Multiple Sclerosis Resource Centre
  • Home
  • About MS
  • MSRC Services
  • Get Involved
  • MS Research News
  • MSRC Groups
  • Useful Resources
  • Welcome To Josephs Court, MS Centre Of Excellence
  • Advertising
  • Best Bet Diet Group
  • E-Newsletter
  • Contact Us
  • Investor in People
    You are here : Home » Get Involved » MSRC Interactive » Help, Advice and Inspiration from people with MS » What Has Helped You » Treatments / Techniques » Incontinence


    A A A
    [Print this page]

    Share |

    The Super Supra-Pubic Op - Mo Sidney

    Urinary IncontenenceI first became aware of the supra-pubic catheter through an e-mail contact who had been advised to have one fitted herself. The word 'catheter' filled me with dread and I was convinced there was no way that I would ever have one fitted.

    But my bladder problems were affecting my life to such an extent that I was hardly going out at all for fear of not getting to a loo in time when urgency struck.

    Eating out in restaurants invariably ended in upset when I would suddenly have to leave the table mid meal and struggle to the toilet. Flights were off the agenda because of the difficulties with airline toilets.

    A few months before, I had talked to a continence advisor about the urgency and discomfort. My urine was tested for an infection, but there wasn't any. She scanned my bladder to see if it was emptying properly and suggested I should try and re-train my bladder. The idea behind this is to try and hold on for a few minutes longer each time you feel the urge, increasing the length of time each day.

    The continence adviser asked me to keep a chart over a month of everything I drank and every time I urinated over 24 hours. In a 24 hour period it's normal to urinate seven to eight times. To begin with I was going ten or eleven times, but as the weeks went on I got down to six or seven.

    This retraining worked wonders when I was at home and knew there was an accessible toilet close by, but the thought of going out still filled me with panic.

    So my thoughts turned to the supra-pubic catheter. As a former nurse, I had come across suprapubic catheters as a temporary measure after surgery, but I wasn't aware you could have one put in permanently.

    My continence adviser thought that having one fitted was the answer to my problems. She gave me some leaflets and I found more information on the internet.

    A Suprapublic Catheter

    After talking it through with my husband, we decided that having the operation was the only way to solve my problems and get some social life back.

    On the NHS there was a three month waiting list, so I decided to go private to get it done quickly and before the summer. The following week I saw the consultant and within the week I had the operation. It can be done under a local but my consultant preferred to do it under a general anaesthetic. Being a coward, I was more than happy with that!

    It's an easy operation with very little discomfort and it takes away all the worry that bladder dysfunction can cause. As my consultant said, "It's just like having your ears pierced and if you don't like it, we can take it out and the hole will heal up very quickly." So remember it is reversible.

    I went down to theatre at 3pm and I was allowed home that same evening at 8.30pm just feeling a little groggy but glad it was over. Initially I was sent home with a bag attached but on the second day the continence nurse came to the house and fitted me with a flip-flo valve which was wonderful.

    This is how it actually works

    A tube is inserted into the bladder just above the bikini line and a little balloon is inflated inside with sterile water to stop it from coming out.

    The tube is changed after 6 weeks initially and then every 10-12 weeks. There are several lengths of tube depending on your height but generally a standard length is used.

    After my first change I opted for the shorter female tube but this didn't work out for me as it wasn't flexible enough and didn't reach anywhere. i.e. over the toilet pan. I thought it would be more discreet - especially for swimming but it turned out to be the opposite.

    The bladder will only empty out of the flip-flo valve if it is open. You turn it on and off like a tap. Up for off and down for open.

    The catheter tube comes out just above the bikini line and it can be tucked neatly into underwear or under a leg strap. You can swim and shower with no problems and it doesn't interfere with sitting, like urethral catheters do, or with the intimate side of your relationship.

    We have found freedom again

    Now, several weeks later, my husband and I have found freedom again. We've been out to eat several times, gone shopping for the day and driven in the car for hours, stopping for a pub lunch with absolutely no worries. We're also planning a holiday abroad.

    Now, I have the choice of urinating normally when at home or using the valve and emptying into a Pipinette. If we're going out for several hours then I just attach a leg bag. This can't be seen under a skirt or trousers and takes up to two to three hours to fill. You are given larger night bags to use as well but I don't need these as I no longer wake up with the need to go.

    My husband and I have had weeks of uninterrupted sleep, which is absolutely blissful and makes for a much more harmonious relationship!!!

    The catheter may not be everyone's choice, but for me it was definitely the right decision and I wish I had had it done much sooner.

    Water self-catheterisation - Jock McTavish
    Self-catheterisation is a procedure which helps many people with MS to manage their bladder.

    Why do people with MS often experience bladder problems?

    MS causes demyelination on the brain and spinal cord, which interrupts the signal sent by the bladder through the nerves to the brain to tell you when you need to go to the toilet.

    The result is that you can't always tell how full the bladder has become until it is very full (~750 ml) and then there is enough pressure for the signal to get through telling the brain that you really must go to the toilet urgently.

    This sudden signal to go to the toilet can be so urgent that the bladder actually goes into spasm and empties before the person has a chance to make it there.

    Assuming the person does make it, the difficulties don't end there. As soon as the pressure is released the bladder shuts down before it has emptied properly. The result is that urine often gets retained and if the amount of urine retained is considerable (around 100ml or more), this poses a problem.

    The first problem is that the person will find that they need to visit the bathroom very frequently as the bladder will soon feel full again. The second problem is the risk of urinary tract infection as the bladder never fully expels the urine and as it is warm in the bladder bacteria can multiply and thrive in there!

    How self-catheterisation can help is by ensuring that the bladder empties fully by inserting a sterile catheter into the urethra and up into the bladder. A nurse can teach you this procedure and after a while it does become routine to carry out this procedure on yourself.

    There is a risk of urinary tract infection when you self-catheterise but keeping the catheters sterile, use baby wipes and washing your hands thoroughly before you carry it out the risk is less. You can also make sure you check your dispelled urine for cloudiness, smelliness or discoloration.

    Many people find that once they have got used to self-catheterisation the benefits outweigh this risk. After all they no longer have to worry about getting to a toilet all the time and they also cut down the risk of infection due to urine retention.

    Jock McTavish has gone one better and invented a procedure which works for him called water self-catheterisation. This procedure can avoid the discomfort which can be experienced when inserting a catheter, especially when you suffer from paresthesia (very sensitive skin) as Jock does.

    To read more about water catheterisation visit Jock's webpage.

    Botox For The Bladder Is Brilliant!
    To find out how Botox treatment can alleviate urinary incontinence click here

    Related Items
    Bioresonance Therapy
    Colonic Irrigation
    Mercury Filling Removal
    Transcendental Meditation

    Did you find this information useful? Would you like to comment on this page? Let us know what you think! We welcome all comments and feedback on any aspect of our website - please click here to contact us.