It has been almost 4 years now since I started CIC due to my very large prostate (300 cc). I CIC 3 to 4 times a day and still have a good natural void in between because I do not have a median lobe or other bladder neck obstruction. Other than a few UTIs over the years I have never had any problem doing CIC - until a few days ago. I use the Speedicath 14fr coude hydrophilic catheters and always add a little lubrication to help. No other catheter has worked as well as these. So a few days ago I must have nicked the prostate during entry. That is the problem when we get too complacent with CIC - every time is like a new time requiring full attention. There was some pain and a little bleeding then. But now the problem is really getting bad. The prostate side lobes seem to have swelled up from the nick just enough to block my normal voids and make getting the catheter in difficult and painful. There is no problem getting through the upper part of the urethra but as soon as I hit the prostate it is like hitting a wall. Every time I CIC now I seem to re-injure the original injury so there is a little blood when the flow starts. It quickly clears up and when I pull out the catheter there is always a little blood in the lower part. So I don't see how this original little nick can ever heal when I keep irritating it and cause it to bleed every 8 hours. And there is so much discomfort afterwards too for a few hours. I do not have a UTI as the urine is clear. But I worry I am in a catch 22 because I need to give the injury time to heal but I cannot do that because I cannot do a NV do the swelling. I've taken some NSAIDs to try and bring the swelling down and that helps a bit. Any ideas out there from your experience would be greatly appreciated. Thanks.
Howard,
I had almost the same situation a year ago. Unfortunately, I don't have a solution (since my situation has basically stayed at that new normal) but maybe a tip:
When this happened I was using what I think is the best catheter I've found: Speedicath Compact male.
I had to stop using it because I couldn't pass it through (it is a little stiffer and not coude). So I switched to the one you are using. My recommendation is to split your order into half 14FR and half 12FR. I find that 12FR is easier to pass through when I get stuck.
It has really been disappointing for me because the Speedicath Compact Male were by far the best for me.
You have my total empathy. Best of luck!
Hi Howard, Good to see you again, but sorry to learn that your C.I.C. has gone rough on you! I have a similar bleeding problem when I am testing a different catheter. My solution is to change catheter down one size. I see your normal catheter is Fr-14 coude so I would go to Fr-12 which I think is the next one down, but please check on this. Once everything is stable and the hematuria has cleared up go back to your Fr-14. BTW I'm a wee bit different because I switch through Fr-18. Fr-16, and occasionally Fr-14, and always straight. Other than this I don't know what you can do other than change catheter brand, which I have done three times already. Changing the subject completely, what is happening with "Patient"? I've been trying to contact "Cartoonman" to no avail. If you or Mr. Moderator could help I'd be really appreciative! Howard, I really hope the foregoing works for you. Warm regards. alan86734.
Hi Howard. Sorry to hear that you are going through this.
I don't have any direct experience, but I was wondering if wearing a Foley for a number of days might give the area a chance to heal? I'm guessing you are not keen on having a prostate procedure.
Best of luck.
There are foods we should eat or drink for prostate health.ALot of stuff on the internet just typed in what to eat or drink with BPH.Some stuff can make the prostate grow.You can get herbal remedies but make sure it's the good stuff.
Thanks Arlington. So do you still have some blood every time you CIC now? I had hoped that maybe it would still heal over time but just take longer. Does your bleeding get worse over time? If the hematuria stays open it would be a source for infections to occur. I do have 12fr (straight) but they just jumble up and go no where against my large prostate. Good luck.
Thanks Alan - hope you are well. Did Cartoonman get the FLA with Dr. K a few years ago? Maybe he is better now and has moved on. All the best to you. Howard
Hi rdemyan - My uro's nurse just called me and suggested what you said herr - to wear a Foley for a week. That freaks me out!!! Woudn't the scab form against the foley and then get pulled off when I took it out after a week starting the bleeding all over? And I need the coude tip otherwise the straight end would spear my poor prostate. I am looking now at getting a robotic simple prostatectomy maybe next year. It is offered now near where I live in Canada but it is a major surgery though the few men that I know who have had it have done well. I've ruled out other procedures for massive prostates like Holep, FLA. I just worry what would happen if I couldn't continue to CIC like now!! This has always been my biggest fear. Good luck.
Yes - dairy is very bad for BPH. It is both a growth hormone and an inflammatory food. I used to eat a lot of yoghurt but found that when I stopped it I could CIC much easier and less frequently. Thanks.
Howard, I forgot to mention, my bleeding has always stopped after my first or second post-C.C.C session and, perhaps even more important, I'm on a moderate coumadin (blood thinners) 20 mg/week dose per week. Sorry about that! Warm regards, alan86734.
Thanks for sharing Howard. It's a good reminder not to get too complacent when performing cic. I've been doing this going on 3 years pretty soon. I'm now using a Cure 14 straight tip. For a long time I was using FR12 speedicath coude. I would feel the sharp end of the coude so I switched to a stright tip for awhile. Got tired of the slow draining so I thought I'd try the Cure one; it was also less money to my medigap policy - not that it really matters. I think the private insurers get reembursed by the government under medicare. I like the Cure 14 fr hydrophilic. i got a nick a while back. I think I was holding my penis too much upward; neglected to straighten it out when I reached the prostate. Anyway, thank goodness it must have been minor because the next time it didn't hurt at all. Cic is still a pretty good option for me especially now because I'm retired and home most of the time with the coronavirus thing.
Howard, I was on Foley Catheters for a long time. Actually, 3 months. During that time I had lots of UTIs but the only bleeding came from the bladder itself. Having a rubber hose vibrate up and down while touching the wall of the bladder usually set off some bleeding that would stop after a week. I don't know a thing about CIC, but the Foley would probably reduce the movement a bit over doing CIC for a week or whatever time you are running it. If it was the prostate that you hit, this would relieve the irritation. I don't know if the scab would attach itself to the Foley, even if it was lubed when inserted. However, my TURP is similar to having the prostate "nicked" (and then some) and I'm still healing 4 months out. The urologist told me that prostates take a LONG time to heal. I know that 7 weeks out, I had a lot of blood clots on a cystoscopy view and I don't know that a lot of them have come out. Maybe you can get your urologist to do a cystoscopy just to have a look?
Hi, Howard,
Sorry to hear you're having cathing troubles. Over the past 3 months I progressively had more difficulty with my CIC. I seemed to have the most trouble at the sphincters. Sometimes to reduce inflammation, I've done a water fast for 24 hrs. Someone on the forum suggested it, and I'll send you his information, if I can find it.
Because I was having trouble with CIC and because my bladder stones returned, I opted to go with FLA, which Dr. K did on April 30. My prostate had grown to 120 cc, and he removed the tissue that was pressing into the base of my bladder and prostate tissue along the urethra. In all about 45% of my gland. I'm still early in my recovery, but can report that I've had no pain or discomfort from the procedure. The only pain and discomfort has been from the Foley catheter.
Foley's are a pain, to be sure, but I'd consider that as an option to let things heal up in your body. Dr. K put me in one for 14 days because he removed so much tissue. I was doing okay with it until day 10, when it suddenly decided to come out on it's own! That's another story--but has a good ending.
Steb
Thanks Steb - wow that was a big step and I am glad to hear you are doing well. How did you and Dr. K navigate all the Covid restrictions to get your FLA? Do you live nearby? Did Dr. K also take care of your bladder stones? I cannot imagine having to live with a Foley. I am a crybaby when it comes to discomfort. So you must have just take it out yesterday - how are you now? Please tell me more about your experience. Did the water diet really help with the inflammation? I took Ketorolac for 3 days (strong NSAID) which did bring down the inflammation but then it lead to excessive bleeding from my prostate wound. I am trying to go 24 hours w/o CIC and just small NVs before I have to cath tonight. I might just get the prostate out with the RSP and be done with it. All the best to you Howard
No, the bleeding lasted about 3-4 weeks; however, it is still more difficult to pass through, so I have not been able to go back to the Speedicath Compact Male catheter which was so good for me. I don't know if it's permanent, but my urethra definitely seems more obstructed now. It could have been avoided: my urologist suggested that I go off of my medication since I was using a catheter anyway and that's when it happened.
One difference between you and me is that I have not been able to void naturally (at all) for about 4 years.
I had a PAE in 2015 which didn't work - partly because I have an enlarged median lobe. I'm following the FLA procedure w/ Dr. Karamanian, but am in no hurry until there are more double blind clinical results.
Hey, Howard,
I live in Idaho and flew to Houston for the FLA. Took precautions like wearing face masks, using hand sanitizer and washing my hands a lot. The planes and airports were not crowded at all, which helped. I booked a hotel about 1.5 miles from the surgery center, and the room had a kitchenette so I opted to eat in my room to avoid additional exposure. Several friends offered to go with me, but I declined as I didn't want to possibly expose them to Covid-19. I hired a nurse from an agency in Houston to be with me for 12 hrs after coming out of sedation. It all worked out really well.
Dr. K did not take care of my bladder stones, but he and my urologist in Seattle agreed that doing the FLA first will make stone removal much easier. That surgery is scheduled later this summer, as I need some recovery time.
Your reluctance to use a Foley indwelling catheter is understandable. Chances are you will only need it for a week or less. Like with CIC it's important to keep the process clean. There are medications available to help calm bladder spasms, if you have them. If you go ahead with the RSP, I imagine they'll fit you with a Foley for at least one or two weeks.
I had my Foley in for 10 days, but it was supposed to be in for 14. Evidently, the balloon that keeps it in the bladder deflated or burst, and the catheter started coming out on its own. I almost had to call the EMTs, but Dr. K had given me his personal cell phone #. He told me to call anytime day or night I had a problem or question, so I called. He calmed me down and calmly walked me through the process of removing the Foley. What a relief!
The trauma of the event led to intense bladder spasms for the next 20 hrs, but I got through it.
While my body is adjusting to the FLA, I'm back doing CIC. My prostate is still inflamed from the procedure so CIC can be difficult at times. I'm pleased to report that even with my inflamed prostate, my natural voids this week have increased from 10 ml to 70 ml. The 70 ml isn't consistent yet, but I've had several at 50 to 60. I'm hoping to see that continue to increase. Eventually, I may be able to stop CIC all together.
If you're interested do some research on intermittent fasting. One forum member, Stan98754, talked about it in a thread entitled Prostate Median Lobe. I have found fasting to be helpful and have used it several times over the years.
Hope you find a solution for your CIC problem.
Steb
That's interesting about the fast. In what ways has it been helpful for your BPH?
Best of luck!
Hi Steb, You are very courageous and I admire you. I wish you a speedy and pain-free recovery. It is too bad we all have to deal with the problems. Please keep us informed of your progress. Regarding the bladder spasms - what drug did you use to stop them? Was it effective and what were the side effects? Do you know if Foleys come with the coude tip? With my large prostate a straight tip would skewer my prostate and probably make things worse. Do you have any bleeding now when you NV? Thanks for your help. These are scary problems. Howard
Thanks Arlington, I also had a PAE in 2016 at UNC that provided no relief for me. The IR there told me I could stop taking my medications (Avodart and Uroxatral) but I did not stop taking them. I wanted to see some good results first from the PAE but that never happened. All the best Howard
I had mine at UNC also (2015). I liked them - it just didn't help. My prostate was 57 cc's w/ the enlarged median lobe.