QUESTION: I just started to use intermittent catherer once a day because of bph.I then discard catherer after urine comes out.i understand low incidence of infection with this type catherer.if you do get an infection and are on anti-bacterial meds what do you do if you cant use imtermittent catherer and you don't pee enough
ANSWER: Howard, the decision to use intermittent catheterization is based on many clinical factors. Urinary tract infection (UTI), as you note, is a risk from this technique. However, if a UTI occurs, the infection is treated with appropriate antibiotics but there is no need to stop the intermittent catheterization. To follow is some information I have written on this topic.
Intermittent catheterization is generally performed either by the patient, his family or a health care worker. Although it sounds like a difficult chore, it is very easy to learn and accomplish. It can be performed with steri;e disposal catheters as you are doing. However, it is often performed with a clean rather than a sterile technique so that hand washing and the use of either a clean or sterile catheter is all that is required. The great advantage is that there is no need for an indwelling catheter and all the potential complications and discomfort that the latter may cause. Furthermore, if a urinary tract infection develops, it can be aggressively treated as the likelihood of resistant bacteria (which is a concern with chronically indwelling catheters) is not an issue.
Catheterization is usually done about 4 times a day at spaced intervals using 12 Fr. catheters. With the clean catheter technique, the catheters are re-used after washing your hands and then the catheter with soap and water. Once a week I suggest sterilizing the catheter either in boiling water or by the microwave technique (see reference at the end of this note). They are then placed in a clean plastic zip lock bag which you carry with you. I also recommend carrying a small kit with you that contains sterile water soluble lubricant (such as packs of Surgilube or Lubrifax) and antiseptic packets (such as alcohol or Betadine). Before catheterization, your hands should be washed with soap and water. If no clean facilities are available for this, carry either a hand sanitizer (such as Purell) or use an alcohol wipe to clean them. The tip of the penis is wiped with the antiseptic, the clean catheter tip is then greased with the lubricant and the catheter is passed into the bladder. This can be done standing. If one prefers to sit on the toilet for the catheterization, for most individuals, it works best if one faces the back of the toilet.
As an alternative to the clean method, sterile catheters can be purchased in bulk for a relatively small price. The technique is the same except these catheters are disposable after use.
Technique to sterilize catheters for re-use: http://www.urologycp.com/sterile.html
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QUESTION: I was told the risk of infection with this type of catherer, is very low and many people use it for years with no problem.inserting the catherer does not irritate the penis
Howard, the risk of infection using a new sterile catheter for each catheterization is less than using the same catheter that one keeps cleaning and then sterilizes once a week. If one uses a new sterile catheter each time and puts on sterile glove (rather than using clean washed hands) the risk of a UTI is even less. Many people use the "clean" rather than the "sterile" technique also for many years without problems. I hope this clarifies it for you. The real aim is to to be sure the bladder is periodically emptied completely. This reduces the risk of infection and kidney problems. Good luck.