Urologist Wants Me On a Catheter.

In My Humble Opinion
1

My old urologist retired, and I saw my new urologist for the first time. (I call him ‘new’. But he also worked in the office for a little while.) Anyways, he said something to me my retired urologist would never say. He wants me to use a urinary catheter!

First a little background. I have had problems with frequent urination since at least age 9. My now-retired urologist used to tell me that is because my bladder doesn’t fully empty. Plus he said, I have an unusually large bladder FWIW (more on that later).

But my ‘new’ urologist scanned my bladder (after emptying a little). He said I had at least 1 liter of fluid in there! Maybe 2! And he further told me, if I wasn’t careful, my urine would back up into my kidneys and kill me (!). He said I must start using a urinary catheter at once. Since it was rather sudden, I asked him for a couple of weeks to prepare for such a major life change. And that is where I stand at the present.

I do have a couple of questions about the matter, not surprisingly. I asked him when I could take it out. He said just leave it in there until I see him next. (I hope I misheard that part.) Also, what if I want to shower? Or do sexual things? And what about when I sleep? I apparently am a rough sleeper. I have already woken up with a sprained shoulder, and other minor injuries in my sleep. Plus, not to get graphic, but don’t men have erections in their sleep? What happens then?

I should also add, the doctor and others have reassured me about the procedure. Presently, I constantly feel like I have to urinate, even between bathroom breaks. He told me for once in my life, I could feel relief. That is a little appealing, I must say. Plus he said the catheters today are much better than the ones of old.

I also find it hard to believe there was 2 liters in my bladder. My former urologist never said that. Was the equipment broken? He said it was newer and more accurate. But I still find it hard to believe.

So what to expect? And what about my above questions? Please chime in if you have your own experiences with urinary catheters especially.

:):):):):slight_smile:

2

I have kidney damage because I didn’t know my bladder wouldn’t empty as a result of an enlarged prostate. You need the catheter in for a few weeks just to find out how well your kidneys are working currently. If medication or an operation can’t resolve your problem you should learn to insert and remove a catheter yourself. That sucks but it beats dying. Sex will be out for a while, at least using your penis, until you can insert/remove a catheter. Once you can do that you’ll only need it in for a minute 3 times a day to empty your bladder.

Did the doctor mention your creatinine level? That’s the usual measure of kidney function, you’ll need that tested after you’ve been on the catheter for a while to establish a base line reading. Don’t remove the catheter until then or you’ll just have to start over to see how well your kidneys are working.

I hope this works out for you. Either you have to ask your doctor more questions or find a better one who will give you more information.

3

I think you need to clarify a few things with the good doctor.

Bladder capacity is typically 500 - 600 ml. There is no way you had 2 L in your bladder. Perhaps you mis-heard him?

Also, it is unlikely that he was talking about leaving the catheter in for an extended period (this is referred to as an indwelling, or “Foley” catheter). Unless you are completely bed-bound, these are usually reserved for short-term use due to likelihood of eventual bladder infection.

I suspect he was talking about a “straight” catheter, which is inserted, left in for a few minutes to drain the bladder, then removed. Much less chance of infection (and you don’t have to worry about all the other issues you would have with a Foley).

Straight cathing is done to ensure complete emptying of the bladder when there is residual urine left after peeing.

You need to talk with him again and get some straight answers.

Good luck!

4

I can’t tell you about the catheter, but I can tell you that a college friend of mine ended up on dialysis in his 20s and eventually getting a kidney transplant from his mom because urine was backing up in his bladder, and it eventually trashed his kidneys. He had no idea anything was wrong until it was too late.

5

Bladders stretch. 2 liters is a lot, but more than 1 liter is not unusual with the OP’s condition. Leaving a Foley in for weeks is typical in these circumstances. I’ve never heard of a danger of infection, as matter of fact frequent use of a straight catheter which would be necessary for the OP without the Foley sounds more likely to cause an infection to me. The OP describes having a Foley in currently, his description would be quite different otherwise.

6

Ahh, missed that on first read.

7

I don’t understand the different views of Doctor one and two. You might want to consult with another urologist. One that will focus on the cause of the frequent urination and enlarged bladder.

As for my experience…

I couldn’t empty my bladder. Always had 600 mililiters in my bladder. Over the course of 8 years, I had 4-6 UTIs (urinary track infections) a year. They were not painful, but when the pee smelled bad, I would get a urine culture and the specific antibiotic. My problem was a constricted urethra due to enlarged prostrate. Because I couldn’t empty the bladder, the urine became a place for bacteria to grow.

Last December, I was hospitalized. My bladder now contained 4 liters of urine. Yes, they do stretch. It had wrapped around my intestine and now no poopsies. In February I had the TURP procedure which allowed me to pee like a sixteen year old. Some say the bladder cannot shrink, but I believe mine has.

Now to get to the catheter. I wore a pee bag for four months. No problems. Except it is not really a babe magnet. Unsightly, and since I wear shorts year-round very obvious. You can shower with the pee bag or disconnect it. I never had an erection with the catheter inserted.

The urologist suggested self catherization. I said, I can’t. It hurts too much when the nurse inserts it. But, the auto catheter was a lot smaller (18 French) and eventually I could insert it. And did so for three times a day. The urologist said after peeing in the morning check the volume left in the bladder. Drain the bladder with the catheter and measure. When it had less than 250 militers for three consecutive days, we could assume the bladder has indeed shrank. And no more auto catheter.

It has been almost a year since the hospital. And life is good.

I hope this helps. Look for a physician that will find the cause of your discomfort. In the meantime don’t be afraid of the catheter.

8

My late spouse suffered various bladder and kidney infections during his lifetime. You CAN get an infection with a Foley catheter, although it’s not real common because usually when you have one you’re in a setting where people have a grasp of cleanliness and infection control. “Clean intermittent catheterization” in practice has a higher rate of infection but the fact that it is done three times a day (or more) by a non-medical person outside of a medical facility is no doubt a factor. Even so, a risk of infection (of a sort usually easily treated outpatient) sure beats some of the alternatives (like needing dialysis or a kidney transplant).

My spouse self-cathed for a couple decades, in all sort of conditions. He never went on a trip without taking a supply of sterile catheters with him, and had a very precise and careful routine for the process. But yes, he did get bladder infections. Generally handled outpatient with medication. (Had two fungal bladder infections - antibiotics don’t work on those, you know, need a different pill for that)

On the other hand, NOT cathing resulted in severe kidney infections that landed him in the hospital for days at a time.

He decided that threading a catheter up his willy at home several times a day was preferable to spending time in a hospital, so that’s what he did.

As someone else noted, failure to properly empty your bladder can result in failed kidneys - at which point the inability to pee is the least of your problems.

I guess what I’m saying is… yeah, I get that the notion of using a catheter has a certain level of squick. But if you have a medical condition that requires you to do that then do that. There’s some adjustments to be made, but you can adapt and get on with your life.

There does seem to be a generational divide regarding catheter use - when I first met my spouse and married him doctors seemed very opposed to the use of them outside a hospital setting. Then there was a change of urologists (much as you experienced) and he was encouraged to self-catheterize at home (and work, and on trips, and… well, as the primary method of eliminating urine). The result was improved health for a considerable period of time. I guess everything was functioning better as a result. It is my understanding that intermittent catheterization is now considered standard practice.

I don’t know you personally and I’m not a doctor, but if you have a condition that requires you do this I would suggest doing it. Also, during a 30 year marriage we worked around any inconveniences or adjustments required. In other words, yes, he could shower, we had sex, he wasn’t left alone in the world.

Good luck and try not to freak out. Yes, it is (and probably will continue to be) an annoyance but it’s something you can manage and deal with.

9

Good post Broomstick.

For me self cathing was a great option. It got rid of the pee bag. And being somewhat self-conscious of the pee bag, I adapted easily.

The cath manufacturer said they were for one use only. Due to my location, it was difficult to get sufficient catheters while using them three times a day. The urologist said I could use the same one for a week. They showed me how to care for them between uses. I was as sanitary as possible. And it worked.

With a 24 hour catheter and pee bag, normal copulation was out. I never had the desire. But as the stick mentioned with intermiten use, sex was accomplished.