[Lalla]

Hi All,

I'm a C6/C7 quad thats been in wc for more then three years. Due to having a spastic bladder, I made use of a condom catheter until last year August 2007. My urologist (Prof) did a urodynamic study and advised that the pressure in bladder and kidneys were to high. He advised that i go onto intermittent cath. He does not want me to use indwelling as he says it causes the bladder wall to collapse and also doesn't eliminate UTI.

I had the BOTOX done to curb the spastic bladder and its worked wonderfully well so far. The problem I'm experencing with intermittent cath is constant UTI's! I would say that on average I'm contracting a UTI every 2 weeks which i don't think is quite normal. I've even had to be hospitalised on three occasions due to the UTI becoming severe! I always do a culture of urine for the appropriate anti-biotic but the drugs clear me for a week or so and then its back. I've done cystoscopy for bladder and also scan of kidneys which showed normal results. I'm tired of taking medication and no results.. its becoming highly frustrating and very inconvenient!

I make use of a FUJI catheter, it's a soft silicone catheter thats kept in a tube with a sterile substance. The catheter can be used for 6 months to a year. Since yesterday, 08/05/2008 I began using the NELLATON catheters which last for about a week.. I'm not sure if this will help???

My urologist advised that I might need to go on a daily chronic anti-biotic (Macrodantin) which I'm def willing to try. However if this does not work what other alternatives can i consider? Also, Are procedures such as supra-pubic reversible?

I would really appreciate any advice

Regards,
Lalla

[Quad65]

I've used a condom catheter set-up since 1965. I went through a period of chronic UTIs, too. I found a good urologist that performed a sphincterotomy on my bladder sphincter. They go up through the urethra with a little Roto-Rooter like device and snip the sphincter muscle to weaken it. That way, you can empty your bladder more easily and there is little if any residual. I had to have it done again about 2 years after the first one because he was a little conservative the first time and I evidently had a tough sphincter.

That was about 15 years ago and, to my knowledge, I've not had another UTI and I don't take any medication whatever.

The procedure has to be done carefully because the nerves that control erection are in that neighborhood and there is a small risk of erectile impairment. Fortunately, that didn't happen for me.

[knowthill]

I started out using intermittent catheters which worked well for about 10 years. I then ended up taking Macrobid because of bladder infections. Part of the problem for me was the small amount of liquid up take. And keeping the cathetes clean.

My inability to tell when my bladder filled caused dizziness and headache. Also I had incontinent problems. I now am using indwelling. There are many down side to this system so stay with intermittent as long as you are able.

[Trinity]

Lalla, on May 8 2008, 07:56 AM, said:

I make use of a FUJI catheter, it's a soft silicone catheter thats kept in a tube with a sterile substance. The catheter can be used for 6 months to a year. Since yesterday, 08/05/2008 I began using the NELLATON catheters which last for about a week.. I'm not sure if this will help???

Have you tried single use caths? Maybe this should be your first step

Trinity X

[qbounce]

I'm with Trinity on this. Been using IT's for two years, except I throw each one out when done. No cleaning, no reusing, and it's a safer deterrent from UTI's.

[Lalla]

Thanks for the all the advice guys..

I just got discharged from hospital with serious infection (Staph Aures).. Seem to be ok now, I'm using the Nellaton catheter.. they last up to a week. I'll see how it goes else I'll try the throw aways!

Quad65.. Dude I've heard of the sphincterotomy procedure, just had a few reservations about the risks involved. So when they snip the sphincter, is it permanent? Do you contantly leak into the bag or does your bladder fill up to a certain extent and then empty? Is your sex life impacted in any way with the leaking?

Sorry for so many questions.. just need to kno all the pros & cons!

Regards,
Lalla

This post has been edited by Lalla: 22 May 2008 - 11:13 AM

[Quad65]

I can only speak to my own experience with the procedure. Some SCIs refer to it as the 'snip and drip'. In my case, I don't dribble or seep urine constantly. My bladder fills to a certain level, then drains. I can help it along by tapping or pushing on my bladder to trigger a mild contraction. It sometimes helps if I raise my self slightly off my seat cushion. Sort of stretches out the stomach wall and helps me empty out well.

I've been very fortunate in not ever having a spastic bladder or problems with spasms in general. In fact, for me, they've been more help than hindrance.

As I mentioned, there is a slight risk of erectile impairment. I had to have the procedure done twice, about two years apart. I'm able to achieve erection pretty well, especially with Cialis, and sex isn't too much of a problem. I don't have any leakage during sex. My wife and I like mornings for several reasons. We're both rested, my butt isn't sore from sitting all day, and I can empty my bladder well before intercourse. I was injured at 17, in 1965. I'm 60 now and a Grampa. Got married in 1978, had a daughter in 1984. My wife would say our sex-life is as good, if not better, as it ever was.

It is a permanent procedure and as far as scarring goes, I've not noticed it causing problems, at least that I can tell. I suppose each person is different.

As for the condom-cath set-up, I've used it since shortly after my accident, going on 43 years. I like it and never had any real problem with it.

Let me know if I can offer any other help.

This post has been edited by Quad65: 22 May 2008 - 04:32 PM

[Lalla]

Hi.. Thanks for all the advice, I'm certainly going to look into it!