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|Foley Catheter Experiences and What I Learned:|
A Male Perspective
Copyright May 1, 2005
All rights are reserved by the author
Unfortunately, I've had quite a few experiences with the Foley urinary
catheter over the past 12 months. Through these experiences I soon found
out that even with the verbal explanations, handouts and searching the
Internet there were several important things that I had to learn by myself.
Here I will cover some of my experiences with the Foley. I expect that
most of this article should fall in line with what others have experienced.
This article will not be discussing the catheter operation or the care
instructions given to me by the doctor's office. Anyone reading this should
follow instructions and guidelines as given by their own doctors and/or
nurses and to refer to your health care professional for any problems
The info is organized as follows:
1) Before you leave the house
The nursing staff told me to wear loose clothing if I’d be going home with the catheter. I was told that most people considered sweats (shirt and pants) the most comfortable and I found this to be true. I also found out the hard way that boxers were a lot more comfortable than wearing briefs if you return home with a catheter. If you're not sure, bring a choice of clothing. Wear old clothes so you won't care if they get stained by the antiseptic or some blood.
Consider bringing some urinary pads/sanitary napkins to soak up any leaks on the way home. If you wear boxers consider safety pins, tape or switching underwear. Be creative and address your needs.
2) Things to know about the catheter insertion (when not inserted during
There have been several types of examining tables. Some have been the
same type as in the doctor's office. Others have been a surgery table
that had stirrups with a removable section. Most of the time, my back
was raised for comfort. Several times I was on a flat table. The nurse
would then start getting the equipment set up. Before and during any work,
the whole procedure was always explained.
If the catheter will be staying in, a syringe will be inserted into the second tube in the catheter to fill up the catheter balloon (there are 2 tubes at the penis end for a two way catheter). Depending on whether the catheter is a two way or three way it may take from one to several 10 cc syringes. The catheter may be pulled outwards a bit after the balloon has been filled to seat it against the bladder opening. To me, this part is fairly uncomfortable, and at times has led to bladder spasms. Pushing the catheter back in, just a bit, can ease pressure on the bladder and may relieve the bladder spasms.
If the catheter will be worn any duration, the nurse then sets up a leg band and leg collection bag. As far as I'm concerned, the most important part of the catheter care is a properly adjusted leg band. This is an elastic band with a Velcro "loop" that holds the catheter in place and, most importantly, keeps the catheter balloon from pulling down against the bladder. The nurse always explains the set up and care of the catheter. I found that adjusting the leg band for a small loop allowing for some movement of the penis worked best. This loop kept pressure off the bladder as I moved around. If the leg bag is not adjusted properly it will either pinch the tube stopping the flow of urine or will pull on the leg band eventually leading to pulling on the catheter balloon. I like a tube length long enough to sit without stretching the tube but short enough not to push on or kink the tube while walking. I usually set up the bag so that the tube is slightly twisted around my leg and passing on the inside of the knee. Then when standing the tube is near the front of the knee cap and when sitting the tube moves toward the inside of the leg toward the back of the leg. I would suggest that before getting dressed you try sitting and standing while adjusting the leg band and the leg bag to find out what works best for you.
3) Things to know caring for the catheter (at home)
When I was going to be home all day, I did not use the leg bag at all. I made an extension for a night bag handle so I could hook it to the waist of my sweat pants. This kept the bag and tubing lower than the bladder, kept the bag off the floor while walking, and allowed me to use both hands without messing with where to put the bag. I found that using an extension for the night bag allowed me to change from walking around to lying down, or using an easy chair during the day without changing bags and only minimal adjustments to the night bag. I found this to be very convenient.
When changing bags (leg bag to night bag) I found it almost impossible not to spill urine without someone to help me. I eventually just got a container to put the old tube in while attempting to connect the new one. I also used paper towels to catch the small amount that was spilled in the process . Using a clamp on the catheter helped a lot. It was also challenging to keep everything sterile when changing bags. If available, consider asking for help until you get the hang of it.
One problem I had was with erections, which caused pain and seemed even more painful if it woke me from a sound sleep. The pain would cause the erection would go back down in a matter of seconds. The first time this happened it was very confusing but once fully awake I was able to understand what had happened but it did take a minute or so to figure it out. The nurse suggested using some lidocaine jelly by exposing as much of the catheter tube as is reasonably comfortable by pushing down on the penis, then injecting the lidocaine along the tube of the catheter. Then release so the penis moves back up the catheter. There really isn't much room to do the injection but if you can get some in, it will help with the erections during the night. Be sure to clean off any excess jelly because it will dry up and cause rough spots on the catheter. If the catheter has rough spots from dried soap or jelly, when an erection occurs it will feel like sandpaper (very painful). Unfortunately I was not told about this possibility until after it occurred and found it to be a painful learning experience, more so than the original catheter insertion.
4) Things to know when the catheter will be removed
5) Things to know after the catheter has been removed
Occasionally I get a fever several days after the catheter was first inserted. For me the fever occurs every time the catheter has been in more than 2 days. When my temperature starts going above 100 I take Tylenol to bring it down. For the most part this feels like the flu and is completely gone in a day or two.
6) Other experiences
On several occasions the nurse thought she was doing me a favor by quickly pulling the catheter out during the removal. For me this was a sharp pain that quickly dropped off to some discomfort. Shortly after that I noticed a growing pain in my testicles. The pain continued for 2-3 days. This pain was bad enough that it made it uncomfortable to sit or walk and I would wince for every bump in the road the car went over. Overall it was a lot more painful than the slower removals I've had. I know that a quick removal works for some people but not for me.
When I had a three way catheter inserted the pain did eventually reduce to discomfort (15-30 minutes). However, the larger balloon caused painful bladder spasms. It took 4 Percocet and 2 suppositories (maybe detrol?) over a 3 hour period before the pain was under control. I made the mistake of not taking the maximum prescribed medication immediately.
During one hospital stay I had an improperly installed or partially blocked
catheter. I was on an IV and was encouraged to drink as much as I wanted
but not allowed anything solid. Although I could feel a lot of pressure
building up in the bladder none of the nurses would believe that I had
a problem. They would check for urine going into the bed bag and then
pretty much ignore me. One of the nurse's aids did try to help me and
spent about 1/2 hour after her shift lifting the catheter drainage tube
to let it fill with urine then dropping it. The extra suction created
by gravity did help empty the bladder. She got around 500 ml out of the
bladder and things felt much better, this was about 11:00 pm. Although
she recorded this on my record no one believed me when I again complained
at 4:00 am that the bladder was getting full. Finally at 9:00 am they
decided to remove the catheter and told me I couldn't leave the hospital
until I could urinate. I told her that I was going to explode and needed
a urinal right away. She didn't believe me but after about 2 minutes I
was able to void over 700-900 ml. When she did return and checked the
urinal she didn't say a word. I was released shortly after that and again
no one said anything about the full bladder. Since then I have learned
that the nurse should be able to press on the abdomen and check for a
full bladder (distention). Unfortunately no one did this. They only checked
the bed bag for increasing volume. Obviously the IV and liquids was putting
in more than was being removed via the bed bag and none of the nursing
staff believed there was a problem.
The moral to this story is if you decide to go to a teaching hospital, expect to be watched or even worked on (under supervision) by medical students. In this case you should remember that this is the normal and necessary learning process and this is something that they’ve all seen before, no matter how personal. Also, as in my case, you can refuse to sign the release form or simply ask the students to leave however, this somewhat defeats the purpose of going to a teaching hospital.
I hope sharing some of my experiences may help someone new to catheters. After a few experiences with catheters you'll know what works best for you. Best of luck with your catheter experiences!