Rescue Instillations 16 FR Catheter

**Bessie** · 04-17-2007, 03:35 PM

I had an instillation yesterday and the catheter said 16FR on the outside of the package. They used marcaine, solculef, and heparin. It was uncomfortable going in and then when I used the restroom the first few times it felt like I was peeing out razor blades. Is this normal??? It also feels like I have been punched in the stomach. I am suppose to have 1 instillation every week for 6 weeks and I am scared!!!

**leelee88** · 04-17-2007, 04:17 PM

I have never had one so I dont know.. I just wanted to say I am sorry it was so painful for you..((((((((hugs)))))))))

***kadi*** · 04-17-2007, 05:24 PM

How long did they have you hold the solution? When I first started with heparin/marcaine/sodium bicarbonate instillations, I could only hold the solution for 25 min. Now I've over time worked up to holding it for 50-60 minutes & that doesn't seem to cause the irritation holding it longer does.

If you are having a lot of urethral burning, you might ask for a non-latex catheter and / or a smaller size. I found that even though I'm not officially allergic to latex, it burns. I now use a 12French non latex, but they do make pediatric catheters & that can be really helpful for IC patients.

Hang in there--

**L. Thomas** · 04-18-2007, 12:46 AM

For instills I use a 8fr pediatric feeding tube so I think the one I use is 1/2 the size of the one you had. Some people are sensitive to latex. That may be a problem for you also.

I have the "stomach punch" sometimes but not that hard. It is more like a backward UTI pain. Sort of a feeling that your bladder is "sucking in" that remind me of what the inside of a jar would feel like when you break the seal as you open it. But it is only mildly uncomfortable and it doen't happen all the time, maybe once in 6-7 caths.

If solculef is a steroid that can cause pain also.

**Berkshire Road** · 04-18-2007, 07:30 AM

My doctor gives me 10 fr. catheters for my at-home instills. As long as I relax before it goes in (breathing out can help a lot), I barely feel it. Maybe you could ask your doctor about getting a smaller size.

I recently was in the hospital and had to have a Foley put in. Now that's a big tube -- not to mention that the nurse's technique was not exactly gentle. Ouch! I was bleeding from my urethra for two days afterwards.

So, I think it's a combination of size (small is good) and technique (on the part of both the patient, who should breathe out as it's going in and relax as much as possible; and of the nurse, who should be aware of the patient's reaction and moderate her speed and force accordingly), that makes for a reasonably comfortable experience.

**L. Thomas** · 04-18-2007, 11:24 AM

One thing I know now is that everyone’s anatomy is different They are taught to stop advancing the catheter when the urine starts to flow and then back off a little. I think that sometimes they push it so quick that it hits the back wall of the bladder before the urine starts to flow. I think that I have been cathed before and the nurse pushed it too far and hit the back wall of my bladder. I have done instills for about 3 years and I know that sometimes the flow is slow starting. I know my anatomy well enough to tell how slow I need to go and when to stop and let everything catch up.

**bamafan** · 04-19-2007, 12:23 PM

My nurse uses the pediatric catheter, I also take some pain pills before I go for my treatments. This seems to help also! The first seem to be the worst one, but I also felt funny in my stomach, it also hurt when the cath went in and also when comes out. After my first one I felt like i needed to go to the bathroom but would go and nothing would come out, also I burned to. But I only have to hold it in for 15 to 20 min. the doctor says after this time it really does not work. Bamafan

**ihurttoo** · 04-19-2007, 01:42 PM

16 French!! WOW!! and OUCH!! No wonder it hurt! That is HUGE! Well, at least to me....mine are 5 French, (less than 1/3 of the size of yours). I am a firm believer that size matters! I would definately be asking about using a smaller cath. It is bound to make a big difference.

I also find that it is much more comfortable cathing myself than when others do it. Maybe it is b/c I always advance it VERY SLOWLY. But, like others, I have also been cathed by people who were rough and it definately hurt both during and afterwards.

I hope your Dr. will agree to using smaller caths. I really think it would help alot.

I hope your next one goes much better and that you start feeling better soon.

Hugs,
Amy

**Bessie** · 04-19-2007, 02:48 PM

Thanks everyone for the suggestions. I go in next Monday for the second instillation and I will ask for the smaller size. I will also try to relax and not hold my breath too hard. I know I probably tensed up and that did not help at all. I am going to try a few more instillations and keep my fingers crossed that they help. My pain is 24/7 and I really need some relief

Thanks again.......I really appreciate everyone here

**Breezy1218** · 04-20-2007, 08:22 AM

I am not familiar with instills (I haven't had one...yet) but 16fr is a common size for indwelling catheters, that much I know. I wouldn't call it "huge" but like I said, for this particular situation I am not very familiar. I know on my floor we stock 14, 16, and 18 for inserting foleys.

**L. Thomas** · 04-20-2007, 03:10 PM

I have instilled for a while now and I don't think I know anyone that uses larger than 10fr. The larger sizes do drain the bladder faster, but the way I understand it, instill are to calm the bladder and keep it from being stressed. Smaller catheters cause less stress and less pain for most.

I do know that when I had my last urodynamics the catheter was 22fr and the one for the scope was 25fr (or 27fr). I remember thinking "how is THIS going to feel?" I was shocked that I didn't have pain before, during or after.

I also self-cathed after out patient surgery with 16fr (they weren't going to let me go home until I peed so I told them I could take care of that if they would get me a catheter. Boy did they look funny but I got to go home). I didn't have problems then either. I really think I could use a larger catheter but it only takes 10 seconds or less to empty when I use the 8fr. And the 8fr is easier to store in the "carry with you bag" than a larger one.