Indwelling catheter for senior?
July 26, 2023 10:59 AM Subscribe
My dad has BPH and a trabeculated bladder (with numerous diverticula, incl one large calcified one). Retains urine to a degree (150-350 ml) which leads to frequent UTIs. We are chasing bugs with cultures and antibiotics including a prophylactic one that misses some bugs. Urologist wants to avoid a catheter, arguing he’ll still get UTIs because there’s a foreign body involved. That’s the medical opinion - looking for anecdotal experiences wrt indwelling catheters + UTIs in seniors with dementia. TIA
An internal medical specialist said the current environment is like a stagnant pond where bugs are just going to keep growing no matter what.
My dad already had a TURP, and the urologist didn’t see anything on a scope this year that suggested he’d want to operate on anything. Ultrasounds and CTs have been done as well. My dad’s GP is referring him back to the urologist and I’m wondering if a catheter might help, like at all. Maybe it’s worth the risk?
An internal medical specialist said the current environment is like a stagnant pond where bugs are just going to keep growing no matter what.
My dad already had a TURP, and the urologist didn’t see anything on a scope this year that suggested he’d want to operate on anything. Ultrasounds and CTs have been done as well. My dad’s GP is referring him back to the urologist and I’m wondering if a catheter might help, like at all. Maybe it’s worth the risk?
Response by poster: True, thank you. My dad actually did this a few years ago when the ER gave him a temp one, and I completely forgot. Yikes.
posted by cotton dress sock at 12:18 PM on July 26, 2023 [1 favorite]
posted by cotton dress sock at 12:18 PM on July 26, 2023 [1 favorite]
Best answer: Hugs to you! This stuff is hard.
posted by cakelite at 12:33 PM on July 26, 2023 [2 favorites]
posted by cakelite at 12:33 PM on July 26, 2023 [2 favorites]
Is it possible that a condom catheter might help? Nothing goes inside, so possibly less chance of infection.
Just a reminder to keep up his probiotic intake to help counter the antibiotics.
posted by hydra77 at 12:50 PM on July 26, 2023 [1 favorite]
Just a reminder to keep up his probiotic intake to help counter the antibiotics.
posted by hydra77 at 12:50 PM on July 26, 2023 [1 favorite]
Best answer: Intermittent "straight" catheterizing to drain the retained urine is done all the time with older men. It's a pretty simple process, especially if the prostate is not enlarged - I'm guessing it's not after a TURP.
It's just what it sounds like, a sterile catheter another person, or your dad after training, inserts into the bladder after your dad or typically every 8 hours. It can be drained strait into the toilet or into a measuring basin. There is no long trailing tube or bag, just the catheter part. A new catheter is used every time. The goal is to empty the bladder so there is no residual to become infected.
It is much less intrusive in a lifestyle sense than an indwelling catheter, but also greatly lowers the risk of bladder infections. People with neurogenic spinal conditions are often trained to cath themselves, taught proper hygiene techniques to avoid introducing organisms into the bladder. Self-catheterizing can be a lifelong procedure or a bridge to an indwelling catheter or other procedure.
If he is not able to self-cath you can train a willing family member to do this, as well. This would be something to discuss with his urologist, but it's a pretty conservative suggestion in terms of dealing with residual urine. The catheters are prescribed by a doctor and are generally provided only by the medical supply company his insurance has a contract with. It can be a pain to find out exactly who to call or what is covered by insurance. If the doctor agrees to give this a try, there is probably a nurse/medical assistant/insurance specialist in the office to guide you. Best of luck! This is something I've had to deal with for a couple of different older men. One continues to straight cath, and one progressed to a Foley indwelling cath as other health problems worsened.
posted by citygirl at 2:07 PM on July 26, 2023 [1 favorite]
It's just what it sounds like, a sterile catheter another person, or your dad after training, inserts into the bladder after your dad or typically every 8 hours. It can be drained strait into the toilet or into a measuring basin. There is no long trailing tube or bag, just the catheter part. A new catheter is used every time. The goal is to empty the bladder so there is no residual to become infected.
It is much less intrusive in a lifestyle sense than an indwelling catheter, but also greatly lowers the risk of bladder infections. People with neurogenic spinal conditions are often trained to cath themselves, taught proper hygiene techniques to avoid introducing organisms into the bladder. Self-catheterizing can be a lifelong procedure or a bridge to an indwelling catheter or other procedure.
If he is not able to self-cath you can train a willing family member to do this, as well. This would be something to discuss with his urologist, but it's a pretty conservative suggestion in terms of dealing with residual urine. The catheters are prescribed by a doctor and are generally provided only by the medical supply company his insurance has a contract with. It can be a pain to find out exactly who to call or what is covered by insurance. If the doctor agrees to give this a try, there is probably a nurse/medical assistant/insurance specialist in the office to guide you. Best of luck! This is something I've had to deal with for a couple of different older men. One continues to straight cath, and one progressed to a Foley indwelling cath as other health problems worsened.
posted by citygirl at 2:07 PM on July 26, 2023 [1 favorite]
Response by poster: I wouldn’t be able to do this, nor would my dad, but I will ask and see if he can get regular in-home visits? Not sure if that’s done where we are but I will ask! Thank you!
posted by cotton dress sock at 2:24 PM on July 26, 2023
posted by cotton dress sock at 2:24 PM on July 26, 2023
Best answer: A permanent indwelling catheter is an additional significant infection risk and requires attentive cleaning on a regular (a couple times a day, at least) schedule. Unlikely he could keep that schedule by your description, but the right caregiver could, in theory.
posted by Pantengliopoli at 4:27 PM on July 26, 2023 [2 favorites]
posted by Pantengliopoli at 4:27 PM on July 26, 2023 [2 favorites]
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posted by cakelite at 11:57 AM on July 26, 2023 [8 favorites]