Simon – T6 paraplegia

How I manage going out with a catheter

Because I enjoy being sociable, spontaneous and getting out into the wilderness, I wanted an option that best suited my medical condition and lifestyle. Having the enclosed catheter with bag has given me the freedom to live my life to the fullest given my restricted mobility. Having the correct supplies/equipment opened more possibilities than I anticipated and allowed for greater spontaneity and excitement.

Here is what I do:

• I always do a catheter first thing in the morning and last thing before bed. And always do a catheter before leaving the house.
• I check my carry bag before I leave the house to ensure I have an adequate supply of catheters and associated supplies. I do this in case I get held up or decide on the fly to have a big drinking session out socialising or stay out overnight.
• I always have my carry bag hooked on the back of my wheelchair when I leave the house.
• When travelling, I carefully monitor my fluid intake so I won’t run out of catheters.
• I drink plenty of water during the day, when there’s a toilet available, to ensure bladder health.
• I slow my fluid intake down after dinner so I won’t need to get up during the night to empty my bladder.

How I catheterise myself

I use this equipment:

• Multigate Enclosed Catheter 14FG Intermittent Sterile with Gel and Bag
• Aqium Antibacterial Hand Gel
• Ocean Antibacterial Wipes Handypack
• Plastic Bags
• Carry bag.

I carry all the above supplies in a small carry bag, including multiple enclosed catheters, plastic bags plus a spare pack of wipes and spare hand gel.

I use the technique below for doing catheters even when I can’t get to a toilet such as in the car, laneways, in the bush or parkland, or in a room at other people’s houses – it takes about 10 minutes:

1. Try to find an area with privacy. If not, I head for the most secluded spot.
2. I position myself with my back facing the most exposed area and lock the wheelchair brakes.
3. I slightly reposition myself forward in my wheelchair, grab my carry bag and take out and place the enclosed catheter, plastic bag, wipes and hand gel on my lap.
4. I place the carry bag on the ground/floor, up against my wheelchair tyre.
5. I undo my pants/jeans and take my penis out of my underwear.
6. I open the enclosed catheter pack, leaving on the protection cap and rest it on my lap.
7. I open the wipes, then sanitise my hands with the hand gel, let them dry, and pull out a wipe.
8. I then use the wipe to clean the area around the urethral orifice.
9. I grab the enclosed catheter, remove the protection cap, steady the penis with one hand and carefully thread the catheter through the urethra until urine begins to flow.
10. When the urine stops flowing, I slowly draw out the catheter until urine starts flowing again. I wait until it stops and repeat this again until the bladder is emptied.
11. I slowly remove the catheter and thread it back into the bag using the provided paper under pad.
12. Using the eyelet on the filled, enclosed catheter bag, I hook it onto my wheelchair brake.
13. I use the same wipe to clean my penis and redress.
14. I tear open the top corner of the bag and empty the urine into toilet, or if outside, onto the grass or into a drain.
15. Once emptied, I roll up the enclosed catheter and place it back into its packaging and tie it with the used wipe. I then place it into a plastic bag and tie a knot.
16. If I can get to a bin, I dispose of it, otherwise I place it into my carry bag and dispose of it when I get to a bin.
17. I sanitise my hands using the hand gel, then place all the supplies back into the carry bag.

How I have sex when I’m using a catheter

First I check my bladder to see how full it is by pressing above my pubic bone, and empty if needed. Otherwise, I let spontaneity guide me, which has strengthened the relationship with my wife.

Since I have been doing intermittent catheterisation, I haven’t been restricted outside of the usual limitations such as partner unwilling, no privacy, illness and so on. Previously when I had other forms of catheterisation such as suprapubic, indwelling or condom drainage, I had difficulty with erections and needed medication like Cialis or Viagra. I also had issues with hygiene and spontaneity.

With condom drainage, my wife and I weren’t comfortable with her performing oral sex due to urine leakage and my penis being soaked in urine in the condom, whereas now it’s not an issue.

Indwelling catheters gave me issues with spontaneity as it wasn’t possible to have intercourse or oral sex with it was in place and the suprapublic caused erectile issues, pain and bladder damage.

I can now gain an erection whenever required without medication, and am not restricted to just having sex at home, so we now regularly do it in the car, on day trips, public toilets, overnight stays and so on.

How do I travel with a catheter?

When travelling on multiple night stays, I pack a large supply of enclosed catheters plus supply accessories mentioned above, in a sports bag/suitcase.

When on a long-haul flight, I bring my carry bag with me and if I can’t get to the toilet, I will use an enclosed catheter in my seat and my wife/friend/carer will empty the urine in the airplane toilet. For privacy, my wife/friend/carer will hold up the airplane blanket to obscure the view from other passengers.

Doing catheters when travelling is the same as doing them when I’m out and about in the local community.

Am I stuck with my first bladder management choice?

All the options I have tried have been reversible, except for the augmentation cystoplasty.  Since I had the augmentation cystoplasty to allow me to do intermittent catheterisation, I haven’t had issues with infection.

What do I do if I get an infection?

If I feel an infection coming on, I see the GP to get a urine sample tested. If an infection has been detected, my GP prescribes the appropriate antibiotic.

When I was having problems with my bladder (overactive and damaged bladder), my GP referred me to a urologist who then thoroughly assessed options and recommended the best one going forward in regard to my health and reducing my risk of bladder complications.

What’s the best equipment available?

I found using an enclosed catheter which collects urine in a bag to be the most practical, convenient and efficient when it’s difficult or impossible to get to a toilet.

With the enclosed catheters, I don’t need an accessible toilet available, which in turn has given me much more freedom and independence. The only thing that restricts me now from going to a venue is whether I can physically get inside.