Anyone Self Cathing? I still am after over 10 years.

Men's health
1

Haven’t been here for awhile, but hopefully someone here still remembers me? if not, I used to post a lot about self cathing (CIC).

In a nutshell, over ten years ago my urologist said I would never be able to have a natural avoid again without a TURP. His exact words, “when pigs can fly”.

So they must be flying, because many natural voids over the past ten years and in fact, for the past couple of months, all the voids were natural and my bladder empties completely.

I owe it all to CIC. My bladder ain’t new – nor am I – but it’s in significantly better shape than it was before I started self cathing.

Jim

2

That's good to hear. I've been CIC for three years now, but I don't see much improvement. I still can't empty my bladder. I was doing it 4 times a day until about three months ago. Now I do it 5-6 times a day. I don't know if that will make a difference.

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Are you having natural voids as well, or are you exclusively voiding via catheter?

If you do have a natural void, how many ml of urine comes out of the catheter, right after. That would be your PVR (post void residual).

If you're not having natural voids, how much comes out of your catheter each time.

I have found that tracking the numbers can lead to better CIC strategies that may improve the overall condition.

Jim

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I do have natural voids before I do the catheter. The residual varies, but it's usually in the 300-400 range. My natural voids are around 50-75 mls.

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So adding 50-75 to 300-400, means your bladder at any one time is holding 350-475 mls.

400 should be the maximum, because you don't want to stretch, quite the contrary. The solution then is to increase the number of times you cath today.

When I hit a plateau, I found that giving my bladder a "vacation" helped. So I would increase the frequency of caths per day to keep my total bladder volume down to 300 or even 200ml. After a few weeks of that, I would often find my natural voids started to increase.

I have a few threads here about bladder retraining with CIC, but not sure how to access them.

6

Most of the time during the day, my voids are around 300 or less. The first morning one is usually in the 400 range. I could do it more often, but I'm already doing it 6 times. Usually 5 during the day and once in the middle of the night.

I actually did read a lot of that thread of yours a few months back.

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Hello Jim, I remember your discussions about CIC, in fact I started 5 years ago because of them. I am still doing it 5 to 6 times per day. When I am very full I can void a little on my own, about 50 ml. The PVR after that would be between 300 and 400. Normally I use the catheter and void about 240 ml, without natural void first. It is interesting that you say you increase catheter frequency, to keep "total bladder volume down to 300 or even 200ml" and it increases your natural voids, after a few weeks. Basically you are shrinking your bladder so you feel the need to void at a lower volume. I have never tried that , but I will try it now, and let you know how it works out. Thomas

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Yes, both shrinking and hopefully allowing it to regain some elasticity by not keeping it stretched all the time.

It may also make you feel the need to void earlier, so the detrussor muscles will have to push less urine by the enlarged and obstructive prostate. sometimes I'd cath up to 10 times a day for a month or so for what I call a "bladder vacation".

I still do that every year or so if/when I feel things regressing. Haven't had to cath once for the last couple of months, knock on wood.

Found something new to increase natural voids. I'll post a little later about that in this thread.

Good luck and definitely know how things work out.

Jim

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This is regarding a new natural void technique I have found helpful, but first, for some reason was not able to edit my last post, is this function still available? Anyway, I wanted to add that of course with over 6 CIC's a day, you will probably not feel the urgency, so it's more or less timed voiding as opposed to as you feel it.

So the natural voids. You know if you take a garden hose and put your finger over the end, the water shoots further? That's because you're constricting the hose diameter, therefore building up pressure.

I found the same thing works with my personal "hose" :) The basic idea is that you give it a gentle tug at the start of, or right before you natural void. This lengthens the penis and seems to somewhat constrict the urethra. The result, for me at least, is that the urine comes out under significantly greater pressure. And while I haven't yet, done a volume study, I think the void is also significantly more. It appears that the added pressure, sort of helps suck the urine out of the bladder, almost like a pump. Still looking for a name, but we can use P&P (Pull and Pump) for now :) If you try it, curious if it works for you.

One other natural void technique is voiding while reclining or lying down. I came upon this when temporarily bedridden for another ailment and had to use a urinal. What I found was that I got more void volume in the reclining position. This may have to do with the repositioning of my prostate. This can be combined with "tapping" and/or "tickling/rubbing" the bladder while voiding, both of which seem to stimulate the void reflex. I've gotten 400ml plus natural voids this way very often with almost zero residual.

Jim

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Jim, Yes, I do the pump and pull sometimes and get some to come out that would not have. I think this is similar to milking a cow. Why it works I don't know. It may be that it is changing the shape of the prostate and bladder. The penis is connected to the prostate and the prostate is connected to the bladder so when you pull the penis it pulls the whole system. This allows me to get the catheter into the bladder sometimes, by pulling the penis it pulls the bladder sphincter over the catheter rather than pushing the catheter into the bladder. The connection of penis to prostate to bladder, is the reason some penis length is lost after surgery to remove the prostate . Thomas

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Hello Jim! This must be fate as I haven't looked at this forum for a good 2 years but today I wanted to give a link to this forum to a friend who is having BPH problems. Then I see your name!! WOW! You saved my life back in 2016 when I my kidneys were backed up and I was told I needed to either self-cath immediately or have the RSP surgery. Back then I was taking prednisone just to pee! I came home and searched the internet in panic and found this forum and YOU and you patiently taught me to CIC. To this day every time I finish a cath I always say "Thank you Jim". I guess I'm over 10000 now. I am so glad to see you are doing well. I continue to use your patented dive bomb method and try to follow your 400 rule. It was your 400 rule that got my kidneys and bladder restored to normal. The only catheter I have ever used is the Coloplast Speedicath 14fr Coude hydrophilic. It continues to serve me well. But sometimes if I rush it too much I cause a bad prostate bleed and have to back off the number of caths until the cut heals. I continue to suffer from nocturia polyuria and generate from 800ml to 1000 ml at night. This is the main reason I have not had my prostate removed. It acts like a middle sphincter muscle at night. True I can use kegels to strengthen the outer sphincter for the daytime but at night I would pee everywhere. My prostate is 300 gm but I still have a good NV as long as the total is below 500 cc. Above 500 cc I go into retention. I continue to write down my NVs and my cath volumes. I will try that penis pull method you mention here. One problem I am having is that I am approaching the end of the full length of my catheter at 12 inches. My uro recently did a cystoscopy on me to see if I had developed some curvature to my urethra but in fact the urethra was perfectly straight. He measured the prostate at 4 inches but I knew that because that is where the resistance starts when I CIC - 4 inches from the green cup. This worries me because I would have to move up to a 16 inch Coloplast catheter which is also 14fr and coude tip but not a Speedicath. I did get some samples and they are really scary! The other thing is that the top 2 inches of my current Speedicaths, just below the green cup are not lubricated but instead are very rough. I am told that that is for men who cannot control the green cup and need to hold the catheter further down. My problem is that that rough area enters my penis since I use almost the whole length to get into the bladder. My lube does not stick to that section so sometimes I get irritation. Have you ever heard of someone using the entire length? Anyway, I am so glad to see you are well and I hope life is going well for you. Thanks again for all that you have done for me. I am forever grateful! Howard

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HeyJim, I had a Turp about 4 years ago. Thing seem to improve, not all I had hoped for but better. Seems I have lost what little improvment I had gained. I have went back to having to get up many times each night. Well I sure don't want to go through more surgery!!! I have thought of self cathing at night. I thought just maybe it could help. I am soon to try a Speedicath Coude Tip. I have a very large prostate and have had trouble getting a straight tip passed it. I have ordered the Coude Tip. I self cathed before the Turp with success . Now four years later I have had no success getting passed my prostate with a straight tip. Thanks So Much

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Hi Howard, Good to see your name again. Sorry for taking a couple of days to respond but I just got the notification. This site got even harder to use than before. I have a few thoughts and I'll put them down here within the next couple of days.

Jim

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Hi Howard,

First, thanks for the kind words. Yes, it sounds like we had good timing. I haven't been here much lately for a number of reasons, not do I seem to get notifications. (A little off topic, but do you know what happened to the whole FLA group? Last time I checked, years ago, some were starting to have relapses.)

So, I just learned something about the Speedicath. Didn't realize the last couple of inches weren't lubricated till you told me! I get pretty close to the end myself, so tonight I'll see if I go past that part or not.

If external lube doesn't stick to the catheter surface without the coating, have you tried to coat generously the entire catheter? I did that for a bit when I had some difficulties. What happens is that the lube will then get into your urethra a little, so hopefully when you get to the dry part, it will slide easier. If you try it, let me know how it works out. If that doesn't work, maybe try cathing in different positions, like sitting, where the urethra may be shorter although not sure how convenient that might be.

But if none of that works out, why do you have to go from 12F to 16? Isn't there a 14F? And I guess if nothing works out, you might have to start trying either other hydrophilic's, or non-coated coude catheters that should take external lube better.

So with me, funny thing going on and not sure why, but have a few theories. A couple of months ago had a UTI so was doing a lot of cathing, maybe six times a day. Treated it and since then, no need to cath at all. None. And the crazy thing is that I don't even need to cath if my bladder is holding more than 400ml, which in the past made it impossible for my detrussor's to push the urine past the prostate.

I am going to try and locate my dusty bladder scanner -- haven't used it for years -- and do my own urodynamic study to see if anything has changed, especially with my diverticulum, but it is odd. It's almost like I turned back the clock to a point ten years before I even had to cath!

That said, I did notice that if I don't cath at all my PVR's are high and between my void and PVR, it's definitely over 400ml, which means the bladder may eventually stretch, so as a compromise, even though I don't have to, I'm cathing twice a day, morning and before bedtime, just to give the empty the bladder completely at least twice and also make sure my kidneys are protected, even though I don't think I'm anywhere near a back pressure situation that I had just before I started CIC.

Again, not quite sure why this happened after all these years. One possiblity is that I started doing pelvic floor exercises for an abdominal muscular issue. Maybe 15-20 minutes each morning. Maybe that is it?

Let me know how things go and again, good hearing from you.

Jim

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Hi John, That's what Coude tips are for, going around corners -- and in our case that corner is our enlarged prostate! Just make sure you have the curve going the right way, because it's not exactly intuitive. The tip should actually curve toward you, not away. I posted a good diagram of that, but not sure where it is now.

Surgery won't solve overproduction of urine at night, so don't even think about another surgery for that! The bladder can only hold so much, even if it empties completely. But if you're not getting it emptied completely naturally, cathing before bed, or once in the middle of the night, might help to some extent.

Let me know how the Coude works out.

Jim

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John, I found that if I pull down and stretch my penis, while inserting the catheter, it goes in much easier.

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Thank you, Ted. I will try this.

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Thank you, Jim. I will update soon .

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Hi Howard, I thought that you once solved your bleeding problems with the Coloplast Speedicath 14fr Coude hydrophilic by switching over to the softer Cure catheters. I can see that you now switched back to Coloplast Speedicath 14fr Coude hydrophilic, still with bleeding problems. Did you have problems with the Cure catheters? I'm still using them. Hank

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Hi Jim, I too just got your notification. It's too bad they changed their notification methods. I will write you later tonight and thanks for responding. Howard