I've only been self-catheterizing for about three weeks, and wonder if I need to catheterize every time I urinate, or, would it be sufficient to do so only three times a day: upon arising, at mid-day, and before retiring for the night?
Hi Charles,
Being a 1-month owner of a Foley, I'm wondering the pro's and con's of Foley vs CIC's.
Don't you get a "bladder full" feeling, as a cue?
I understand the bladder holds 400-550 mL; and, over-streching may result in loss of tone.
I use catheter about 5 to 6 times a day....it is best to empty bladder frequently so as to not stretch your bladder muscles...also emptying regularly reduces pressure on kidneys and helps to prevent infections...I have been doing it for 10 years, no problem when you get into the habit
Best wishes
It is generally good practice to self-cath first thing upon awakening in the morning after one urinates and at least one more time just before going to bed in the evening. It is important to measure your residual urine amount each time you cath because you will need to add a self cath in mid day if your residual is more than 300 to 400 ml . In my case self-cath three times a day was necessary which I did for 10 months before a TURP procedure corrected my situation which BPH with a prostate size of 80 to 85 CC.
Charles, Are you able to void naturally ? If so you can keep your retained volume under 400ml, with 3 times per day. If you are in complete retention, (unable to void naturally) you may need to cath 5 to 7 times per day or enough to keep the urge down and/or the retained volume less than 400ml. Of course the frequency also depends on how much water you are drinking. I tend to drink less water to keep the frequency down, especially late in the day.
Thomas
As others have suggested, you should measure the volume of your voids (natural and catheter) to determine how much you are retaining. After awhile, you can get a rough approximation from the time it takes to empty your bladder with a catheter. I have been doing CIC for over a year. Before I started, I was retaining 1.5 L. My bladder was enlarged, and when I did void naturally, it was only a few ounces and it took over a minute for that to come out. I currently cath 4 times per day, with no natural voids.
I can void naturally, and the stream has increased in volume since I began CIC about a month ago. Maybe the catheter has somehow opened up the urethra a bit? My residual after urination measured about 250cc using an ultrasound scan in my urologists office, and that was when he said I needed the TURP procedure. I opted to try CIC, and it so far seems like it was a wise choice, as the residual amount after urination has decreased, and is now usually between 75-150cc, urinating about 6-10X/day, and catheterizing 3X/day: upon arising, at mid-day, and before going to bed.
Charles, it depends on the individual. The common practice is dependent on the catheter volume. If it's consistently below 200ml during the day, then you might not need to cath at all, except for perhaps once before bedtime. It's what I have been doing for the last year. If it's above 200ml, you might want to cath more often. How often is up to you. Hank
Congratulations on your ten years of CIC. At age 82, I doubt I'll last that long, but so far it has worked out for me, and had become just another daily routine, like brushing my teeth. I am drinking a lot of liquids, so void 8-10X/day, as I have had a couple of kidney infections; and I am using the catheter 3X/day.
Hi Bob, this is my take on Foley vc CIC. It really depends on how easy it is for you to do CIC. If it is relatively easy for you to self cath, then CIC is definitely better choice. Some people claimed it's easy as brushing teeth. Lucky guys!!!
However, if it's difficult for you to CIC, usually with pain and bleeding, then Foley is the way. Hank
I'm self-cathing 3X/day, and my residual has decreased from about 250cc, to 75-150cc at present, after only one month of CIC. If this success continues, I'll forego the recommended TURP procedure. At age 82 I don't want to take the risk.
Thanks, Hank. My urologist said my residual amount should be less than 100cc, and two ultrasound sounds showed it at 250cc. My catheter volume is now 75-150cc, so has definitely improved. My main concern is that I don't have a continual residual volume sufficient to allow stones to develop in my bladder. I had to go through a laser-procedure a couple of years ago to break up 8 stones that were too large to exit through the urethra--a very unpleasant procedure. I figure that with self-catheterizing 3X/day, I will be able to avoid having this happen again.
Hi barnie, can you share what type and size of the catheters you are using ? Also, do you occasionally run into any difficulty at all ? Thanks. Hank
The ultrasound measurements at the doctor's office tend to be higher because they usually make you sit for a long time before telling you to go pee.
Anyway, 3 times a day is better than once , if you don't mind the inconveniences, or lazy like me. 😀 Hank
I had a terrible experience with the Foley after a bladder stone operation. It was painful, and I constantly felt like I was urinating. It also leaked so badly I had to sleep on a folding cot, outside, with a plastic sheet covering it! The second time was after a kidney infection completely stopped the flow for almost 24 hours, and I had to go to the ER. The Foley was in place for about a week before it was removed, at which time I went back to CIC, which has worked fine since I got the kidney infection under control. My experience with the Foley on this occasion was not a bad as the first post-op experience. I didn't get a "bladder full" feeling while on the Foley, as urine is constantly being released into the bag, or nighttime box. With the CIC procedure I get a mild sensation when the bladder is storing approx. 400cc, but it's easily remedied with urination every couple of hours, and with the use of a catheter about 3X/day.
Bob, If you want to start CIC, the best way is to get trained at a Urologists office and have them order supplies for you. Definitely start out with the Red Rubber type, using KY Jelly water soluble type lube. Squeeze some of the jelly on a towel or gauze pad and twirl the tip of the cath in it to coat the first 4 inches. Size 14 Red Rubber is good to start with. You will have a lot less abrasion and bleeding, but you might have some bleeding the first day or two.
Thomas
I used to go by the clock. I've been doing CIC for about 16 months now. I don't measure every time now but, as someone said, you kinda get to know how much you're getting out. Now, I'm mostly using urges. Whereas at first (I was in total retention for the ultrasound test) I had to be retaining about 400 ml before I get an urge, now I get them at more like 250 - 350. If your natural voids plus your cath volume is over 400 ml on a regular basis then you should probably do it more often. From what you say, it sounds like you are able to do natural voids better than I. Usually in the morning I have to just do it because I know its been at least 6 hours but I don't feel it at all. I'm grateful its that way because I can typically sleep without having to get up most of the night. Often in the morning though I only have less than 300 ml which shouldn't be stretching my bladder out. I understand the normal capacity of a typical male bladder is @400. Trying to keep your residual under 100 ml sounds a little bit rigorous to me.
I do not void naturally at all. I catheterize 5/6 times a day. there is no defined time . it is when you feel that you want to pee. Dont hold it. I used to think I could only use catheters four times a day, but I have learnt that you cannot go by times in between. For example I may go three times in the morning and then another late afternoon, then after tea. Then before I go to bed at 10pm Not always 6 times.. Sometimes 5 ....but never four.
Thanks, Keith. My morning total output is between 500-600cc/ml, so I'm probably drinking more liquids than I should late at night. I've only been at this for about a month, and have much to learn. My residual after urination when I started was 250-300ml, and is now down to about 150ml, so I guess that's progress.
My urologist says that the desired volume when you catheterize should be between 200 and 400 cc's each time. So do the number of times that gets you that result.
Best of luck!