Kenalog instills-time to hold, can't void after

[HKay66]

I was wondering about Kenalog - not as many seem to use this.
I have had my 1st 3 instills which were Heparin, Kenalog, Sodium Bicarb and Marcaine. They weren't too bad to get, the problem was going after.
My doctor at Northwestern in Chgo said to hold this solution 3 hrs before voiding. That is no problem for me, but then I can't go after. After about 4 hrs I am able to start getting little bits out at a time and by 5 hrs and lots of water I am able to get most out. I also have to really push to get it out. I seemed to be doing better after the 1st 2 instills (all a wk apart) but last week after my 1st somewhat normal void (at least 7-8 hrs later) I had terrible pain and the next few days were the worst I had in about a month.
Now 4 days later, I am still worse that a few weeks ago, but better than the 1st few days. Is holding that solution for so long bad? Could that have flared me up or all the pushing? I asked the nurse if it was bad to hold it that long and she didn't think so - I am not so sure! Is it the trama of the cath or the solution that would freeze me up??
Any input would be great!!!
Thanks,
Holly

[carried_cub]

Are they using lidocaine gel in your urethra to pass the catheter? I'd hate to think not (ow!) but for me, when that wears off is when I start to be able to go a bit at a time.

I'd definitely mention this to your doctor. They may be able to try something different, adjusting the anesthetic quantity or draining the solution for you after awhile, if they think it's a problem. Once you work out the cost/benefit analysis, I hope you get more relief!

I'll have this question come up later this week; my first instills (Marcaine, heparin, Kenalog, gentamycin and sodium bicarb) were done by my uro and the last one it took a good seven hours before I started to feel anything at all. Once I did my bladder was full enough I was pretty uncomfortable. My urogyn wants to try them now and when he planned to do one after my cysto/hydro he said he'd clip the tube and drain it after a certain time frame after I told him how long it took me to pee after the last one. So we'll see how it works out!

[BT2008]

Hey Holly,

My instill cocktail recipe is the same as yours: Heparin, Kenalog, Sodium Bicarb and Marcaine.

You don't say what your primary IC symptoms are, but--going to pee every 4-5 hours would be fantastic--I would think!! If you weren't able to empty your bladder at all, now that would be a problem. But, if frequency is one of your primary symptoms, it sounds like the instills are at least helping a lot with that problem!

Are you experiencing any discomfort during that 3-5 hour period of time? If so, it could be that you are having bladder and/or urethral spasms, especially since you said you have to push so much. In addition to the instills, I also take a muscle relaxer called Zanaflex (I take the generic) 4mg 3 times per day which works really well for bladder, urethra and vaginal spasms. If your doc would give you a muscle relaxer like Zanaflex, maybe you wouldn't have to push so hard.

And yes, pushing or straining will most definitely make your bladder hurt! Don't do 'dat!!! :tsk: :lmao: That's why so many of us take a muscle relaxer, or have found other ways to help us pee. Such as:

Have you tried turning on some water, either in the bathtub or sink, whichever is closest to the toilet? Most of the time just hearing water running will make my bladder relax enough to finally get a flow going and empty.

As far as holding the solution in your bladder, is it uncomfortable to hold it for 3 hours? Are you having to hold it through a lot of urgency calls? If there is no discomfort, I wouldn't think it would be a problem. I never had a prescribed amount of time to hold the solution, I just always held it as long as I could--which was usually anywhere from 45 minutes to 1-1/2 hours. But, sometimes longer. So, I don't know if it makes any difference or not, but if it concerns you just ask your doc.

I hope some of this helps! Good luck, and let us know how it goes!
~Beth

[kadi]

I do instillations of marcaine, sodium bicarbonate & heparin. If I hold the solution more than an hour it burns. And the one night I fell asleep with it in, I wet myself the entire next day. I'd ask your doctor some questions about the holding time for your solution if you're having difficulties after the instillations.

[L. Thomas]

I is normal for me to hold an instillation for 5 hours. Actually I do instillatitons before going to bed so I won't wake-up during the night to go to the bathroom. I would check with your MD since my instillations do not contain steriods.

[HKay66]

Thank you to all who had input in the rescue instills and holding times/pain!!
I had another Monday and talked to the nurse more about it. She told me if after 6 hrs and I couldn't go it would be a problem and to call/come in.
(Yes, I would say 6 hrs w/o going may be a problem!) She said it was the Marcaine and Kenalog that made everything so numb. I am a lot better after this instill than last - phew! I did a few things different this time: I asked for the non-latex catheter, based on Kadi's advice, and started trying to go at about 2.5 hrs. I also didn't push at all this time, like before, and applied my moist heat rice packs and took a warm shower to try to relax. I also went into this instill at a lower pain/discomfort level which also probably helped. I started getting little bits out at about 3.5 hrs. Each time I tried the rest of the day I went small amounts until about 9 hrs later. I did actually have a good day yesterday (day after instill) and felt better than I had in quite awhile:) I even had some voids that didn't give me that yucky,painful after peeing feeling - I am so used to that and when it doesn't happen you want to cheer!!! We'll see how today goes - sometimes I am on pins and needles waiting to see how the day goes. I'll keep a positive attitude for only better days ahead...... (for all of us!!!)
Holly

[WildBerndt]

I have had a DMSO treatment, and the first few were fine, I could void after an hour of holding it in. But I got my 4th one, and I tried to go to the bathroom and I couldn't. I tried for an hour to push ANYTHING out, and nothing was coming. SO I called my doc, and he had me come back in and put in an foley catheter:cussing: And I had to wear it for 2 days. Even after I had the cath taken out, I was in misreable pain for a week. I was passing blood and was going to the bathroom every 20 minutes. It was like a bad flare up times 10! And I think that they had just stuck too many caths, and my bladder was just sick out if. The only think that helped was a week of stronger pain medication and lots and lots of water.

We never found out why that happend, but he hasn't wanted me to have any installations since then. So maybe this is a common occurence with these instillations.