[tonyjose]

Hi all
Ive been catheterising 5 times daily for 6 years, but now for a month or so i am having difficulty in inserting the catheter. The catheter reaches till the sphincter and refuses to go , and it will take 5-10 mins of gentle pushing to get it inside the bladder.

My urologist says this is sphincter spasm and prescribed 1 week course of dynapres(flomax) .4 mg tabs. but this didnt help. Now he says that a sphincter dilation has to be done.

But i am reluctant to do. my fear is whether it will cause leakage or any other complication . I think its better to continue pushing than doing any 'urological procedures'. what do you think?

I hope some of you can give me some advice.

Thanks
tony(26 years t4-para)

btw i am from india.. is there any one else from india?

This post has been edited by tonyjose: 11 August 2006 - 05:00 PM

[Simon]

I presume by dilatation he means sphinteroctomy ie cutting your sphinter?
I had it 5 years ago after 15 years of automatic bladder drainage through bladder training. Had to have it as was getting reflux to my kidneys as my bladder was emptying fully. Just discovered that despite my op I still have a 600ml residual when sat! 75% damage to left kidney.
So now have spc.
Anyway, my guess is you would leak with having the 'snip' so would need to wear a sheath between caths. On other hand the constant forcing of your sphincter may lead to bleeding.
I've heard botox can now be done but will only last months.
So choice is yours!

[russ1]

It's why I had the spc done in the first place - in rehab they removed the indwelling so I could go onto self intermitents. After about 12 hours my sphincter shut down tight and wasn't going to let anything through even after oral and injected diazapan (I think) and various other things - Was going seriously dysreflexic when they put an emergency SPC in. I opted to stick with it, this would clearly be an option rather than operating on bladder.

I thought botox was to tighten things up not loosen them down - or were you suggesting botox after the snip?

[tonyjose]

Thanks Simon and Russ , that was really helpful...
Ive dicided to go on like this for somemore time and see how it develops. I am careful not to exert much pressure and is lubricating the catheter more. Ive read in this forum that slowly breathing in/out helps and i think it works.

Then...should there be any specific cause that triggered these spasms now. i had no problem like this before.
An ultrasound was done but it was normal. will it be some infection in the tract or something like that? or some irritation in the sphincter area?
pls share your thoughts

tony

[Ricky]

Hi, In respone to the tight spincter muscle. im having the problem inserting my catheter too. im a c6 incomplete quad. it takes me 15 min to cath and im getting frustated too. i seen blood at times coming from my whole but it goes away. i dont want surgery either. I tried cordura pills once and it helped but it gave me vertigo....do you think marijuana might relax the spincter muscle?

[nomis]

I presume you've tried changing your body position - sit up, lean midway back, more lean...
Could it be cold catheter - try running hot water over it, shake, insert (also softens so less abrasive).
Activity before using catheter -spasm often increased if inactive, eg sitting at computer.
Lie out flat on your stomach (hope the bladder ain't too full) before catheterising to break spasms.
Deep breathing makes sense when used as a relaxation technique - big breath in > hold > hold > let out slowly all the way, all > etc
Marijuana - try it and see.

[Trail-Boss]

Hey,
My husband, Trail-Boss, had the Botox Injection done, no snipping involved. He was getting UTI's very often. After the Botox he has had only one during the 6-7 month period. You get a new injection about every 6-7 months. Painless. It seems to be working for him.