I am considering having a TURP but want to try self catheterizing to see if I can postpone or avoid the TURP. I would appreciate any information as to what to expect, avoid and employ (size, shape, and brand of catheters) as well as any suggestions as to method of insertion (things to do and things to avoid doing). I am scheduled to have my urologists nursing assistant show me how to insert a catheter in a week or so and would like to go into that session as informed as possible. I would greatly appreciate anyone who has had or is having catheter experience to share any words of wisdom with me. Worried in Colorado
I have been self cathing for over two years. It has become second nature. There is a lot of information available on the catheter manufacturers’ websites. There are also videos on YouTube. If you search for self catheterization or clean intermittent catheterization on the internet, you will find a lot of information. There is nothing to be overly concerned with. That said, I injured myself the first couple of attempts. Catheters are made with different materials and tip designs. I found the straight tip latex and soft plastic catheters work best for me. My injuries were from using stiffer plastic coude tip catheters. Some catheters are pre-lubricated or hydrophilic. The catheter manufacturers and distributors will provide samples, once you have a prescription. Try different catheters until you find the ones you like best.
Hi Barry,
I was in your position 5 years ago. My BPH symptons were very bad and I was told I needed a TURP. To say I was worried was an understatement. Fortunately, the medical center was up to date and their protocol in cases like mine was either to Foley the patient for six weeks prior to the TURP or teach the patient to self cath. The reason, based on studies, was that during that six week period the bladder could get a rest and potentially rehabilitate to the point where the TURP would be more successful.
A very long story short, by the time it came time to do the TURP, the self cathing (CIC) was working so well for me that I cancelled the TURP. I have been doing CIC ever since.
I started CIC 6x/day and over time my bladder got better to the point where today I don’t have to self cath every day, and at times I have gone months without it. To be clear, I wouldn’t go into CIC with the expectation of being able to go off it, but many of us have observed some degree of improvement with bladder function because of CIC.
Many here took to CIC like a duck to water with no issues. In my case, I had a very rough first month. There a a couple of self cath threads I started that will detail things more. But happily to say, in spite of my rough start, within months CIC because as routine and painless as brushing my teeth, just didn’t take as long 
If your insurance will cover it, I recommend single use hydrophillic catheters. Less friction. A very good starting catheter is the Coloplast Speedicath Coude model in size FR14. That’s what I started with and then after some practice dropped down a size to FR12. CIC is very easy to learn but technique does help and again, you should check some of the CIC threads.
CIC isn’t for everyone, but for me, and some others here, it has changed my life, as profoundly as any of the stories you read with different successful surgeries, including TURP. And it did so, without some of the risks and side effects such as retrograde (dry) ejaculation. It’s not a big deal to many men, but it is to others. If you’ve never experienced retro ejaculation, your urologist can give you a pill like Flomax to simulate it temporarily.
I see absolutely nothing to lose by trying CIC prior to TURP or any procedure, but try and give it at least 3 months, because again, the beginning can be rough in some cases. But then again, recovery from surgery can be rough for some as well. If you decide CIC is not for you, then you can always revisit TURP or some of the other less invasive procedures. But if it works out for you like it did for me, it will be a real life changer. Please free to ask any question.
Jim
I’ll start out by saying that it’s good that you’re putting off getting a TURP. My original urologist told me that it was the only way that he could address my BPH (I was retaining urine and had already started catheterizing). He started out by saying: “you’ll never ejaculate again”. What he was saying of course was that the TURP procedure would most likely result in the ejaculate going into my bladder instead of out. Instead of getting a bipolar TURP as he was suggesting, I opted to catheterize for several months while I researched my options. About 9 or 10 months later, I had a Rezum procedure done, with excellent results, no Retrograde Ejaculation, etc.
As to the use of catheters, I was instructed in the urologist’s office by a lady PA who did an excellent job of explaining how to use catheters and avoid any UTIs. I don’t believe that this site allows links to be posted, but if you google " how to insert speedicath", there is a good video that should be helpful. I found the Speedicath with coude tips to work perfectly for me, but if you ask 10 guys on here, you will get 10 different opinions about which catheter is best.
Don’t be afraid of using catheters. If you’re careful, there shouldn’t be any pain. Best of luck to you.
Jim, I took your advice and uesd the Coloplast Speedicath catheters for 3 years, resulting in very frequent bleedings.
I was about to give up cic 9 months ago and go for hoLEP, then someone on this forum suggested Cure catheters. They are much much softer and comfortable so I haven’t bled since.
I wished I didn’t start with Coloplast Speedicath. I think they are too stiff, can cause injury more easily.
Actually my usual advice is to try several types of catheters. I tried about a dozen, including Cure Catheters, until I settled on the Coloplast Speedicath Coude. I will also say, from observation here, that most who have used the Speedicath like it. I am happy you finally found a catheter you like.
Jim
I agree with most of what has been said here. I am 83 years old, and about a year ago my urologist recommended the TURP procedure, as I was retaining way too much in my bladder after urination (about 250cc).
After several months of research, and some very helpful advise and information from the CIC-community on this site, I decided to Try CIC, and it has worked out well for me.
I started out with FR12 coude-tip reusable catheters, and have stayed with them. Initially, I was catheterizing 5-6 times a day, but have reduced the number to 3-4: once upon arising in the morning, once before retiring at night (and I never have to get up at night), and once or twice during the day.
I seldom give it a second thought now, as the 2-3 minute procedure is so simple. Care must be taken with hygiene, but that’s been no problem. I use antibacterial liquid soap, Betadine, and rubbing alcohol; the latter injected into the large end of the catheter with an earwax syringe, just before I hang them up to dry.
Barry,
I would recommend the red rubber/latex re-usable catheters to start with they are the softest, most flexable and least abrasive. Bard makes a good one called GentleCath. Bleeding and UTI are very common when first starting to cath, so you should do everything possible to avoid abrasion to the urethra. You have to self lubricate the rubber re-usable catheters, with water soluble lube, and they are very flexible, so you have to insert them with your fingers, which means you fingers must be very clean. My Urologist recommended size 16 in the red rubber, which I still use occasionally, but the 14 or 12 may be easier to get in the first time. You will probably end up using what ever you Urologist’s office has the first time, but they will probably use the red rubber type. Collect the urine in a measuring cup. If it turns cloudy or smells bad those are signs of infection so get help immediately, probably an antibiotic. Rising temperature is also a sign of infection. Be aware of after hours, weekends, and holidays when Urologist’s offices and urgent care facilities may be closed. If possible get an after hours phone number from your urologist.
After you have done CIC for a few days to a week you can try some of the stiffer pre-lubed plastic catheters.
Good luck,
Thomas
I have done both CIC with a regular tip and coude. The regular tip was much easier. The coude was painful. Earlier this year I was scheduled for a bipolar TURP and was hoping to avoid it by doing CIC. I tried, but failed. Too painful. This is easy for some and difficult for others. My urethral lining is very sensitive. My TURP operation was very easy, no pain, and I went home the same day after 4.5 hours, but had to wear a Foley catheter for 3 days after. Had I stayed overnight in the hospital I might have not needed the Foley. My recovery was fast and easy. I am glad I had the TURP. I continue to improve with less frequency/urgency and now my sleep is improving, Retro was not an issue for me.
My only comment is that as you age your Prostate can still grow, and I got to the stage where I could not get the catheter past the Prostate so had a TURP and in 12 months it had grown back and I was self cathing again until that would not work, and they wanted to do it again, but I refused and had it removed as there was Cancer there as well.
When will there be preventive research so that procedures and catheters will be a thing of the past?
great post jim. my only add would be to say you could start small and work up. I bought two or three in sizes 8 10 12 and worked my way up starting with the eight. 12 was good. the smaller ones were to whippy. this was a with a speedicath straight tip. hydrophilic.
You have received advice from several experienced members who follow a CIC routine. As you can see everyone has a little different experience. Everyone’s plumbing is different. A few follow up comments:
In the USA, catheters are sold as single use items. I do not recommend reusing them, except in an emergency. It just invites infection.
The only two times that I have been injured and had bleeding was the first couple of times that I tried inserting coude tip catheters. I have successfully inserted them subsequently, as I gained more experience and confidence. However, if you don’t need them to get around obstructions, why use them. They must be inserted in a certain way, and that just adds to the complexity.
I don’t know what the advantage is for using small diameter catheters. I use size 18FR and 16FR. My uro told me the larger the catheter, the larger the lumen size (inside diameter), which empties the bladder faster.
Try different brands and lubricants until you find the ones that work best for you. There are many options out there. Plastic catheters vary greatly in stiffness, which can make a difference in ease of insertion and chance of injury. Even, hydrophilic catheters vary in the degree of slickness.
Best of luck.
Hi Moto,
You said, "…my only add would be to say you could start small and work up…
The reason I recommend starting with FR14 and working down is because FR12 is significantly more “bendy” and can be difficult for beginners, esp when trying the no-touch “dive bomb” method I talked about in the self cath threads. The idea is to use the smallest size catheter that “works” as smaller size should equal less friction. FR14 is sort of in the middle so you can work up and down depending on how it works. If FR14 is too bendy, or otherwise won’t go in, then move up. If it works fine, then go down. That said, more than one way to skin the cat, and I’m glad you found your own way.
Jim
Just a note on reusing catheters. I am fortunate because of insurance that I don’t have to, but some here have to pay for each catheter. Some of the hydrophillics can be three or four dollars each, so at 180 a month things can add up. Compare that to rotating three or four red rubber catheters a month! If you follow proper disinfecting protocols you should be fine. People have been and still are using disposable catheters for years. Of course the catheter companies would like you to throw them away after a single use, more profit lol This pertains to non-hydrophillic catheters using external lube. Hydrophillic catheters are single use, at least their coating is.
Jim
I want to thank everyone that has jumped in to provide me with the information and comfort that has followed my request for support. I am more appreciative than I can express for the kindness, time and valuable information and suggestions you all have given to me.
This community is an invaluable asset to me and I am sure I will lean on it and learn from it as my personal journey progresses.
Heartfelt Thanks and best wishes to all of you.
Barry
Barry,
That is what we are here for. To crystallize my thoughts, self cathing may or may not be the answer to you situation, either temporarily or even permanently. That said, you might owe it to yourself to find out because there is little downside compared to a surgery which can cause permanent issues. If CIC doesn’t work out, you can always take the surgical step.
As to all the other stuff and debates here on who makes the best catheter, etc, don’t dwell on it, because that’s not the main issue now.
But if you decide to go ahead with CIC, it really comes down to which catheter works best for YOU. That is the best. Try a red rubber, try a coude and a straight, try Speedicath, try Cure Cath. It doesn’t matter which one you use as long as it works for you. I tried more than a dozen before I found what works best for me.
Jim
I don’t think the FDA is concerned about manufacturers’ profits. They are labeled in the USA as single use for the reason that there is a greater risk of infection if reused. For that reason, I don’t recommend reuse, regardless of disinfection protocols.
Barry,
.
I was on catheters for over 10 months before my Rezum which successfully cleared my BPH blockage without any of the complications associated with TURP. After the 1st urologist I saw said that he only did TURP and old mono TURP at that which was at the absolute bottom of my list of BPH surgeries beccause of its’ known morbidity and complications, I decided to see another urologist.
.
If you live in Colorado like I do, there are more options available to you in the metro-Denver area than just TURP. One of the urologists who has been doing Rezum the longest in the U.S. is located in the metro-Denver area. I had my Rezum done at Advanced Urology in Parker/Lone Tree. I would easily go back there again if I needed too. I cannot say that about the 1st urologist that I saw.
.
During the 10 months that I was self-cathing, I had the time to research the various BPH procedures that are available today and also research the various urologists in the metro-Denver area. If you live in Colorado, then you have a lot of options available to you. If the TURP that your current urologist does is the newer plasma/button TURP, then it is not as bad as the old mono TURP.
.
Still, I would not do plasma/button TURP when Rezum is available.
.
Good luck to you,
.
Steve
Correction: One of the urologists who is among those doing Rezum the longest in the U.S. is located in the metro-Denver area.