I CIC 4 times a day and have reasonable natural voids in between. But I sometimes develop irritation in the urethra from the catheter that results in inflammation which makes it difficult to natural void so I have to self-cath more often which aggravates the problem. This is just irritation and not a UTI.
I take Advil which helps but was wondering what other people do for this problem. The inflammation creates a lot of pressure which makes me feel like my bladder is still full even after a CIC. And it makes sleeping very difficult. Thanks. Howard
Makes sense that Advil might help with the inflammation, however it might be counter productive to having natural voids. So if you're taking an Advil right after being irritated, your lack of natural voids and feeling of fullness may be more related to the Advil than to the irritation.
What type of catheter do you use? Is it a coude or straight? Possibly experiment with a different type of catheter.
In the beginning, I was told that you shouldn't be just gentle when you self cath, but VERY gentle. Sometimes we forget that, especially if in a hurry. Also, sometimes we are a slave to a schedule when not necessary. Sometimes, depending on our void and residual patterns, we can skip a cath, or even a day. If that's the case, then less may be more in those cases.
Jim
I cath 4 times a day too, but have no natural voids. Have you tried different lubricants. I have found some brands work better than others. Also, as another poster mentioned, you might want to try different catheters.
Smaller size catheters (from 14fr to 12fr) solved my similar problem of prostate irritation and inflammation after CIC. Hank
Did you try alpha blockers ? They might help you with natural voiding. Hank
Thanks pluff mud! I've tried 3 different lubes but they don't seem to make a difference for me. I do like the Coloplast 14fr coude's as they have just the right flex for me. The 12s are too soft to get through my prostate.
Just curious - are 4 CICs a day sufficient for you with no NV to keep your bladder empty? What are your volumes when you CIC? Thanks. Howard
Thanks Hank - I did try the 12s but they just bunched up at the start of my prostate (external sphincter). Howard
You might be able to solve the bunching problem by guiding the catheter with your CLEAN fingers touching the hose part closer to the penis, as opposed to only touching the funnel. I've been doing this since the start, no UTI whatsoever. Hank
Hi Jim - Do NSAIDs in general interfere with natural voids or is it just Advil? Why is that so? I've been taking a prescription NSAID called Torodal for the past 24 hours which is much stronger than Advil. It has reduced the inflammation and my NVs are up to 100ml but is that working against natural voids? Prednisone is a steroidal anti-inflammatory which really works well for me but too much is a serious problem.
My catheter is the Speedicath 14fr hydrophilic coude. Thanks. Howard
My bladder got distended. I was only voiding a small amount on a frequent basis and retaining 1.5 liters. I don't measure the volume on a regular basis, but usually void between 400 - 600 ml overnight and 300 - 400 each time during the day. Although I sometimes feel the urge and try, I haven't had a natural void since I started CIC last summer.
I use a straight tip latex or soft plastic catheter. The latex in 18 fr and the plastic in 16 fr. Coloplast makes a soft plastic catheter that is more flexible than the standard one. My preferred lube is Dyna Lube.
Hi Puff,
You might consider increasing your frequency to 6x/day. That would lower your bladder volumes, compressing it more and possibly speed up a rehabilitation process. Four years ago, I was also retaining 1.5L with small, infrequent voids and now my bladder functions fairly normal with CIC only required a few times a week. I started 6x/day and sometimes even more.
Jim
Hi Jim - Could you elaborate as to why NSAIDs like Advil/Motrin etc can reduce the ability to natural void? I stopped the Toradol since I might have been making things worse. Thanks. Howard
The literature suggests antihistamines and decongestants are bad for bph, but with NSAIDs it's mixed. Some say they are beneficial for their anti-inflammatory effect, and some suggest an increased risk of retention. So I guess it's trial and error, but if you're going to use them then it's important to track what they are doing in terms of retention.
Jim
Thanks Jim. Another question on CIC:
When I awake in the morning I usually have about 600ml in my bladder and cannot NV right away. But as I go about my activities I can NV about 4 times with each NV about 100ml over the course of an hour without any pushing. So then I am left with my usual 200ml residual.
My question is this: is it better to just CIC right away when I awake or is it better to let the bladder muscles get some exercise by NVing those amounts over the first hour?
Thanks Jim. Howard
Very good question. First, what you describe is normal. Movement/activity can make a NV easier. As to which approach is better -- empty completely with CIC or multiple NVs -- it depends on what you are trying to accomplish.
If your goal is bladder rehabilitation over the long term, I suggest starting with a period of maximum decompression of the bladder which generally means CIC 6x/day. That's what I did. During this period you want your total bladder volume (CIC volume plus any NV preceding it) to be under 400ml. This keeps your bladder from stretching and gives it time to heal and recover from years of abuse.
Later on, you may be able to decrease frequency, and then start "testing" things. I started a thread on this called the "on/off" strategy, however I don't recommend this in the beginning.
As to bladder muscles getting "exercise", I found they were adequately exercised during my natural voids and during period I didn't have a natural void I would "push out" gently during part of the cath process (maybe every other CIC) to simulate the NV process and therefore to stimulate the detrussor muscles.
In my case it took a couple of years before I saw significant results. As mentioned I started self cathing 6x/day with a very stretched and dysfunctional bladder. IPSS score was in the "severe" range. Today I self cath only a few times a week, and my IPSS score is in the "mild" range.
While my results are the most dramatic posted to this discussion group so far, others here have made significant progress with their bladder function through a program of self catherization.
Jim
On re-reading my post, above, I guess I forgot to directly answer your question. As long as you're self cathing, regardless of strategy or goals, in your case I would CIC on awakening as opposed to the process you describe. In fact, if you had to pick only two times to CIC, in general that would be before bed and first thing in the morning. Of course, much better IMO to set your schedule by total bladder volume (keep it under 400ml) which generally translates into 6x/day for someone with no or very little NVs. And btw nothing wrong with keeping total volumes even lower than 400ml, what you want to try and avoid is keeping them higher although sometimes they are bound to creep up a bit, especially the first morning cath.
Jim
Thanks Jim. I guess since I still have some inflammation it would better to CIC first thing in the am. Last night I self-cathed before bedat 11pm and took out 400ml with an NV 0f 100ml prior to it. Then I was awakened at my usual 2 am in extreme agony and took out 600ml with no NV. Then I slept to 7am and awoke in great discomfort. But instead of a CIC I went about my activities and NVd about 100ml every 30 minutes until 11pm. Then I did CIC and took out 350ml w/o trying a prior NV.
So I think I will follow your advice here at least till the swelling is gone and CIC first thing in the am. I do have lots of NVs during the day again at about 100 to 150ml so still below my normal of 200 to 250ml. I'm doing 4 CICs a day whereas I as doing 2 a day before I got this irritation. Thank goodness I can do CIC - what a blessing relatively speaking and I owe it all to you. Thanks again for being there for us. Howard
Hi, Howard,
Don't know if this will be helpful, but learning to relax my pelvic floor helped reduce urethra irritation for me, especially getting through the sphincters. Also, I started to keep a food journal, which helps me connect the dots between what I'm eating and inflammation in my urethra and prostate. Alcohol, chocolate and spicy foods can make CIC painful for me (your triggers may vary). Over the weekend, I enjoyed some corn chips and jalapeno bean dip (yep, I knew better but man, it was good) When I went to CIC 2 hrs later, I couldn't get through. Tried 4 times, but it was too painful. I took some extra vitamin C (it is somewhat of an anti inflammatory) and waited another 2 hrs to let things settle down. Then I was able to CIC.
Stebrunner
Thanks stebrunner for the tips. How do you relax your pelvic floor muscles? I once got a chart of the muscle group and try to visualize the muscles before I CIC and then repeat "relax, relax" as I see them loosening up. It does help as you say.
I use to love eating hot food like Mexican, Cajun and Indian. But I also found that these foods would aggravate my BPH because they aggravated my colon/rectum so I had to stop them several years ago. I sure miss it especially while downing a few beers!!
Also it is important to control constipation. I had a big problem with that a few months ago that made it impossible for me to get the catheter in. It really freaked me out as that is my lifeline to keep away from the doctors. Anyway I got help here with advice to take MgO (250mg) twice a day and that had really helped me with CIC. Now if I can only find a way to get back to sleep after I CIC at 3am!!
Thanks and all the best.
Howard
Hi, Howard,
I'm sending you a PM with the links to some YouTube videos that helped me learn to relax my pelvic floor. Early on when learning CIC, I realized that I was flexing or tightening my buttocks and lower abdomen in anticipation of pain. Jimjames suggested learning some relaxation exercises, which included some Yoga poses. It helped me a lot.
I haven't had problems with constipation, but can see how that would be a problem. Like you, I find I'm using CIC to keep away from the doctors!
Stebrunner