www.incontinentsupport.org

I have been dealing with urinary incontinence for 30 odd years with variously using condoms (external catheters), super-pubic catheters and nappies. However lately my bladder and sphincters have sort of gone on strike. I found a large amount of residual urine last year - 500mls - and was told there was nothing they could do about that and I would have to do intermittent catheterizing.

Everything has been fine since than and I have catheterized 4 times a day but still have night-time leaks of varying amounts. last week, though, I rearranged what I drink and managed to stay dry overnight. After a weeks trial I have dumped by protection - apart from the bed pad - and sleeping is great. However, by morning I am very uncomfortable. One morning I drained out 1.3 litres and another was more than 1.4 litres!

I had been considering asking for sphincters to be cut and allow continuous drainage but presently not needing any protection beats anything else. Oh, and I am using the Coloplast Speedicath catheters which are compact to carry and simple to use and dispose of.

I had my urinary sphincterotomy in August, 1999. It ended years of intense bladder pain and the reflux threat to my kidneys, at the expense of continual uncontrolled leakage. Although it was the ideal solution for my situation, please think long and hard before you go that route, because you may never again enjoy normal bladder control.

Ah, someone who has had this done! I've not been able to find anyone to talk to about this before. The urologist who got me onto this self-cathing reckoned that a sphincterotomy would not help - though I would have thought that is would allow for continuous drainage. He wanted me to either self-cath for preference or use some sort of permanent catheter.

I have been using various methods of dealing with drainage for more than 30 years - sheaths (external catheters, supra-pubic catheter and nappies) so I am familiar with all these. My present state, though managing without any devices at all except cathing 4 times a day is all very well but I feel uncomfortable quite a bit and it can be a bit painful in the morning. I can drain up to 1.4 litres first thing.

I just wondered if it is worth trading discomfort for needing my sheaths and bags back. Ho do you get on with the drainage?

Wheels5894,

My urologist wants me to begin using external catheters; however, I've tried them several times, with no luck so far. I wear protection of some sort, hopefully protection that is appropriate to the situation, 24/7. When I'm home, I wear protection and use the toilet every hour or so, to extend the wearing time of my diaper. I monitor my fluid intake, and, when I travel, I always keep a gym bag with my changing supplies handy. A sphincterotomy is major surgery. I bled profusely afterwards for three days, and needed three visiting nurse visits after I returned home. I could not believe the diameter of the Foley that was in me when I woke up in recovery. One potential problem is that, if done inexpertly, a sphincterotomy can result in the development of scar tissue, which can make repeat surgeries necessary. To prevent that, find a urologist who has long experience with this procedure, and hope he/she does a sharp, clean cut that will prevent scar development.

Thanks for the advice, Patrick. I have suffered sores around the meatus of my penis in the past but, fortunately, sheaths are much better than they used to be. I have been using ones from Manfred Sauer which are good and sticky but don't damage the skin. You can get samples from them so it might be worth looking up on the Internet. I don't know in which country you reside so I can't, easily suggest the best site.

Just to clarify, do you leak all the time or has it just reduced the volume so you pass urine frequently in small amounts. I had heard it results is a continuous drip.

Wheels 5894,

My leakage is variable. In the summer, when I spend time working outside in the heat, I have very little leakage, no matter how much I drink. In cooler weather, when I drink 16 oz (1/2 liter) at a meal, my leakage can become a steady stream that will challenge even a nighttime diaper.

Thanks Patrick! That's a great help. I'll be seeing the urologist this summer for a cystoscopy so I'll ask a bit more then. By then my bladder will either have settled down and stopped being uncomfortable a lot of the time or I'll be ready to do something about it. Were I to have to op I would just pop a sheath and bag on which works great in a wheelchair.