thatsmymango

Where you are placing the hole is probably to far from the bladder, hence it is irritating your urethra at a narrow section. I tend to go for about 3" from the outside edge of the balloon. So that's maybe about 4" from the catheter tip.

The double balloon catheter posted by Roo and the Duette cather posted by rick50 are not the same, and are designed for different functions. One is for bladder drainage, one for delivery of drugs to the prostate region. The Duette catheter is for bladder drainage. It has two balloons, both of which go inside the bladder. These are intended to prevent the negative pressure of drainage from sucking the bladder wall into the drainage eyes, which can cause trauma. The double balloon catheter is for prostatitis therapy. The larger of the two balloons goes inside the bladder and seals the bladder neck, the smaller outside the prostate/sphincter, sealing the urethra. There are two separate inflation ports for these balloons. The third port is for instilling antibiotics, which emerge from an eye between the two balloons. The purpose is for direct delivery of antibiotics to the prostate area to treat prostatitis. The device is not for draining the bladder and is not left in place for long periods. To adapt it as a stent for incontinence, a hole would need to be created beyond the larger of the two balloons inside the bladder. There are also 4-way catheters, with two balloons like this one, an injection channel like this one AND a drainage channel.

The "Holey Foley" I'm referring to is basically the idea posted right near the start of this very long conversation. It's a normal Foley catheter, inserted normally. The only modification is a hole in the catheter outside the outer sphincter ... say about 3 inches up from the balloon. With the catheter plugged where the urine would normally drain out, the urine instead leaks out of the hole and drains via the urethra without control into a diaper. Of course it means you have the catheter hanging out of you, which some folks don't like. Personally, that doesn't worry me and I think it's safer. It can be removed and changed easily and (other than the added hole) is a standard medical device. My situation .... I have mild spina bifida. No mobility problems, but plenty of bladder problems. I wear diapers to manage incontinence. But even though it leaks, my bladder doesn't fully empty, so I must also use intermittent catheterization to make sure empties fully a couple of times a day. However, I find the intermittent catheterization tiresome ... and after a few weeks it can begin to hurt. Originally, to give my urethra a break from the intermittent catheterization, the solution offered was to have a Foley catheter in place for a couple of weeks every now and then. But I hate all the straps and tubes and bags associated with normal Foley catheterization. Another option was an indwelling catheter plugged with a valve during the day (and I would open the valve to empty my bladder at regular intervals) and attached to a bag at night. But truth be told, as well as hating the straps and tubes and bags, I missed diapers when I was catheterized that way. I've worn them pretty much all my life ... they are part of who I am, I've grow attached to them. Simple as that. Hence turning to a Foley catheter modified with the hole. It ensures my bladder empties completely and gives me a break from intermittent catheterization. It means I need to change diapers more often than usual, but I'm fine with that. Also I can wear a bag if I want to (for example if I want to have a few beers and changing diapers might be awkward). After a few weeks my urethra is fine again and I can go back to the intermittent catheterization. I must say I'm intrigued by the dedication and ingenuity shown by the folks designing and testing self-made indwelling stents that ensure bladder drainage without being seen from the outside. But there are quite a number of potential problems. My long post yesterday was simply intended to highlight benefits and challenges and potential risks all in one place. If something like that became available and I was certain of it's safety in use and at insertion/removal I would consider it. There is currently a stent in development commercially with a magnetically operated valve … but not yet available as far as I’m aware.

Absolutely, abvegas !!! As you probably sensed, although in my lengthy post I was trying to see the benefits of both types, I have concerns about self-made stents and feel that "Holey Foley" idea is much the safer way to go. It only involves a minimal alteration to a well-proven and accepted medical device. More than that, the Holey Foley has been discussed by urologists, who didn't see much wrong with the idea in pronciple : it allows for a "flushable" sealed system so that diapers can be used for collection : it can also be used with a normal urine collection bag, as urine will take the "route of least resistance" ... i.e. when the end is not plugged the urine will flow into the bag rather than out the side hole.

This is in my area of work. There are a few risks associated with catheters ... and with these self-made stents. I'll run through them and maybe it will help. Infection There are two main ways an infection will occur: on insertion of any kind of catheter or by bacteria entering the urinary tract up a Foley indwelling catheter from outside. Let's look at the latter first. There are two main ways bacteria can enter the urinary tract up an indwelling Foley catheter: Bacteria can travel up the catheter through lumen (the hollow internal passage in the catheter through which urine drains). When used "normally" (i.e. attached to a regularly changed urine bag) the Foley catheter is a sealed system. However, there is always a chance of bacteria being introduced when bags are changed and so on. And there is also a risk that old urine trapped at any point can provide a place for bacteria to develop. Bacteria can travel up between the catheter and the wall of the urethra. This most commonly happens because of poor hygiene, and often because of contamination by traces of feces at the point where the catheter exits the body. Neither of these applies in the case of intermittent catheters because they are not left in place long enough. Now insertion. With either Foley indwelling catheters or intermittent catheters, insertion is a "risk time" for introducing an infection. The risks are different depending on who is doing the insertion. When a Foley indwelling catheter is inserted by someone else (for example, in a hospital setting), an aseptic (sterile) method is always used because the transfer of bacteria or other infectious agent is always greater between the person doing the insertion and the patient. That's why when a nurse or doctor inserts a catheter there is a whole kit of wipes, antiseptics, gloves, etc etc. Of course doctors and nurses treat and handle lots of patients, so the risk of them transferring an infection is quite high. The same is true when someone performs intermittent catheterization on someone else ... for example a carer and a disabled person. An aseptic method is recommended. Intermittent SELF-catheterization is different. Before the 1970s, urologists only recommended sterile intermittent catheterization, which was impractical for many and so indwelling catheters were more commonly used. Then in the early 1970s a Michigan urologist called Jack Lapides established that intermittent self-catheterization in conditions that are simply "clean" rather than sterile is fine, and poses no greater risk of UTI. The reasons were not well established but are believed to be to do with the fact that we are less likely to infect ourselves with our "own bugs" than someone else is with theirs. Once the safety of "clean intermittent catheterization" had been established, that's when intermittent self-catheterization became commonplace, and gave people with voiding problems freedom from indwelling Foley catheters and from the UTIs with which they are associated. SELF catheterization with longer term foley catheters. This is a grey area, because, frankly, you aren't supposed to be inserting your own Foley catheters, so no research exists to say whether "self-Foley-catheterization" is safer than another person doing it. So, in terms of infection, what does all this mean for the Foley catheters modified with a hole outside the sphincter and self-made invisible stents ? Let's look at the modified "Holey Foley" catheters first. To be very clear: I'm talking about Foley catheters that are "modified" with a hole outside the sphincter, inserted normally, inflated, left in place emerging from the urethra, and with the drainage end plugged so that urine flows out the hole and exits through the urethra. Risk 1: Contaminating the catheter when modifying it. There is a possibility that you can introduce bacteria to the catheter when working on it. But practically speaking, if this is done in the cleanest possible conditions and using clean implements and the catheter is then thoroughly cleaned and sterilized before insertion, the risks should be small. If an infection is caused you will know about it quite quickly and act accordingly. Once in place for a few days, if no infection has happened, you're in the clear from that risk. Risk 2: Introducing an infection on insertion (other than one caused during modification). As I said above, self-catheterization is considered less likely to cause infection than catheterization by someone else, but this has only been established for intermittent catheters. So it is sensible to use as sterile a methods as possible. Risk 3: Bacteria traveling up the inside lumen of the catheter. With the end blocked, this risk is reduced, but is still there. One risk is the growth of bacteria in old urine trapped in the blocked end. A sensible approach to minimize this risk is daily to sit down for a while so that your bladder will not drain because of pressure on the urethra, and then take the plug out and allow urine to flush out the catheter. And always pay strict attention to hygiene while unplugging the catheter end to avoid introducing bacteria. Risk 4: Bacteria traveling up between the catheter and the wall of the urethra. This risk is actually less with a "Holey Foley" than a normal Foley, because, as many have observed previously, it is constantly being flushed out with urine, which is not the case in normal Foley catheter use. But still sensible to maintain good hygiene. All in all, with good hygiene the risks are there, but can be minimized. So what about the self-made invisible stents? The good news is that the number of major risks of infection are halved, in that only Risks 1 and 2 above apply. However, those risks may be greater with the self-made stents because they may be made from materials that are not sterilized or cannot easily be sterilized, and their surfaces seem usually to be more complex than a Foley catheter so that there are more places for bacteria to "hide". So, whether to leave stents in place or take out and wash? It's a judgment call, but it may be that if no infection occurs in the first week or so then none is likely to occur. Normal practice is to change Foley catheters at somewhere between two and four weeks (doctors argue about this and nobody has proven the "best" time yet). So if you're comfortable with it in place, a couple of weeks between setrilizing should be fine. But infection is not the only risk associated with stents and catheters... Bladder wall damage With any catheter or stent there is a risk of trauma either to the wall of the bladder where the end of the catheter touches it or through "suction trauma". Bladder wall damage will cause pain, especially if it happens at the same time as a UTI. More scarily, it has also been associated nastier things like an increased risk of bladder cancer, although the connection is not established. Holey Foleys present considerably less risk of bladder wall damage ... no more than a normal Foley. Catheters have rounded ends and surfaces both for ease of insertion and to minimize bladder wall damage caused but contact. A concern with self-made stents that have surfaces, ends or retention mechanisms that are not well rounded is that they are more likely to cause bladder wall damage. Suction trauma occurs if a good deal of urine suddenly passes out of the catheter. This can happen if the drainage "eyes' of the catheter have been resting agains tha bladder wall. With the "Holey Foley" it can happen after sitting because the urethra is compressed (you may have noticed you suddenly leak a lot with a Holey Foley after standing up). Once all the urine drains there is a negative pressure that can suck part of the bladder wall into the drainage eye. Nothing too serious now and then: it can hurt a bit and cause cramps. But not good if it happens too often. Urethral trauma Urethral trauma hurts. If it causes scarring, it can also lead to urethral strictures, where the urethra will narrow and will need to be repaired surgically, either by urethral dilation using catheters or sounds, or by urethrotomy ... which hurts a real lot. Urethral trauma can happen on insertion or removal using normal catheters, but with care and good lubrication the risks are not too great. With a Holey Foley, the edges and positioning of the hole are the risk. The edges of the hole should be smooth. Ragged edges repeatedly rubbing on the urethra could cause trauma. The hole should be positioned at a wide section of the urethra. You'll discover yourself where is comfortable. The benefit of the Holey Foley is that, other than the hole, there is nothing else that is likely to cause trauma. With the self-made stents the external end of the stent is sitting within the urethra, and even if the edges are well rounded and materials are soft, there is still quite a risk that repeated rubbing against the urethra through normal movement will cause trauma and stricture over time. Gotta keep working on the designs guys! Another major cause for concern about urethral trauma and self-made stents are the insertion and removal techniques. Sounds, hooks, strings ... all of these could cause trauma. Be damned careful! If anything hurts, don;t do it. Calcification Calcification of catheters (or any indwelling urethral device) can occur over time. Essentially salts can build up on the device surfaces and provide a home for bacteria to develop, or even cause blockage. This only really occurs over extended use and should not be a problem with regular changing of devices at 2-4 weeks maximum. Blockage Blockage of catheters or other urethral device can be caused by bacteria or calcification, or by bladder wall tissue loosened by trauma. If you find you suddenly cannot empty your bladder with a device in place, remove it as soon as possible and drink a lot of water to flush out the urinary tract. Materials Foley catheters are made from materials that are well proven to be compatible with the urinary tract. They are selected to minimize the risk of allergic reactions or of other interactions with tissues or fluids. For self-made devices I guess a concern is that this is less clear. Sorry for such a long post ... I hope some of this will be useful to you in furthering your work !!

Each to his/her own, but I am incontinent and I don't mind people asking such questions at all. Maybe it could be worded a little better, but I think it's worth reading between the lines a little. I'm sure no offence was intended. I've been incontinent all my life. Diapers are part of who I am. I think at this stage I would miss them terribly if I was suddenly cured (which is not likely since I have spina bifida). I have come to enjoy the feel of them and am reliant upon the security they offer. While I don't ENJOY being incontinent as such (let's face it, it can be tiresome and a damn nuisance often), I'm used to it. It's normal. If anything, there is a part of my brain that finds the concept of "holding it" and finding toilets quite a scary prospect (not something I've ever reliably been able to do). Accepting incontinence as part of me and not stressing about it has been my way of dealing with it. That's not the same as "enjoying it", but it's a happy acceptance that that is the way it is. I enjoy being ME ... and wouldn't really want to change who I am in any way. I've achieved a lot in terms of life and career, all of it while being incontinent and in diapers. I am guessing THOSE are the sort of perspectives the original poster was asking about? In any case, users of this board must know that such questions are asked and such things are discussed. There is a whole section of people WANTING to be incontinent, for goodness sake. This is a place where incontinent and continent people mix, basically because of some sort of shared interests ... these interests may be very varied, but somewhere or other they overlap. There are plenty of other organizations and forums for incontinent people, in which such discussions never occur.

Hi Repaid1 Actually i never heard of that movie. I chose "thatsmymango" because I have been based in SE Asia for some years now (working for an international aid agency) and I like the mangoes very much indeed !! Funny to hear something similar has been used as a tagline ... I empathize with the sentiments !! I'll PM you about the other matter.

When I was living in the UK, things were pretty much always the same for years. I was supplied with TenaSlip by the health authorities ... occasionally Molicare if they changed supplier. I preferred Tena Maxi ... always a safe option. But since moving to Asia things have become much more interesting!! I'm like a kid in a candy store. Some are good, some are not so good, but it's interesting to have the variety. (See my compendium of Asian diapers ... http://www.dailydiapers.com/board/index.php?app=gallery&album=2624 ) Sure, Tena are available here (and still plastic-backed), but I have stopped using them. Now I mostly use a brand called Dr P (crazy name!!), a plastic-backed disposable. The "basic" type is a normal thin daytime diaper, and there is a more absorbent daytime use option as well. Both come with purple and yellow hearts on the front tape "landing area". (http://www.dailydiapers.com/board/index.php?app=gallery&image=22636 ) The "Maxi overnight" Dr P is an awesome diaper ... I never saw absorbency like it. In all types the tapes stick really well even after refastening a few times. (http://www.dailydiapers.com/board/index.php?app=gallery&image=22634 ) I also use a Chinese brand called (somewhat depressingly) ElderJoy. They are a daytime diaper only, but pretty good. The plastic backing has a great silky feel to it and, like Dr P, the tapes stick really well even after refastening a few times. They come with multicoloured hearts all over them. (http://www.dailydiapers.com/board/index.php?app=gallery&image=22633 ) Traveling affords me the opportunity to test diapers from other countries. The best diaper I found to date (anywhere!) is a Korean Kimberly Clark brand called 디펜드 (phonetic Korean version of Depends) (http://www.dailydiapers.com/board/index.php?app=gallery&image=23118 ). Unlike Depends elsewhere. Japanese disposables, like the Ellemoi Ichiban are interesting just because they are different, but I don't use them so often unless stuck. (http://www.dailydiapers.com/board/index.php?app=gallery&image=22635 ) Cloth outer shell, not my thing!!

Interesting perspective, BitterGrey. Thinking purely of Diaper Lovers (and leaving aside the roleplay/"being babied" factor that ABs are interested in), I think there are a couple of factors that influence diaper preferences that need to be differentiated. One relates to childhood experience, while the other is purely to do with the senses and is "of the now". And one would fit very much into your thoughts about regional differences, but the other less so. I guess some DLs are DLs because of one or other of them ... or both. One often hears of older DLs preferring the cloth diapers they had as a child, while younger ones favour the disposable. (One wonders will the plastic backed disposable be replaced in even younger DLs' affections by the "cloth backed" disposable?) That perspective would suggest that there ought to be regional variations as you described, based upon childhood exposures and national 'diapering culture". And there seems to be some evidence to support that. Certainly in the UK where I grew up there is a fondness amongst some DLs for straightforward terry towelling diapers (nappies), whereas in the USA I gather there is an interest in prefolds and birdseye materials, which were not really familiar items in the UK. Meanwhile in Japan we see pictures of the omutsu style diapers with simple cloth soakers held in place by quite elaborate covers. But there are other factors about wearing and using diapers that do not relate to childhood experience ... for me anyway. I've been incontinent since birth (mild spina bifida). For me, diapers perform a very necessary practical function for me ... my clothes would be wet without them. But I have come to like wearing them ... they are simply part of who I am. I grew up in the second half of the 1960s and into the 1970s with cloth diapers and plastic pants. Yet I have no affection for those ... none whatsoever. For me they seem bulky and insecure. So in my case at least, that childhood experience did not "fix" the type of diaper I prefer. I much prefer plastic backed disposables. Disposables create a "snug" tight-fitting feeling which I have grown to like a lot. I feel terribly exposed without them. I like the bulk between my legs. I like the squidginess of the expanded absorbent gel. And I like the feel of the plastic outer. I like the rustle. These are all tactile, "of the now" factors that people from any region or era can appreciate in modern disposables ... they are independent of childhood experience. So from that perspective, for some DLs childhood experience or culture may have very little effect on DL feelings and practices. That's certainly the case for me As ever things are complex But interesting !!

I use Dr P all the time. It depends which type you buy. The "Standard" ones are poor in terms of absorbency (palest blue packs in medium size). But the "daytime use" ones (darker blue packs) are good ... and the "maxi overnight" ones (darkest blue packs) are fantastic ... amazing absorbency, they've never let me down.

Dr P overnight .... I live in Asia http://www.dailydiapers.com/board/index.php?app=gallery&image=22634

Not a diaper bag as such, but I carry a bag around with me most of the time. I live in the tropics and it is too hot to wear a jacket ... so many men carry a small bag or use a belt pouch to keep stuff that would normally fit in jacket pockets. I have a Crumpler bag in which I keep my camera, spare cellphone and chargers, a small umbrella (for sudden tropical rain!), notepad, pens, work ID, etc. And there is a discrete zipped section which neatly holds a spare diaper and some wipes to freshen up with. A second external zipped section is available if I feel I may need two spares.

Hi Champ I'm also in Asia ... Western Pacific. Welcome!

A word of advice. Only use Hiprex when you have a UTI. Using it "just in case" to prevent infections could lead to antimicrobial resistance, so that if you DO gat a UTI, it will not work and a stronger antibiotic will be needed. Just drink plenty of fluids to keep the urine dilute and the urinary system "flushed out".

I love the way this thread has reached its 36th page. Goes to show the whole idea is one we love. The modified catheter provides the type of incontinence some of us have sought for a long time. I have been using the method for more than a year off and on ... mostly on for the past three months. My reason is maybe slightly different from some others. I was born with mild spina bifida, which means the nerves that control my bladder are dysfunctional. This has two effects: a ) I leak. Urinary incontinence. So I must wear diapers ... or some form of urine collection device, but I prefer diapers to all the tubes and sheaths and bags, etc. b ) My bladder does not empty fully. That means that pretty much all of my like I have had to self-catheterize a couple of times a day to make sure my bladder is empty in order to prevent urinary tract infections and possible kidney damage. But I hate self-catheterizing. It can be painful and it is simply a drag. The modified indwelling catheter means my bladder drains properly, and the fact that the "modification hole" is inside the urethra and the constant "flushing" with urine prevent external bacteria getting into the bladder. I must wear diapers anyway, and this method means I can simply rely on them completely, no need for putting catheters in and out several times a day. The only time I take out the modified catheter is either to change it or when I have a social function to go to that will involve drinking. At such events I revert to self-catheterising to try to keep my bladder empty and minimize the incontinence (along with wearing a diaper of course). I use a 14fr with the hole about 3.5" from the balloon. I have never had issues with UTIs. The effects of sudden flooding after standing up and reduced leakage while in bed (or lying down anywhere) are quite normal. When sitting there is extra pressure on the anterior urethra that will help prevent urine escaping ... but stand up and that pressure is gone and the flood gates will soon open. When lying down, the weight of the internal organs is not pressing down on the bladder in the same way as it does when standing. So the pressure inside the bladder is less. Often I can sleep through the night with minimal leakage ... but as soon as I stand up the bladder will steadily empty. It's a clever system that has made my life easier. I have discussed it with a urologist and they confirmed that it should theoretically be quite safe, with the caveat that the "modification hole" should not have sharp edges as irritation of the urethra could lead to strictures. (If you can feel the hole irritating the urethra, take it out !!)