Suprapubic catheter

[nkh18]

I've had my last meeting with my urology specialist. She has determined that my bladder is not emptying sufficiently ( because of testing she's done) Her suggestion is to have the suprapubic catheter put in. What are the pros and cons of this? I have a little time to decide. She thinks it's due to the progression of my MS. I may still try the vaginal tens unit even though she doesn't think it will help. Any advice?

[pennstater]

I don't have any experience with a catheter, hopefully someone else can answer for you.

I am sure if the tens unit would help when you don't empty sufficiently. I know it helps as part of physical therapy for incontinence, when the muscles are weak. But retention issues are different.

I hope your get some advice from others soon.

[nkh18]

Thanks. I had been looking at this as an incontinence issue and not a retention problem. The treatments might be different.

[Seasha]

Hi nkh18. You were inquiring this awhile back and I posted about my Botox treatment about my experience with incontinence. It has certainly helped me!

https://www.msworld.org/forum/forum/...inal-tens-unit

[Kimba22]

Sorry I didn't notice your latest post on your other thread where you mentioned you had you're bladder testing done til now. With your limited mobility and dexterity, makes perfect sense that your doctor recommended a suprapubic catheter. It has made my life better.

Pros

• Fewer UTIs. Had 1 this year, some years none at all.

• No longer have to worry about getting to a toilet. All I need is an empty container to drain the bag when its full.

• Can drink as much fluid as I want, whenever I want. (It is important top drink plenty of fluids to keep the urine flowing.) This will dilute your urine possibly reduces the risk of infection. It will also help flush out any debris in your bladder.

• No longer have issues with constipation.

• I can go out for extended periods without the need to find a bathroom.

• Allows me to sleep through the night

• Dry mouth resolved, which came with taking oral medications. No longer have dental problems that were caused by it.

Cons

• Must be changed every month. (I have a home care nurse come to my house, so don't have to make arrangements to get my doctor. Sounds like you would qualify, too.)

• Can still have leakage through the urethra ― catheter or tubing could be kinked, not positioned to drain properly, bladder spasms, UTI, obstruction, drainage bag too full

• Bag might leak, or tubing might disconnect from catheter

• Had to add an antispasmodic to my med list (don't take it all the time, just when I'm having a lot of bladder spasms)

• If the sp catheter comes out, it needs to be replaced asap. The opening starts to close within a few hours, and another surgery would be required if this happened. (The balloon that holds it in could break, catheter accidentally pulled out, etc.) Mine fell out once, right after the person from the home care agency left. I don't think she put in correctly. She told me she'd never done a sp catheter before, after she pulled the old one out. Luckily, the agency was able to find someone else available who could come out to put a new one in. Otherwise would've been a trip to the ER.

• clothing choices are more limited, not to accentuate the leg bag. Also so can access it to empty.

• Body image ― took awhile to accept, but know had to be done

I no longer have enough finger dexterity to connect the catheter securely to the catheter bag, or release the clip on the overnight bag to empty it, so my husband does it. I can still empty the smaller leg bag (just has to a type with flip valve on the drain spout).

My bladder has gotten weaker, since it's constantly drained through the catheter. If feel the urge to go, can't wait very long to see what might be wrong and fix it.

It's obviously not perfect, but the pros have far outweighed the cons for me. I've had it over 6 years.

Retention is sometimes a side effect from Botox, so wouldn't be a candidate for that, because of your poor hand dexterity.

I never tried PT for my bladder or the vaginal tens unit, so don't know if it would’ve helped. Because of my history with infections, my urologist wouldn't have wanted me to wait months to find out. But I did try other things first (self-catheterization, Botox), and it helped. I still had to catherize to make my sure my bladder was completely empty with Botox, though. I had problems with both urgency and retention. I finally got a sp catheter because my mobility problems. It was just becoming too hard for me to use the bathroom or commode.

Best of luck

[nkh18]

Thanks for your detailed reply. I've decided I'll go ahead with the suprapubic catheter - scheduled for next month. Realistically, I think I knew it was the best option for me, but was holding out for another solution. It sounds like you've adapted very well, so I'll try to do the same. Thanks again.