I have struggled with urinary incontinence and urinary tract infections since 1984, 6 years before I even knew I had MS, so I was more than ready for a solution to this embarrassing and tedious problem once I knew the cause.
The doctors advised me to wait as long as possible for a permanent catheter and in the next breath they told me to drink plenty of fluids. They performed their tests. My bladder is so spastic that it can hold only 3 oz of liquid before emptying spontaneously. That left me afraid to drink too much for fear of the consequences. I wore the thickest pads I could buy, but it just wasn’t a good solution.
My kidney tests began to show an overall dryness throughout my body tissues due to my curtailing of liquid consumption. My neurologist informed me it was time for some sort of catheter so I could drink enough to be properly hydrated. I had waited 11 years before taking the plunge. Decision made, I went to my urologist’s office and announced that I was ready for a suprapubic catheter.
The surgical insertion required a general anesthetic and I went home the same day with little or no information on how to take care of my new apparatus. The insertion point is just above my pubic bone. The catheter has to be connected to a piece of extension tubing which fits onto the leg bag which I strap around my shin and ankle.
Because the catheter is not in my urethra, it does not interfere with sexual intimacy.
It is marvelous to be able to drink as much water as I can hold and not have to worry about accidents. The catheter balloon has deflated and has come out of my stomach which requires a trip to the ER to get one re-inserted, but 3 times in 10 years isn’t much.
I still use pads and depends to protect from the little amount of leakage that can occur around the stoma (insertion site). Primarily, the extra protection is for occasional bowel incontinence. I prefer to be prepared.
When I got the catheter they told me it would last for5 to 20 years. After 10, everything is still going well except for the ever present UTI that is generally a bi-product of using a catheter. The doctor rarely treats the infection to avoid causing me to become resistant to the medicines they use to treat UTI’s. If I experience symptoms, then we treat the infection.
The catheter needs to be changed once a month or thereabouts. I get this done at the doctor’s office because my blindness does not allow me to see well enough to follow the sanitary process used to exchange the old catheter with a fresh one successfully, but many people have a family member trained in how to change it out or may be trained to do it themselves. This is not a difficult process.
Once a year, my urologist takes a quick look around inside my bladder to make sure everything is ok. He also performs a renal ultrasound and a complete metabolic panel (CMP). That is the extent of regular testing except for when an infection gets too symptomatic and I require antibiotics for a time. Usually, remembering to drink lots of clear liquids keeps the flares at a minimum. I do take one medication called Uroquid to acidify my urine. I tried high doses of Vitamin C but that upset my stomach too much.
You must be able to bend to unhook the elastic straps to empty the bag. Assembling the bags and tubing takes dexterity and some strength of the hands to get everything properly fitted together tightly. Of course, if you have help from a caregiver, you may have the assistance available to allow you to manage the care of the catheter. It is easier to drain a bag than it is to have to endure the exercise of dressing from the skin out when your pad or depends or whatever protection you have used, fails to keep you dry.
I have Medicare and private insurance which covers the cost of the supplies needed to maintain a suprapubic catheter. Some people wash and reuse bags and extension tubing. I do not because my insurance coverage is so good and because I lack the stamina to undergo such a rigorous process that must be done very carefully in order not to introduce contamination which could worsen the likelihood of infection. I will not bore you with the list of items needed for the care and keeping of the catheter. Some items sit on the shelf in case they are needed to flush the tubing and are rarely used. Others are staples that I go through on a regular basis.
I would be happy to answer any more specific questions if anyone has them, leave a question in the CONTACT tab at the top of this blog and Linda will pass it along to me.
After 10 full years with the suprapubic catheter, I fully intend to maintain it for another 10 or more if possible. It has given me a freedom I did not have when I had to carry a truckload of extra protection and an extra set of clothes everywhere I went. I would recommend it to anyone whose incontinence is out of control. ~Helen