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Catheter blood clot blockages

User
Posted 17 Oct 2019 at 06:40

Bit of background : My Dad has had a catheter now for over 12 weeks due to urinary retention,(at the time he couldnt urinate) following a full course of radiotherapy treatment. He recently had another catheter put in as they were concerned he wasn’t  ready yet for it to come out.

Questions for anyone that can help/advise

- He seems to struggle with blockages from time to time..he has been given some ‘wash outs’ but has been referred to the doctor now for possible medication on helping with this issue. Is this simply clots building up? His bleeding is on and off (showing up in urine sometimes), should he be having another blood test to assess the bleeding or is this normal following radiotherapy?  He also complains about weakness in one leg sometimes while walking about but figured this could be the hormone therapy. Basically looking for options now and life after Catheter removal. 

thanks everyone

User
Posted 17 Oct 2019 at 22:26
Men do not usually have bleeding from the bladder or urethra as a result of radiotherapy. I think your dad needs to ask his doctors what they think is causing the blood and clots.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Oct 2019 at 23:15

DJB

I started passing blot and clots about three or four months after SRT finished. Now two years later my bladder capacity is around 50ml and I have a permanent SPC. So go and get it checked out, talk to the late effects team in your RT department.

Thanks Chris

User
Posted 18 Oct 2019 at 00:41

Thanks for the replies

I think the occassional bleeding/clot is common with the indwelling catheter he has..but from my research theres a real issue with blockages and build up of sediment with indwelling catheters in general. Hes reached a stage where he struggles to have flow into the bag without considerable effort, particularly on a night..and can barely sleep. The doctor seems pretty unconcerned and has prescribed something to help with bladder spasms (when its in stock that is)

I get the impression that in the beginning radiotherapy inflamed his urether (which seems common), but the indwelling catheter does not allow the urether to heal either...could another catheter be the answer perhaps? Supapubric catheter? That sounds more ideal to allow his urether to heal further...  Thoughts?

He has a followup appointment in the next few weeks but his doctor has advised to keep the catheter in for a further 12 weeks even tho he can barely sleep with the blockages!

Thanks for your advice all

 

 

 

 

User
Posted 18 Oct 2019 at 07:31

DJB

Is he drinking plenty of water especially at bed time ? I find my urine drains more at night and in the first hour after waking, I also drink 300 ml of water on waking up. What do you call occasion blood and clots ? The position of the catheter can make a big difference to blockages, has someone checked the balloon is still inflated ? Does he use instilagel or hydrocaine down the end of the penis ?  I find a SPC is more comfortable than urethral. The type of food and drink consumed can affect the urine and the amount of sediment. 

Thanks Chris

 

User
Posted 18 Oct 2019 at 08:36

I think the callout carer that changes/adjusts the catheter applies gel but he hasn’t been given anything to apply himself. He drinks plenty of water and alot of his urine is a seemingly good colour if not totally clear sometimes. Usually theres some sediment/clotting to pass before his flow will improve. The concern really is his inability to sleep at night (i dont think hes slept properly in a week), he’s constantly monitoring his flow for fear of backflow that troubles him greatly, not to mention the pain. I really feel like a suprapubic catheter might be a more comfortable fit as it would surely allow his uretha to heal. Is it normal to request this from your health team? The local gp seems to brush aside the severity of the situation in my view.

User
Posted 18 Oct 2019 at 11:24

DJB

Modern catheter bags are usually designed to prevent backflow, when I started my journey the bags were different, if you had a blockage I would lift the bag above the bladder and gently squeeze that usually unblocked the catheter. Today's bags don't allow that to work, they are now considered to be closed systems and are supposed to prevent infection.

With a SPC if mine gets blocked eventually I will leak out of my penis. With a urethral I would have "by passed" , that is when urine comes out between the catheter and the eye of the penis, it can be uncomfortable and if the balloon is right at the base of the bladder it can prevent urine passing past the catheter. 

Going into retention and filling the bladder to the extent that it backs up into the kidneys is not good. I have been in retention a couple of times and it is uncomfortable. It is possible that if the catheter is blocked and the bladder fills at some point it will force the blockage out. If I feel my catheter is blocked I hold the urine and it usually unblocks the catheter.

Are you sure the pipes are kink free when he gets into bed at night ? I have 8 ml of water in my balloon but when it is changed they normally only get 2 ml out. From the experience of other long term catheter users that is normal. A deflated balloon may still be held in the urethra just by friction. Don't try to pull it out. Instilagel or hydrocaine is available without prescription at most chemist for £2-3 depending on the size.

Are you emptying the bag before it gets to full.  No more than 2/3 full seems to be the normal advice.

There seems to be a contradiction on urethral healing, some say urine passing a wound is not good, on the other hand guys who have retzius prostate removal have SPC fitted not urethral catheters.

The nurse specialist on this site may be able to offer some advice.

Thanks Chris

Edited by member 18 Oct 2019 at 11:26  | Reason: Typo

User
Posted 18 Oct 2019 at 11:42

Thankyou Mate i’ll let him know

 

 

User
Posted 18 Oct 2019 at 22:38

Just a little followup:

My father had been doing some urination via the Foley Catheter but called the nurse for a washout treatment.

To his surprise the nurse told him his catheter was very blocked and couldn't apply the washout without having another catheter put in. (much to his horror..he finds it VERY painful)

But again, he sucked up the pain and now has it done. 

He's also been put on 5mg of Lyrinel XL tablets for 'bladder spasms'

So it's looking more positive, for now..I just have one more query for anyone in the know...


A foley catheter was seemingly a short term solution for acute urinary retention at the time (few months back)..but he's set to now have this new catheter till January at least. Firstly does a Foley Catheter let a urethra heal at all if it's scarred? I'm only assuming his Urethra is too inflamed or damaged/narrow but surely the end goal is to try it without the catheter? Is this at odds with having the Foley catheter inside?


I'm trying to get him in touch with his hospital team at some point for a bladder scan of sorts..the 'sludge' as he calls it that sometimes comes out the catheter (not often but enough)..is a little puzzling as we have no idea where the debris is coming from.

Thanks all again, great community here. 

 

Edited by member 18 Oct 2019 at 22:40  | Reason: Not specified

User
Posted 18 Oct 2019 at 23:30

DJB

His he stuck with the catheter until January or was he told it doesn't need changing until January . Typically a urethral catheter or SPC should be changed every 12/13 weeks but more frequently if required. Sludge or sediment is quite common in long term catheters and can be proteins or the result of infection. I have had around 12 dilations of the bladder neck and always had a catheter fitted for two weeks so my guess is it is the appropriate treatment.  Performing intermittent self dilation or Catheterisation is a lot more brutal on the urethra. 

Just to note a Foley catheter can be urethral or suprapubic. I joined a couple of Facebook sites "urology and catheters"  and "suprapubic catheters" they are closed sites so you just need to join.

Thanks Chris

Edited by member 18 Oct 2019 at 23:32  | Reason: Typo

 
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