Clean Intermittent Self-Catheterisation (CIC) as an option

I posted back last October I think when I was looking for recommendations for private CBT therapy. I had been referred by my GP for NHS therapy but was advised that the waiting list was several months.
I had a look at the BABCP website but like others I could not identify any therapists who specialised in AP treatment.
Eventually in February I was contacted by the local NHS Wellbeing Group and was assigned a therapist on a telephone consultation basis. This involved weekly calls over a period of about 6 weeks but to date I have not seen any major improvement. I did not ask directly but I'm not sure if the therapist had ever encountered AP before. Looking at some tutorial videos it seems possible that a CBT route could take some months or even years.

Currently my wife and I are booked on a short cruise at the beginning of June and I am not confident that my AP issues will be sufficiently resolved by then to make that trip an enjoyable one (or even a possibility). It will involve a drive to Newbury (about 3 hrs) with an overnight stop followed by a drive to Portsmouth to join the ship. Once on board I think I'll be fine with the cabin facilities but the journey to and from the ship is looming as a potential difficulty.

Just as an aside I had to cancel a holiday last September due to my AP issues as I could not face the 5hr drive to Scotland with the likelihood that I would struggle to use the public toilets en route.

I know that people with enlarged prostate issues do use CIC as a means of relief while they wait for surgery (or to put off surgery).

I have also seen comments on another thread about long haul flights where CIC seemed to be suggested as a safety option.

Any experience out there from others with using CIC or any comments related to its use would be appreciated.


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#1284 by arlowood

Hi Arlo

Here is a copy of part of a posting elsewhere on the forum.

I do get caught out occasionally & have to resort to using a catheter, if I can reassure you, with the right catheter it's not as scary as it sounds. Being able to use a catheter really helped me get my life back - days out are now possible without the fear & discomfort of a painful bursting bladder by the end of the day, or sneaking off to find somewhere hidden to pee - I used to drive miles to find a secluded wood or disused farm building etc to pee & making elaborate excuses to do so. At time I even had to wait till everyone else in the house was asleep or out before being able to go.

The catheter I use is a single use telescopic catheter called Coloplast speedicath Compact male (Coloplast item code 28692), it's really discrete & easily hidden - not much bigger than a fountain pen when packed, it takes a bit of practice & getting used to but so worth it, they are really simple & easy to use anywhere, yep I've even done it in a portaloo!

May I encourage you to have a conversation with your Doctor, you will need a prescription to get the catheters at the very least. When I went, I printed of pages from the UKPT website along with product information for the catheter, you will probably find you will know more about the condition & catheters than they do, they will usually believe that its impossible to hold your urine, with the urge to go eventually overcoming any desire to hold it, where you will just let go involuntarily, even my consultant urologist had this belief. I was initially given the hospital type catheters which require creating a sterile area, gloves & inserting something like wet spaghetti! Here's a link to the Coloplast web site for catheter information - www.coloplast.co.uk/speedicath-compact-m...WEB=SpeediCath%C2%AE

I hope you find this encouraging, it does take some work, but you can & will be able overcome your AP & there are many people here that will help & encourage you along the way."

Because I was advocating the use of a catheter for guys in your position, I felt I should experience it myself so I asked someone I knew who carried one on him if he could supervise me trying it. There was no pain, only a weird tickling sensation in the urethra. It slid in easily, there was an odd bump as it passed through the sphinctre, and then the wee came out. Then it slid out easily.

Guys say that because they know they are bombproof, all the anxiety goes away, and sometimes they can pee naturally.

So do go to your GP. Some may say that there is a risk of infection. The UKPT's experience is that in men there is not, though for women there is. Most medics' experience is of in-dwelling catheters in hospital; and hospitals are a source of infection.

Cheers

Andrew

#1285 by andrew

Hi Andrew
Many thanks for the encouraging reply and I will certainly follow up with my GP to see whether he is amenable to issuing a prescription. As you have hinted, I thing AP is a little known affliction within the general medical community and it may take some persuasion to have my GP accept the need for a "safety valve" CIC catheter just to allow me to lead as close to normal a life as possible.

I had picked up on the CIC procedure on another forum dealing with BPH (Benign Prostate Hyperplasia) where the ability to pee properly is affected by the prostate compressing the urethra. CIC seems to be used more widely among BPH sufferers but I think it is probably less well known in the AP community - at least that's my impression.

As I said earlier, my understanding is that the CBT route could be quite protracted and I don't want to put my life on hold completely if there is an interim solution. I'm in my 70's and have suffered with AP to some degree most of my life. However in the last year it has become much more acute to the extent that I'm finding it difficult to use a cubicle in a public toilet, whereas this had mostly worked in the past.

#1286 by Anonymous

Hi Andrew
Thanks for the prompt response and the encouraging comments. I'll certainly have a go at my GP surgery to se if I can persuade them to issue a prescription for catheters to use in an emergency. I get the impression that probably a large proportion of the GP community know little about AP and it may be a struggle to gain some understanding.

I became aware of CIC from another forum dealing with BPH(Benign Prostate Hyperplasia) where an enlarged prostate can lead to difficulties with urination. Some use CIC to manage their condition while deciding whether to submit to surgery.

I myself have an enlarged prostate (I'm in my 70's) and this has to some extent compound my AP problems.

I am due to see a consultant about the BPH and will quiz him about the AP to assess his understanding. I may also broach the subject of CIC if I feel he is minded to help.

#1289 by arlowood

Hi Arlowood ,I use the flocath catheters ,they are not the answer to the problem but they are a definite “get you out of jail card”when you are faced with problems like flying or days out with friends and family.They are about 14” long and what I do is pop one inside my sock and up my leg ,the trouser then keeps it hidden and stable so I can walk about with it without anyone knowing.As stated before it is not really painful and you soon get used to it.As for the infection rate being virtually nil,over the years I have had 3 infections caused by it even though the catheter I use the fingers never come into contact with the actual tube,,so I would say that the advantages far outweigh the disadvantages but be always aware of hygiene when using them.

#1290 by Anonymous

Hi Arlo

Look on our website at the page called “Professionals” and then click on “For General Practitioners”. There you will find three useful articles.
1. One from the Nursing Times explaining what paruresis is.
2. The second from the Professional Nurse magazine is an article about a survey done by nurses and recommending self-catheterisation
3. A clinical article from the website of the Royal Australian College of GPs.

Andrew

#1291 by andrew
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