2 replies to this topic

[longtimequad]

Hi. I'm a C4 quad going on 26 years now (I'm 39 years old). Back in 1983 during my rehab I had a sphincterotomy and have used an external condom catheter with no problems up until 8 months ago. I now keep getting constant UTIs and my latest urodynamics show that my bladder has stretched & become flaccid enough that I'm maintaining an unsafe level of residual in my bladder (the last, 2 years ago, showed good pressure & spasticity). My urologist is urging me to go to a suprapubic catheter, but I have big questions he seems not to hae real answers for. I'm hoping you can help.

Here are my concerns:

1) I'm fat (210 lbs) and my stomach hangs completely over my pelvis; my pants' waistbands always end up slipping below my belly to my pelvis as well. Moreover, I have always sat completely upright at a 90 degree angle (it really works for me, giving my upper body more freedom of "movement" & the ability to lean forward a good bit when my chin control is out of the way). This makes me think that there will be lots of "interference" between my stomach, pants & the catheter. Further, the fold of fat that overhangs my pelvis presents a dark, moist place for staph & other skin bacteria to grow. This, combined with an open wound into my bladder seems far more dangerous than repeated UTIs. No?

2) Since I still do have spasticity / contraction in my bladder (just not enough to fully empty out) and a sphincterotomy, how likely is it that I'll have leakage from my penis even though the SPC is in?

3) My attendants are largely third world immigrants. Having them keep the catheter & stoma clean is fine, but teaching them to change the catheter safely (what, monthly?) seems troublesome. Is it difficult / involved?

4) I'm very active- a college professor and I travel regularly. Will wound healing of the stoma keep me in bed for any time? Does getting transferred around a lot (airplanes, various seats & beds) cause problems with pulling on the catheter? Do people experience much dysreflexia with the operation or general use of a SPC?

Thank in advance for all your input!

[Cuseman]

HI
I AM a c3-4 incomplete i was also hurt in 1983 i wear the condum drainage and switch over to foloy catherter when i get breakdown on penis from condum drainage i wanted to get the suprapubic but i had gotten a sphincterotomy 13 years ago and my urolgist said i would have leakage.so i never got it. if anyone else out there has had gone through this i would also like to know how they made out

[Austyn]

Hi Longtimequad. I would be very interested in finding out the information you have requested as my partner is waiting on the placement of a SPC and is in a similar situation to you in that he has quite a bit of fat around his abdomen and I am wondering how an SPC will fare in that environment. He is having the SPC put in after an episode of dysreflexia caused by high bladder pressures resulted in a stroke

Having been a nurse who visited people in their homes and changed their SPCs I can say it is not a very difficult job to do BUT obviously very good technique is required to avoid infections and the problems they would cause. Is it possible some health professional could come out to your home and teach your caregivers how to do it correctly? I don't know how your health system works (I'm assuming you are in the USA??).

All the best!