Q. I have been using an intermittent catheter for some time. Does this mean that in the future I will have to use a permanent one? If so, could you fill me in on what this would involve?
Best regards, Sandy
A. There is no indication that people with MS who do intermittent self-catheterisation will eventually require a permanent catheter. Since there are different types of catheters and terminology can be confusing it might be helpful to clarify the difference between them.
You mention a permanent catheter, which is technically referred to as supra pubic catheterisation. It is a technique in which a catheter is inserted directly into the bladder through a small abdominal incision above the pubic area to allow for continual emptying of the bladder. A tube connects the catheter within the bladder to an external bag. The supra pubic catheter is usually used in people who have a urethra that is too narrow for a regular catheter or some other problem that creates an obstacle at the level of the urethra.
Another type of catheter is an in-dwelling or Foley catheter. This is used for either short-term treatment or long-term use. It also allows for continual bladder drainage, but with a tube that enters the bladder by way of the urethra, similarly to a catheter for intermittent use. A Foley catheter has a balloon attachment at one end, which is inserted and filled with sterile water to prevent the catheter from leaving the bladder. The tube empties urine into an external bag. An in-dwelling catheter is used in individuals whose bladder problems cannot be managed effectively with medications and intermittent catheterisation. In your case, if intermittent self-catheterisation is working well for you, there is no need to believe that you would need an in-dwelling catheter. However, if it is not effective in managing your bladder problems you should discuss other options with your neurologist or urologist. I hope this is helpful.
Q. Because of bladder problems related to my MS I stay at home now. I do not like to go out because of the embarrassment an accident causes. When it is absolutely necessary to leave the house, for instance for a doctor’s appointment, I wear an absorbent pad. It’s humiliating and I worry about the risk of being embarrassed. I’m 40 years old and this kind of life is becoming unbearable.
Josè
A. You’ve made a positive step towards changing your life by affirming that staying in your house and using absorbent pads is no way of life for you. As you’ll read in this issue of MS in Focus, there are strategies that can help you gain some control of your bladder problems. It is important that you talk with your neurologist so that you can be evaluated for medications and the possibility of learning intermittent self-catheterisation. Many people with MS self-catheterise just before leaving home. In this way, they have increased confidence that accidents are much less likely to occur, since the bladder has been completely emptied. This is one strategy, but your neurologist and MS nurse can tell you more.
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