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Close To Incontinence With A Catheter


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...

but I would rather not have to deal with bags

...

Have you tried, really?

I find a bag easier to deal with than a nappy. Get bags with long hoses so that you can wear them on the calf (lower leg, I don't know if you Americans call it the same...) instead of the thigh. when you need to empty it, you can just hitch up your trouser leg and drain away. It also keeps the pressure low, specially sitting in a car, because the thigh bags are most times at the same height as your bladder when you sit in the back, whereas the calf bag always will be lower.

They are also less awkward in a public situation; no nappy/diaper to take into the stall, nothing to dispose afterwards, and no leaking spots either. If the worst comes to the worst, you can even drain into an empty bottle in the car, and then empty and dump that at a layby.

I take it that your sis knows about your condition. Most leg bags (well, the ones I've had) have the drain valve designed to accept another catheter connector, so you could just attach a 2l night bag to it and lay it on the floor (just don't step on it! <grin>), which would give you almost a gallon of capacity.

Sorry about your UTI, but with 8 hours that sounds like the was something on the way already, and the timing might just have been coincidental.

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EXPERIMENT

Warnings: This is my experiment - do not attempt this at home. Use of silicone catheter would likely result in an embarrassing trip to the ER. I planned my story ahead of time - this could be extremely hard to explain and then realized there is no real way to explain this away, just tell the truth.

Objective: To eliminate catheter tubing in diaper.

Method: Using modified catheter (not for this experiment) cut just beyond urethra opening with retracted penis using thread to recover catheter and drain catheter balloon.

Materials:

Latex catheter

Hemostat – locking clamp

Jewelers pliers

Upholstery thread

Upholstery needle

Plug for catheter balloon fill tube (small tube) this was fabricated.

Procedure:

Materials other than the catheter were cleaned using alcohol. This does not create a sterile environment, but the area where they will be used is not usually considered sterile and should be flushed with urine being expelled from the bladder.

Insert Foley catheter following normal sterile procedure. For this experiment a non-modified catheter was used. With catheter in place retract penis exposing as much of the catheter tube as you can. Clamp hemostat as near to urethral opening as possible. Test to ensure that catheter balloon is not leaking. The catheter was then cut approximately 3\4 inch from hemostat away from the penis end.

A fabricated plug was then inserted into the balloon fill line that had a loop for attachment to upholstery thread (this is extremely strong thread you will not be able to break it by hand). This is how the balloon can be deflated so care needs to taken that the plug can be easily removed (I used a bit of silicone lube). The diameter of the plug is about 5 to 8 times that of the balloon tube to ensure the balloon does not deflate unintentionally.

Next using an upholstery needle & thread pierce the latex catheter near the hemostat using the jeweler pliers (smooth grip area) being sure to miss the balloon inflation tube leaving 1\2 inch of tube. This could be done twice to ensure a redundancy. Secure the ends of the threads about 6 inches from the catheter with a button. This ensures the catheter can be recovered if it migrates into the bladder. Check all work. Release the hemostat and allow the catheter to migrate into the urethra leaving only the thread exposed. The catheter tube end was now completely inside the penis.

Catheter removal was accomplished in this experiment by retracting the penis to the balloon plug, which was removed by hand without the aid of the thread. Upon deflation, the catheter was removed by pulling the thread very gently with no trauma to the urethra even though the edges were squared off.

This experiment was very successful, but not without concerns. Failure of the threads seemed unlikely as they were tested on used catheters, but uncertainties remained. This was an experiment and I’m not sure if I will continue in this effort, but the results are very satisfying.

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I'm a bit embarrassed to show this because this is not very refined, but I didn't want to put to much effort into this first attempt. This is more proof of concept, than a working design. It should be noted that the end of the catheter was open. To take advantage of the hole in the catheter tube just past the prostate one would need to fit a plug to close off the end, but my problem was that this might restrict the ability to remove the balloon drain plug. Maybe pushing a plug further down the catheter tube so as not to put pressure on the balloon drain tube? So consider this a work in progress for the moment.

Edited by SWet
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For Wetman: I can see a mental picture of a guy in a bathroom stall with his leg held over the toilet peeing :lol::roflmao::wtf2: Sorry, I couldn't resist.

I still don't have the guts to try this but so far nobody has reported and real problems here ;) For those who say they desire to be incontinent, this would be a sure-fire way for them to see if their RL experiences match their fantasy thoughts :whistling: AFAIK this is the first method which really does that safely, so kudos to the originator.

Bettypooh

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For Wetman: I can see a mental picture of a guy in a bathroom stall with his leg held over the toilet peeing :lol::roflmao::wtf2: Sorry, I couldn't resist.

Yep. That's exactly what it's like. Done that quite a few times.

Funny would be to do that at the urinal.

Hurhur.

@ Swet:

I'm impressed. Not just with your ingenuity, but also with the style that you present your developments with.

You are a real pacemaker here!

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  • 2 weeks later...

A thought came to my mind.

We are looking for a way to loose conscious control here, aren't we? So, 'stenting' the bladder/ internal sphincter is probably not necessary, as it is a smooth muscle and not under voluntary control. The voluntary control seems to be just the external sphincter.

So, if we bypass the external sphincter, should we not experience an effect as if we're not 'potty trained' at all? We (if we're potty trained and not re-untrained) are trained to keep our external sphincter closed and only open it at the appropriate time. Bladder pressure will send a signal that it's getting full and then opens the internal valve together with constricting the bladder itself. Only the second valve keeps us from wetting now. If that would be disabled then there's no way of holding the pee once the 'need to pee' signal appears. This sounds to me closer to the more common types of incontinence than constant continuous loss, and very similar to an untrained person.

Another advantage would be that nothing has to go all the way into the bladder or through the prostate, reducing the risk of an infection. Correct placement would be crucial and a bit hard to achieve, as there's no fixed measure, and no real indicator where the stent should go. This has to be determined per person.

Now, has anyone got a good idea of how to approach this? Or are there issues that I've overlooked and that render the thing unfeasible?

Some people here have improved the 'just-an-open-catheter' in very creative and ingenious ways, I'm sure there's an incontinence engineer out there with a concept just waiting ...

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  • 2 weeks later...

Concerns have been expressed about the urine captured between the crimped end of the catheter and the bypass hole punched in the catheter that it could be a breeding ground for bacteria leading to a UTI. Here is an idea, why not plug the catheter drainage tube away from the bladder? Using a biologically inert material of the appropriate diameter inserted through the punched\cut hole in the catheter. This can be done at the time the hole is created thus compromising the sterile field as little as possible. All materials used in this procedure should be as close too sterile as possible. You would still need to use some method to close the balloon fill tube after cutting the catheter, so crimping or plugging the small tube will be necessary.

The catheter balloon fill tube and the ability of urine to flow around the tube after insertion of the plug are considerations. If the plug is of too large a diameter in might interfere with the flow of urine around the catheter. The balloon fill tube could be constricted and it might be impossible to deflate the balloon. I tested for these conditions and found that a plug of the appropriate size did not cause any problems. Note, the plug diameter will vary based on the french diameter of the catheter.

Another concern with this technique is that if you need to initiate urine flow through the catheter you won’t be able to, you would have to remove the catheter. Any thoughts, concerns or comments would be appreciated.

post-9519-0-77676200-1325684611_thumb.jp

post-9519-0-77676200-1325684611_thumb.jp

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Hi Swet,

definitely a solution to the challenge of keeping the distal end of the catheter clean or, with your method, even dry. As I mentioned before, I wasn't too worried about it anymore anyway, because it seemed to be causing no problems. and some octenisept or a tiny dab of betadine in the waste lenght would probably kill any bacteria picked up during instillation.

You are on the way to become my favourite 'urinary engineer'!

On a different subject:

I'm at the moment a bit busy and have run out of catheters, so I haven't tried my own idea (further up) of just stenting the outer sphincter. Has anyone tried that, and if so, to what outcome?

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I had an intriguing idea: why not design a similar device and cast it out of high quality platinum silicone? Silicone can withstand extremely high temperatures without breaking down, so the result could even be put through an autoclave I'd imagine. The main issue would be casting an effective device, but it seems like it should be possible, given that Rusch (et al) manufacture theirs the same way.

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In the ongoing quest to improve the catheter experience I’ve come up with this esthetic change. The closure of the open end of the catheter and balloon fill tube can be accomplished with this design. Using bronze wire & round stock (your local craft store has this), a bit of silver solder and a screw cap (hardware store) you can create an end closure to the catheter. The images show the very simple design. The catheter balloon plug\wire should be oversize, as there is considerable pressure from the inflated balloon.

When using this cap the catheter will need to be pinched closed to ensure the balloon stays inflated when making the cut to remove the “Y” section. The wire portion that plugs the balloon fill line is slightly longer to allow this line to be closed first before the drain line is closed, much easier than trying to do both at once.

One concern with this design is that there is nothing to stop the catheter from migrating towards the bladder. While I haven’t experienced this to any degree it might be a thought to sew a string to the catheter body for retrieval if this should occur.

So if you have some simple tools this seems like a fun project for a rainy\snowy day.

post-9519-0-67645800-1325687726_thumb.jp

post-9519-0-67645800-1325687726_thumb.jp

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I usually give control up when I wear, and let happen what happens. This does not lead to me dribbling all the time, but I do leak a little every 20 to 30 minutes or so, depending on fluid level. I also found that drinking, having cold feet and (this is way weird!) filling the car at the pump makes me wet myself. All this with a nappy on; without, I have quite a good control (the fuel station still makes me need to go really badly).

So, am I thinking the wrong way with the constant flow, or am I playing baby (which isn't really my thing), or what?

And most important: Why the #'1$%! while I'm at the fuel station???

The 'why' I think is just the sound of flowing liquid. I'm the same way. No catheter here, just diapered.

The shower is also a place where I just can't stop it from happening. My urologist just smiles and nods about that one. Typical reaction - at least for those of us who have any problem at all.

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  • 3 weeks later...

A thought came to my mind.

We are looking for a way to loose conscious control here, aren't we? So, 'stenting' the bladder/ internal sphincter is probably not necessary, as it is a smooth muscle and not under voluntary control. The voluntary control seems to be just the external sphincter.

So, if we bypass the external sphincter, should we not experience an effect as if we're not 'potty trained' at all? We (if we're potty trained and not re-untrained) are trained to keep our external sphincter closed and only open it at the appropriate time. Bladder pressure will send a signal that it's getting full and then opens the internal valve together with constricting the bladder itself. Only the second valve keeps us from wetting now. If that would be disabled then there's no way of holding the pee once the 'need to pee' signal appears. This sounds to me closer to the more common types of incontinence than constant continuous loss, and very similar to an untrained person.

Another advantage would be that nothing has to go all the way into the bladder or through the prostate, reducing the risk of an infection. Correct placement would be crucial and a bit hard to achieve, as there's no fixed measure, and no real indicator where the stent should go. This has to be determined per person.

Now, has anyone got a good idea of how to approach this? Or are there issues that I've overlooked and that render the thing unfeasible?

Some people here have improved the 'just-an-open-catheter' in very creative and ingenious ways, I'm sure there's an incontinence engineer out there with a concept just waiting ...

Just one problem: your internal sphincter is under control of your subconscious mind. If you have learned, for example that the bathroom is a dangerous place when others are in there, you won't be able to go in the bathroom when this it is appropriate to do so. I would think that stenting or cathing (or somehow training) the internal sphincter to stay open would cause incontinence. Eventually, the body will defeat the EXTERNAL sphincter. If your garden hose is at full blast but your water is turned off, you can't water the grass.

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  • 2 weeks later...

I’ve been trying a few experiments to create a smooth end to the catheter that would allow the catheter to be shortened and retrieved with a string. I can’t seem to accomplish a smooth transition between the catheter body and the tip. Every version has caused sufficient irritation to the urethra that the catheter was removed after a few hours. I think I’ll just say it was an idea worth exploring, it just didn’t work out.

So my current configuration of choice is a 16 french silicone catheter with two small oval holes with the drain tube blocked just past the holes and with a zip tie to avoid deflation of the balloon. This is close to my first experience with a catheter and seems to be the most comfortable and effective.

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I’ve been trying a few experiments to create a smooth end to the catheter that would allow the catheter to be shortened and retrieved with a string. I can’t seem to accomplish a smooth transition between the catheter body and the tip. Every version has caused sufficient irritation to the urethra that the catheter was removed after a few hours. I think I’ll just say it was an idea worth exploring, it just didn’t work out.

...

Hi SWet,

you wrote in an earlier post that the squared off end didn't cause any problems; was that just a very short trial (<1h) and the irritation only manifests if you're wearing for a longer period? How did you try to modify the end, tapering, beveling? It's just that I had a follow-up idea to that construction:

Measure the lenght of your urethra, then cut a catheter 5cm short of that lenght. Sow a retrieval thread to the end (just like the shortened construction you made, with the button or similar). Now use the very thin inflation tube of an endotracheal tube and feed that into the inflation tube, 1 cm should probably do, because it will be a very tight fit. Sterilise the lot. Use a thinner single-use catheter as an introducer in the open end of this modified foley. When in situ, fill the blocker balloon through the ETT inflater valve, clamp shut with haemostat, cut valve and the sensor balloon, and block off the end (heat up and melt shut, maybe). This should give a minimum of externally visible 'equipment' while still guaranteeing retrieval.

So far only a thought experiment, but what do you (plural, not just SWet) think?

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To answer Wetman: The first trial of the cut off cath was for only a half hour after a “normal” cath session.

I tried using the tip of another catheter cut so that the balloon covered the inserted catheter, basically a double-ended catheter. Even this small ridge of rubber caused irritation. I tried the “Black Cap” which in the picture seems to have very little difference in diameter, but still irritated. I’ve tried a smaller diameter cap, still caused problems. As always you may have different results. I think the longest I lasted was 12 hours and that was not very comfortable towards the end.

After a 24 hour session last weekend with my current configuration (see above), I’m of the opinion that keeping it simple is the way to go for me. No irritation at all, even on removal.

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I need to ask a couple general cathing questions here and instead of starting another thread, I put it here because you all seem to have the expertise I may need :) Being that I am very skittish about trying this, what harm is potentially involved if I start with the smallest cath to be sure I don't oversize it? And second, is there an easy way to learn how to position it properly with no cathing experience of my own? I guess you can tell that I want to try this :) No promises though, but these answers may help me get over my fears! And if I find I can cath normally I will be sure to try this next after that. This is a wonderful concept and I am still awe-struck by it!

Bettypooh

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What harm is potentially involved if I start with the smallest cath to be sure I don't oversize it? And second, is there an easy way to learn how to position it properly with no cathing experience of my own?

Bettypooh

In regards to smaller size, the only reports I've heard of is irritation by the catheter tube moving around in the urethra. The medical profession recommends the largest size that is tolerated, that's why all the different size Foley catheters. Intermittent catheters are usually smaller, typically 14 french since they will not be in place long.

In terms of positioning, a number of videos show correct procedure and are well worth reviewing. The most important aspect of insertion of a catheter is keeping it sterile and go SLOW. My first foley insertion procedure took over 10 minutes to accomplish. I think the reports of sever pain with catheterization is the result of forcing the tube into the bladder. The major problem is excitement\stimulation by the procedure closes off the urinary tract, so one needs to relax and think of other things – take your time.

Bettypooh, I might relate my progression in the catheter experience. I tried the condom catheters first connecting to a bag placed in the diaper. Diapers lasted a long time needless to say, but occasional kinks in the tubing lead to some blow offs that instantly flooded the diaper in a spectacular way. The chance of a UTI is almost zero with this technique.

Then I experimented with intermittent catheters retaining the catheter in place with tape (only did this a few times). In my opinion this likely has the highest potential for a UTI if you wear a diaper with the method. On the plus side the catheters are inexpensive and you can see if inserting a catheter is really something you can do. Essentially insertion is the same as a Foley, you just don't have the balloon to inflate to retain the catheter in the bladder. I never tried the modified\blocked catheter with an intemittent cath, but this might reduce the UTI risk as urine is flowing around the outside of the catheter tube and the catheter drain tube is closed.

These are my experiences, your results may vary, seek medical advice and as always don’t try this at home.

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In regards to smaller size, the only reports I've heard of is irritation by the catheter tube moving around in the urethra. The medical profession recommends the largest size that is tolerated, that's why all the different size Foley catheters. Intermittent catheters are usually smaller, typically 14 french since they will not be in place long.

In terms of positioning, a number of videos show correct procedure and are well worth reviewing. The most important aspect of insertion of a catheter is keeping it sterile and go SLOW. My first foley insertion procedure took over 10 minutes to accomplish. I think the reports of sever pain with catheterization is the result of forcing the tube into the bladder. The major problem is excitement\stimulation by the procedure closes off the urinary tract, so one needs to relax and think of other things – take your time.

Bettypooh, I might relate my progression in the catheter experience. I tried the condom catheters first connecting to a bag placed in the diaper. Diapers lasted a long time needless to say, but occasional kinks in the tubing lead to some blow offs that instantly flooded the diaper in a spectacular way. The chance of a UTI is almost zero with this technique.

Then I experimented with intermittent catheters retaining the catheter in place with tape (only did this a few times). In my opinion this likely has the highest potential for a UTI if you wear a diaper with the method. On the plus side the catheters are inexpensive and you can see if inserting a catheter is really something you can do. Essentially insertion is the same as a Foley, you just don't have the balloon to inflate to retain the catheter in the bladder. I never tried the modified\blocked catheter with an intemittent cath, but this might reduce the UTI risk as urine is flowing around the outside of the catheter tube and the catheter drain tube is closed.

These are my experiences, your results may vary, seek medical advice and as always don’t try this at home.

Q F T, what he wrote, specially the last line.

With the addition that foleys, if they are too small in diameter, get awkward to handle. I would suggest a CH16 (the French measure is sometimes shown as Charriere [after the guy who proposed it], abbreviated as CH, and sometimes as Fr, for French measure, 'cause Charriere was French, go figure.... Anyway, 1 CH equals 0.3mm, approximately 3/256 of an inch), which is not frightening, but not too wobbly to handle either. CH12 or CH14 are very soft and you end up trying to stuff a cooked spaghetti noodle into a hole; it might want to kink, and make the whole thing frustrating at your first attempt.

You were asking about potential harm. First of all, don't worry. This procedure has been done for about 2000 years now, and is usually very harmless. There is something though, that SWet has not mentioned: when to inflate the blocker balloon. OK, when you are inserting the catheter make sure you have drunk at least 500 ml in the last hour. To be sure of the catheter's position you need urine in the bladder. I find it less messy if you attach the catheter bag before insertion, so get yourself one with a long hose. When you are laying down to insert, lift your penis quite vertical, that will straighten out the first few inches of your urethra. After passing an inch or so past your penis length you can point it forward again, whatever makes you feel comfortable. Now there will be a little bit of resistance and a weird feeling as you go through the prostate and the internal bladder sphincter. Relax, breathe out audibly, like blowing; similar to what the ladies do for breathing exercises when in labour. As soon as you see urine flowing, you know that the holes in the tip are in the bladder now. Please note: The balloon is situated behind these holes; you will have to go at least another inch further in before you can inflate. Inflating the balloon before it is inside the bladder is the only way of doing it wrong and causing potential harm by stressing something, so make sure you avoid that. Some people just push the whole length of the catheter in until the Y-part is up to the penis head. Inflate, and pull back until you will feel that the balloon stops you. There, all done. The first ml of liquid for inflation (using sterile water, of course, never air!) can be hard to get in, its like blowing up any kind of balloon; you can maker that a little easier if you inflate the balloon once before you use the catheter (something that is recommended anyway, to check the function of the valve and the integrity of the balloon) to pre-stretch it.

For your first catheterisations you should probably stopper the end, or clamp it with a haemostat, 20 minutes before you take the catheter out; just to have some urine in the bladder. It will be a relief for you to see that you can still pee 'normally' *.

When you take the catheter out, push it back in a very little bit before you deflate the balloon, and leave a tiny bit (<0.5ml) in the balloon. This stops the balloon from crumpling up and irritating the urethra while it comes out. There will be not much need for pulling, the tendency is for the catheter to come out anyway.

During and after every catheterisation, drink a lot.

I hope this helps a little.

* Right, what "if"? Even professionals will tell you that sometimes there's a bit of bleeding. I personally have never had it with a foley (and I had quite some!), and only once with a Conveen Speedicath (a ready to use straight catheter for ISC) that had a bad hole with a rough edge. There wasn't even any pain involved, just a bit red over the next 2 or 3 urinations. This is not a problem, but if you still bleed after 6 hours, consult a doctor, maybe at the hospital's accidents and emergency department, tell them that you do intermittent self catheterisation and you must have scraped something and could they please have a look.

Not that it will be totally dangerous, but it will put your mind at peace.

Oh, and if anything hurts really bad, don't do it.

:thumbsup:

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  • 2 weeks later...

Hi friends, I tried to wear CATHETER but I noticed that I do not leave room to work comfortably.

All movements I had to be measured and slow. should lead and motorcycles

there is a big problem.

So it is not something simple to foras catheter, because there are things that you can not do comfortably.

MAYBE not do something correctly WHOEVER I have an opinion you'd like to hear it.

Sorry for the english. We try to do the best

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Hi friends, I tried to wear CATHETER but I noticed that I do not leave room to work comfortably.

All movements I had to be measured and slow. should lead and motorcycles

there is a big problem.

So it is not something simple to foras catheter, because there are things that you can not do comfortably.

MAYBE not do something correctly WHOEVER I have an opinion you'd like to hear it.

Sorry for the english. We try to do the best

OK, so English isn't your main language, no problem. But I can't make sense of your post at all; the "motorcycles" thing baffled the heck out of me; I'm sure there is a synonym mismatch somewhere.

Nevertheless I would like to know what you have to say. Is there maybe a way to help you to improve readability? What does google translate do for you, even if you just use it as a checking tool? Or is there possibly someone with a knowledge of English and your own lanuage in the board who could help you tidy your post?

Looking forward to reading more...

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