb so it shouldnt fall out. You hold it on the rim of the cap. The problem I found is that since it takes so long my mind wanders and I somehow let go and even still holding both find that it has come out of the limb. I started unlike the video by having six inches of catheter come out of the cap and put the six inches in. It went in very easily. Now you have to hold it there on the rim of the cap pull the end of bag down and put another few inches in till you are finished. But each time and it is often, you pull the bag down your mind wanders away from the cap which you are supposed to be holding and in the end you are just moving the catheter forward but it is not going into the limb. When you are finished you can see how much came out and I think the bladder was emptied. You then have to tear the bag open, youre supposed to be able to do it with your hands but I gave up and used scissors and emptied it. Since the catheter is so soft as I say you can only push in a bit at a time and pushing under the plastic covering is not the same as pushing with a slider. So you push a bit and pull down the bag a bit. Maybe with experience it goes quicker but that is how I found it. I dont think I have to spell out my verdict.
I will now talk about the manfred sauer catheter. I include their website which has a very good and important diagram where the strictures can occur (in five places). I also include the youtube video, (present viewers 1060) which really tells you everything better than I can. I must say that I consider this one the best and safest of all. It was very easy to put in and although on the video it seems he had to use two hands to keep it in, I found one enough since there is no slider to pull it out again and I start six inches away. There is no need to hold the limb tight at all. It is fully covered and stays covered the whole time and really a pleasure to use. Mine did not come with a bag like on the video, it seems that is an extra and that is why all have a funnel at the end. It didnt hurt and quite a lot came out so I think it really emptied the bladder. It isnt very soft and I consider it just right. The plastic cover does bunch and squash down easily to the funnel. I should also add they dont have the 'dummy' limb obscene and grotesque like the others do on their videos! manfred-sauer.co.uk/iqCath.asp
I shall now give my opinion of the catheters I have mentioned one at a time. I will start with the Bard Hydrosil Go that I trained on. It is like a long straw with no covering just a small slider. The tip is not tapered and it has no bag. It is rather difficult not to touch the catheter while inserting it. As I wrote with this type one has to insert it holding the slider about six inches away. Since it is not tapered to a point like a nail it is rather difficult to get it into the opening of the limb. One has to lift up the limb and stretch it sometimes. Also this catheter seems to be more slippery than most and you have to hold the slider tight and you have only two fingers to do it with since it is small. When you put it in you have to hold the limb tight it should not fall out as you move the slider back. It goes afterwards in very easily to the bladder and I believe although as I say I cannot be sure, that it does empty the bladder. It is also one of the quickest to use. So if you have good strong fingers it is suitable but you have to be very careful not to touch it. I cannot recommend it if you dont have strong fingers. I must say I dont like holding the limb so tight. I cant see that they should have a video.
I shall first explain what a catheter is and what it is used for. If for some reason a person cannot pass water then he has to use a catheter, why the hospitals prefer an indwelling one instead of an intermittent one I dont know maybe someone can tell me. The catheter goes into the bladder passing all the 'gates' on the way and the urine passes through it. One has to be trained to use it by a hospital nurse although after reading my posts you will know a lot more about it than a nurse will ever tell you. I cannot see the great difficulty in it and why it needs a special trained nurse and why not every doctor cannot do it. I must state that most of the catheters I have used only once, so I am an inexperienced user. I suppose most people reading this are or at least inexperienced in using a different catheter. It is possible that after using it more often I may come to a different conclusion. Most instructions are rather vague and dont seem to be written for someone like me, and the videos which I will quote are certainly not made by newcomers. Although all the videos make it sound easy that is not what I have found. I must emphasize that all the catheters work and do not hurt but I have no real way of knowing if all the urined comes out. One has to use the correct size a larger size may not fit in. I use a size 14 and one catheter which was written on it size 14 I suspect was really larger and therefore did not fit in. One has to hold it in, by holding the limb (I dont like using the correct word) tight and one wouldnt 'hold' so I suspect it was really less than 14, I cant think of any other reason. So one must basically use the largest size possible. I am not sure if one uses a smaller size, less urine will come out and it will not empty the bladder but I suspect this is the case. Catheters are not allowed to be touched by hand even after being washed which anyway one has to do, so they either have a slider on, or are covered with a plastic wrapping. The problem is, that since the catheter has to be very slippery to go in and up to the bladder one has to hold the slider very tight. Some are very small and and one can only use two fingers which makes it very difficult but others are longer and some a lot longer. One whose fingers are in order wont have any difficulty but not everyone's fingers are so dexterous, mine cant today peel a potato. So you push the catheter in holding the slider, then you have to push the slider back on the catheter before you push the next bit in. What happens then is that the catheter comes out again so it has to be held in by holding the limb tight. It has to go quite far in before one can do that, so one has to start with the slider about six inches from the end of the catheter before putting it in. This is quite far and unless the catheter is tapered like a nail at the end, can be quite difficult to get into the opening. One also sometimes has to lift the limb up and stretch it to be able to do it. There is one catheter which has a much better way of 'holding' it in. There is a cap with a rim shaped like a hat which fits onto the tip at the end in which the catheter only goes one way and you just have to hold the rim to the limb. Some catheters come with a bag with marks on of how much urine it contains, my experience is that they usually all contained about the same amount.Some are made with quite a hard plastic and since there are a lot of bends on the way to the bladder have to be pushed harder but they still go easily. The ones that are too soft and bend easily are much harder to put in six inches away so the best are something in between. Some come with a sachet of saline to flood the catheter before use. One cant use a knife to open the sachet because it is enclosed with the catheter. On the videos they just press the sachet and it opens, I found this very difficult even after using pliers, they just wouldnt open. It took me a long time to open them, maybe I need more experience. That is all for now I intend to write a post of each catheter of how I found it and my opinion of it. I hope also to link the video of each and the number of viewers and see if they increase!
Welcome. While I have not had a cystectomy, your post is important! I am sure there have been many in the past that would learn from a voice of experience. Please post as you see fit and let's trust some that who have those questions can learn from you. Thanks!
DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.