Hi Guys As of yesterday my urologist wants me self-cathing each day until my prostate surgery sometime next month. We went through the whole process step-by-step in her office, but once I was home and needed to do it on my own last night it was a bit of a nightmare. I'm just so squeamish and each movement upward of the cath had my urethra (and then prostate) in freak-out mode. I finally was able to do it, and I'm hoping it gets easier with time (my doc says a kind of mucous lining starts to happen after you do it for awhile, which I thought sounded unlikely). But I thought I'd ask you guys if anyone has any advice about what will make it easier and less agonizing. • Is standing in the bathtub or shower easier than sitting on toilet? • Are there any stretches or moves you can do prior that help thing go easier. • Any breathing exercises? • Is going faster with insertion better than slowly pushing it in (my style of cath has that angled tip on its end)? I tend to go excruciatingly slow which I think makes the whole thing more arduous and freaky. But I'm worried about jabbing to fast into something Thank you all for any words of wisdom! DK
HI David
i can sympathise as i started self cathing a week ago till hopefully an op can fix me .
There is a thread on here started by me just over a week ago which has some useful advice .
From my point of view i found it difficult to begin with but after a few times it becomes very easy. Start off by having your penis in an upright vertical position. For me i found an initial push was needed and then a second harder push just before it hits the bladder . Take a look at the previous thread for tips when you hit these " obstacles" . Be relaxed and confident and to be honest its a walk in the park after a couple of successful attempts. Have a measuring jug available to measure your retention .
Relax , its gets so much easier .
Darren
I’ve been self cathing for over 15 months 4 times per day. It generally takes me 10 - 15 seconds to insert a catheter. I find it easier to stand in front of the toilet. Fast insertion is not better. You risk causing injury. I use a straight tip catheter. I initially tried using coude tipped catheters, but injured myself the first couple of times. Everyone’s plumbing is different, so find what works best for you. I find softer materials, such as red rubber and soft plastic, work best for me. With a stiffer plastic catheter, I find it helps pressing on the perineum momentarily when the catheter gets to the prostate. I also find lubricants also vary. If you will just be cathing for a short period, you may want to use hydrophilic lubricated catheters - extremely slick, but more expensive. Breathing can help you relax and can make cathing easier.
Isn’t it weird. Very few guys do self cathing in the UK. Why is this common practice in the States? Surgery delaying technique to preserve manhood, cost or both? Intrigued BPH sufferer from the UK.
HI Andy
im in the UK.
Thank you guys for the feedback. Reassuring.
Is it normal that after cathing, when you urinate as usual through the day that there is slight burning? I find that disconcerting. I wondering if it’s the lube? They have me using this really goopy clear stuff – not the more watery one.
Hi David,
Definitely never force a catheter; you will injure yourself. When it stops going in, use light, steady pressure and eventually the sphincter will relax and let the catheter pass through. You should hold the catheter so that the curved tip points up towards you. That means that the little tab on the funnel end that you are holding will be facing towards you. If you are not already using self-lubricating catheters (with the water sachet that you break before use), then please do yourself a favor and get some. I recommend size 14 French. After you are more experienced, if you want to go to the smaller size 12, then give it a try. I used to have to sit down because that is how I was taught, but I find standing up is actually easier. Jimjames, who is on this site, has a whole thread on self-cathing technique. You may want to see if you can look it up, including his “dive bomb” approach, which avoids handling the catheter except at the funnel end, and has helped me avoid infections for over two years now.
Good luck!
What type of catheter are you using? I have French Coude 14’s by Bard. I’ve found that a slow, deliberate insertion and removal is best. Go in until you get flow, then go one more inch.
I can only speak for myself. I’m in the USA. My urologist is not pushing for surgery. My bladder was enlarged, and neurogenic. The urologist said that there was no guarantee I would not leak some after surgery. I don’t leak now. I am generally on a regular schedule for cathing. I don’t wake up in the middle of the night with the sudden urge to urinate. Health insurance covers the cost of my supplies. Why ruin a good thing.
Great details to work with. Thank you!
I have been Self-cathing since July of this year. I was terrified when the doctor first pushed me to do it. It’s fairly simple for me now which I do 5 to 6 times a day while waiting for my procedure to be scheduled. Here’s my best advice:
- Use a self-contained lubricated cath that you never make contact contact with the portion that is inserted.
- Never use anything bigger than a 14. Hospitals like to use a 16 and it can rip you up during insertion.
- I use a Coloplast SpeediCath Flex Coude Pro, FR 14/4.7 which comes in a handy sealed pouch that easily fits in a coat pocket.
- I inset it standing up while leaning with my back against the wall and when I hit a spot that is troublesome I take a deep breath and exhale making sure to relax my stomach muscle as I exhale and the cath passes through the troubled area easily.
- I also have attached a 500 cc Coloplast hose and leg bag to the exit end of the cath before insertion. This prevents urine from getting all over the place or on my clothes and provides a convenient way to measure urine volume by what percent of the bag is full at the end. I then just empty the bag into the toilet.
- I always try to urinate first before inserting the cath. That’s important.
- I also wash the tip of my penis with an alcohol swab before insertion.
- For me the direction the curved Coude tip is pointing at insertion is critical to whether I experience any difficulties during the last inch and a half of insertion. For me, the curved tip should be pointing at my face as opposed to any other direction.
All of us are different, but I hope my experience give you some confidence to move forward.
Will try this, thank you for so much info to try!
Hi David:
I had an SRP this past August. I refused to self-cath after one urologist tortured me with first his nurse , then his resident. I went with an indwelling cath until surgery. Still not fun, but easier to manage emptying a bag, than stabbing myself multiple times a day for weeks.
Now, post surgery, I can put out fires.
Dave
Hi David,
I am in the USA and have been doing CIC for several months, as needed. I started with 14Fr straight catheters. I was getting blood at every cath so my uro did a cystoscopy and found that I was encountering some “false passages” which were causing my bleeding. He then put me on Coude tip (curved tip) catheters. I found that the SpeedyCath by Coloplast worked best for me. The other hydrophylic types that require you to break a water pouch to activate were not as slick. I think one has to wait for half minute for the water to take effect. I also tried other varieties in my search tor what worked best for me. I tried the kind that are dry where you add lube like KY Jelly from a packet. They worked well but were more messy and took longer to prep. Then there are pre-lubed types that had lube that was very thick, which made insertion slow and more painful.
After using the Coude tip for several weeks I encountered a problem where it would stop about 2 or 3 inches from the bladder and wouldn’t go any farther. I reverted to straight tip catheters which work OK for me now.
As far as position goes, I find that standing in front of the bathroom sink works best for me. I put a 500 ml graduated cylinder in the sink and direct the flow into that to measure my retention. I always try to void naturally first to avoid urgency on insertion and leaking around the catheter. I’ve even gotten lazy enough to cath in bed at night on occasion. I keep a bottle that can be tightly capped with me to avoid spills.
One strange thing that I found that makes self-cathing easier is to have an erection when starting insertion - it goes easier with less discomfort.
To prep for cathing, I wash hands and wipe hands and penis with a BZK wipe to disinfect. Then with the left hand I open the urethra, and holding the funnel end of the SpeedyCath with my right hand, I carefully aim it at the urethral opening. I push the catheter in slowly using gentle pressure, having my right index finger over the funnel opening to prevent the flow of urine until it reaches the bladder and urine pressure is present. Then I aim it into the graduated cylinder and release the flow. Using this method I never touch the part of the catheter that goes into the urethra. The SpeedyCath is just stiff enough that I don’t have to touch it close to the penis to guide it in.
Recognizing that what works for me may not work for you, I hope you find this helpful.
Norm
Thank you Norm. Wow, what a review!
I have those curved tip too.
What is that silver packet of water for that is included in those for though? It’s confusing.
My urologist had given me separate packets of lube which she said is better.
My main problem now is post insertion burning and irritation of the urethra after I cath. Is that common? It’s driving me crazy.
My god, you must be a pro, doing it in bed. :-0
Darren
Thanks.
Where is this previous tips thread? I too have a hard time at those obstacle areas, and I always feel like I’m going to damage myself to keep pushing.
…burning and irritation of the urethra …
Probably you are using too large a size. Hank
The SpeedyCath that I use does not have the silver packets of water. They are pre-wet and ready to use right out of the package. If your catheters have that silver packet of water, you need to burst them before you open the catheter and let them set for 30 seconds at least to wet the hydrophylic coating. That way they will be more slippery than if you open after the water packet is burst.
The lube packs that your uro gave you are good for the catheters that have no lubrication. I’m not sure how they will work with the hydrophylic catheters with the silver pack of water.
All the best,
Norm
My guess would be its financially related. NICE assess different treatment options in the UK not only from a clinical efficacy perspective but also from an economic standpoint. The cost to the NHS of a monthly prescription of 30-40 catheters is likely to be higher over an extended period of time than a one off surgery.
Catheters are one time use items in the US. I use four a day, so I get about 120 per month, plus lubricant.