Bladder not emptying

Hi folks,

I have SPMS, and have had difficulties with urgency and hesitancy for many years, but have managed fine. Following a bladder scan (ultrasound) it seems I am retaining fluid.

My Urologist has suggested ‘intermittent self-catheterisation’, however, as I have loss of sensation in my fingers, and am petrified of my appointment with the incontinence nurse.

I wondered if any members had any experience of this situation, or could make any suggestions?

With best regards

Mark

Hey Mark,

I have been self catheterising for years and it’s great. I do not have your problem of loss of sensation in fingers. However all incontinence nurses I have met have been fantastic - they could well work out a good plan for you. So nothing to be scared of - they have probably seen it all before

Good luck

Min xx

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No problem been doing it for years.

Just get organised with catheters.

I use Speedicath 28212 and 28922.

When you order off Chemist ask for some freebies ie wipes and plastic bags.

Bertie

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Cheers Min,

and thanks for taking the time to reply- your words of reassurance really help.

Thanks Bertie.

Hi Mark

I know it’s different for men and women. However, there are similarities. None of us want to be taught to self catheterise. It involves getting a bit too personal with a continence nurse. It’s embarrassing at first.

But you have to remember that the nurses have seen loads of peoples ‘bits’ and will take your understandable shyness as the norm.

As far as I understand it, self catheterisation for men is easier in some respects and harder in others. Easier because you can see where you’re pointing the catheter, but harder because you have a point at which you generally have to push past - or the prostate.

My fingers are good in some ways and rubbish in others. Sensitivity is helpful with catheterisation, but not essential. To be honest, all you can do is try ISC.

As a man, you do have options, many men use the ‘sheath’ type of catheter. You could ask your continence nurse about this, especially if you’ve tried ISC and found it difficult.

Opening up on here is a good start to being open, honest and unembarrassed about the entire issue.

Keep in mind that there are many different types of intermittent catheter, if you find one too stiff or another too flexible, you can ask for a trial of lots of others.

One thing I was unaware of when I began ISC was that my supplies of catheters will come from a delivery company. They have many customer service staff who are knowledgeable about all types of product and can advise you with regard to what help you need.

Best of luck.

Sue

Not sure of your pathway Mark, but I thought my prostate was the problem so ended up in a shiny new urology outpatient clinic. Bladder scan, flow testing toilet, etc.

Before MS was confirmed, ISC was offered as the first option. Best thing I have done, and continue to do.

From personal experience… don’t ever try to push too hard. Not nice when the catheter tip bends back.

The catheter might have a little kink at the tip. I angle the thing with that facing up. Whether it’s just in my head or not, I think it helps when the internal urethral sphincter clamps down and doesn’t want anything in or out.

I wouldn’t worry too much about ‘aseptic technique’ if that is mentioned in the instructions. Just keep it all as clean as you reasonably can to get it done.

Try sitting down to pee and leaning forward - I find, as a guy, it helps… good luck

Thanks Sue, for your most kind, thorough and empathetic response. You really do make sense. I have ‘dodged the bullet’ for far too long; I was referred to a Urologist about 18 months ago, and between the hospital changing dates, and me re-arranging, numerous times, here we are.

Your point about opening up on this forum is most pertinent.

Thanks again Sue,

with best wishes Mark.

Hi Mark

You’ve had lots of encouraging replies already, but thought I’d add a bit of my experience anyway. As with many people, I really wasn’t looking forward to starting. I assumed inserting something, er, 'up there; would be uncomfortable at best, or maybe even hurt a little.So when I first did it, I was surprised & relieved at how painless it was - I barely felt anything at all. I quickly became a simple part of my daily routine, and I wish I’d started sooner. I don’t think the lack of sensitivity in your hands should cause much problem. I had a little numbness in my hands (doing up buttons is tricky), but never had a problem with doing ISC.

Good luck

Dan

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I found it uncomfortable to the point that I neglected to do it anything like as often. Unfortunately this has caused my bladder to lose contractility due to prolonged over-distension which makes it even harder to empty and more prone to UTI. There were two points along the urethra where it was hard going and I have only just found out one was because of a stricture - narrowing caused by scar tissue and one way this can happen if you’ve had a hefty kick in the groin which was an occasional hazard from the work I used to do. Been temporarily relieved of that by having it stretched wider.

I have been doing it for years. It will change your life, you get your freedom back. Most nurses have seen it all before {not yours obviously) good luck.

Tony

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From a blokes point of view. Which is the easiest way to insert the catheter to reach the bladder. I just find it too sensitive and give up. Is it to do with the correct angle ?

I have a lack of sensitivity in the general area due to the MS, so perhaps my experience is quite different in that it registers as something going up there but it isn’t painful or uncomfortable. I call the catheters my “Woohoo” sticks.

Only times I have experienced pain / discomfort is when I’ve used too much force and the catheter tip has bent backwards like a hook. Has to come back out… ouch.

Perhaps you can get some anaesthetic gel from the urology, MS teams or GP? Instillagel is what we used in hospitals when I was a nurse for indwelling catheters. Some meds can relax the bladder to aid insertion and some can make the task easier to get a grip on.

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Well it starts with a downward angle because you have to see the urethral opening by looking down but then as soon as I’ve got some progress I point my willie forward because it seems to sllde in easier as it goes deeper. One thing I have noticed for myself is as the tip rests at the top of the opening (that I pinch slightly to make circular rather than a slit) I find that one small rotational twist helps it to enter a bit like turning a screw, but once in, no further rotation necessary.

Hi Mark I have had theses symptoms long before being diagnosed with M.S. I went to see a incontinence nurse she told me I need to stand over toilet and try and re-train bladder didn’t work was going about 30 times a day not good. Then seen another nurse she told me of a new drug called mirabegron since I have used this tablet 4/5 years ago I can hold it for 45 minutes to an hour then totally empty bladder it amazing don’t know if this will help you but worth a try.

Best regards
Frank

Well, I wouldn’t describe self-catheterising as “great”,but Min is right the continence nurses are. It doesn’t happen to all with MS,
but my incontinence disappeared after the Urologist prescribed me
drugs after it was discovered I had benign prostrate hyperplasia.

I have been using catheters for 20 years, they give you freedom and confidence to go out.

Used to stand in insert the catheter,but no longer able to stand so able to sit. Personally I have never had a problem, initially had to use the small tube of gel which basically acted as a anaesthetic.