www.incontinentsupport.org

Hey all,

Believe it or not, I am sligthly considering either getting a foley catheter or a suprapubic. I know both have risks of infection, but what it comes down to is this: convenience of not having to remember to cath, especially in situations where i will be teaching and have to deviate from my established cathing schedule, and bladder pressure. In the car on this trip to and from VA I was overdue for a cath, and my bladder was full. I tried to relieve myself in my diaper, but I couldn't. It seems i can only get myself to urinate without a toilet in a standing position.. Even after i wet the diaper it sometimes feels like i still have some in there. So, i am considering those alternatives. Yes, i know there is risk, but that pain made me consider it as an option.

Any input and insight is more than welcome and highly encouraged.

Peace out!

Rob

_________________
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With my OAB and interstitial cystitis it works good for me. The urologist prescribed catheter supplies long before the interstitial cystitis diagnosis came. At the time of the prescription, it was just extreme urinary frequency. I take it out and go to work for a few days and then when I get home the wife puts it back in. So, I change mine weekly.
In over two years of doing this I've had two UTI's. Of course having an ER nurse for a wife makes it pretty easy to have somebody there to put it in when things get out of hand. I am very careful to keep things clean and sanitize the bags morning and night when I change from the leg bag to the night bag and vice versa. It isn't without its problems, let's face it, life with a bag is kind of a drag......our sex life sucks. But I sleep though the night, ride in a car for more than 45 minutes in comfort, and my friends say I can go the longest without "breaking the seal"
When I am without it, I am super careful about what I eat or drink, avoiding my known triggers (especially at work!!!) sometimes my bladder just aches and I don't feel like I'm emptying. With the foley in, it's like I have no problems at all.

I had seriously considered a suprapubic before (diversion to a pee hole), so I've done extensive research on it. If you do go this route make sure it is a low pressure system, or you will still have to catheterize in order for it to drain. With a normal/high pressure system you still use your bladder and will always need to have a catheter in for it to drain. You just don't feel the catheter so no pain there. As a down side, if you don't cath often enough then it will leak urine.

With a low pressure system you will need a belly bag for it to drain in, and it will drain almost continuously. The belly bag seals over the suprapubic with about as much success as an external cath by the way. And in either case, the suprapubic will have a much higher risk of uti's so being married to a nurse would help. Lastly, both cases will also have the suprapubic located near the belly button. They can't extend it below the waist line, so diapers will never again be a backup option again. Of course, if your intent is to be free of diapers for good (at any cost), then this route may be a decent option.

There's probably more I'm not thinking of right now, but if you have a question on this then I might just know. Of course, I'm not speaking from personal experience here so I could be a bit off.

Rob,
I have been using a Foley for five month now, I like the freedom that this has given me. I haven't had a UTI so far, when I intermittent cathed I had them all the time. Asepsis is the most important thing and I change mine every week, leg bag and bed bag as well. Insurance also covers them were diaper weren't covered under the plan Im on. It is a lot easier for me because of the help I get from my wife. Hands down Im staying with the Foley, but I do pick a couple of days to wear diaper to give my Urethra and bladder a break from it.

I'm confused by your replies Brian. I've not heard of a high or low pressure system? Just a suprapubic foley catheter or occasionally a Button - unless you're thinking of a urostomy?
. In fact I know someone who uses nappy style protection for bowels and bypassing in addition to having a catheter + someone else who is about to do the same.

There are two basically different ways to have a suprapubic "installed". Both have that button pee hold near the belly button. However, the first way is to connect your existing (and usually intact) bladder to the suprapubic so you can drain your bladder this new way using catheters. This is more commonly know as a normal or high pressure system as pressure will still build up in your bladder if you don't drain it often enough.

The second method is to completely bypass or remove the bladder (usually when it isn't working or if you get painful urges). And yes this is called a urostomy as well. This method uses a piece of your intestines to create a small pouch your kidneys will drain into. This pouch is then connected to (or is an extension of) the suprapubic. It is intended to constantly drain so pressure will not build up towards your kidneys. The urostomy is the procedure to create a low pressure urinary system, and actually does not require catheters (though you actually can still use them if you want to).

I'm also aware of and have extensively researched the intestinal bypass too. This is where you have the kidneys dumping directly into the intestines. It can allow for "some" urinary control, but is often fraught with low level leaking from behind since those muscles aren't really designed to hold back liquids very well (as well as constant trips to the toilet). I'm surprised someone would have both a bypass and suprapubic though. Not even sure how that would work since both would be effectively bypassing the bladder in two separate ways.

I see. I had never heard of the procedure where the bladder is removed referred to as a suprapubic before, only ever a urostomy.

No problem. The suprapubic really only refers to just the penetration of the new artificial ureter through the abdomen. There's a lot more behind that penetration too though, including what the suprapubic is being attached to (or not).

I'd bet your doctors are just simplifying things so everyone can better understand it. I know I am.

I'm actually going from things I've read online rather than information from a Dr. I guess technically if the urostomy is placed above the pubis then it is a suprapubic urostomy but I thought urostomies were higher than that, hence my confusion. I've only every seen them called a urostomy or a urinary diversion. And spc or suprapubic catheter to explain when a catheter is going in above the pubis to the bladder. Personally removing or diverting from the bladder sounds very invasive when someone might be a candidate for foley or spc, both of which are reversible

That's understanding. I had to do most of my research online too, and the little info that's out there is fragmented with descriptions for the exact same thing not exactly the same from site to site.

To the best of my knowledge, a suprapubic opening is always placed above the belt line, and often in or next to the belly button. Again, they may or may not require catheters depending on the type of system and surgeries employed.

And yes, they are all very much invasive and should be weighed heavily before going for it. We just have to consider if the situation is bad enough to warrant it, or if the surgery will otherwise produce an improvement in one's quality of life.