Since May 2017 I've used a catheter after having a urinary retention episode that showed my bladder had become atonic, a fancy word for not working any more as it should, likely due to my lengthy history of an enlarged prostate.
I haven't written a whole lot about my experiences with a catheter. Recently I decided I should, starting with a post that has a rather plaintive title, "I've learned a lot about using a catheter. But does anyone care?"
In that post I listed some questions that I wanted to address in other blog posts, regardless of whether anyone cares. If even one person finds what I have to say useful, that's good enough for me, even if I can't be sure that this person exists.
Question #2 was What routine should I use before inserting a catheter? Here's my answer.
This depends on whether a pre-lubricated catheter is being used. Early on I discovered the Speedicath Flex Coude Pro catheter, which I wrote about in my answer to the first question in my list.
It makes inserting a catheter much easier than the basic red catheter that I used for a short time before the Flex Coude Pro came into my life. That required the application of lubricant, a process I never felt comfortable with because I worried about contamination from my hands or whatever.
So I'd put on disposable plastic gloves, which further complicated the catheter insertion routine. This is my current routine, a much easier one.
(1) I pick a Flex Coude Pro from a drawer in the bathroom and place the sterile packaging it comes in next to the sink.
(2) I see whether I can urinate some on my own. Usually I attempt this while sitting on the toilet, since this was recommended by a physical therapist I went to who specializes in pelvic floor exercises, back when I had more hope than I do now that my bladder could recover quite a fit of functionality. Sometimes I pee standing up, if it feels like that is doable.
(3) I close the lid of the toilet, placing a towel over the lid. I do this because I like to have the urine resulting from a catheterization go into a plastic container with marks on it showing how many cc's of urine are in it. This helps me keep track of whether I'm drinking enough water and other liquids during the day. Obviously I don't do this when I have to use a public restroom, which is rarely. I put the container in larger containers, to minimize urine splashes on the towel or elsewhere. Here's a photo of that setup.
(4) I wash my hands with liquid soap. I've gotten into the habit of counting to 30 while I wash my hands. This isn't as crucial as when I had to apply lubricant to a catheter, but still important.
(5) I use a Handzies wipe to clean the end of my penis, using circular strokes that move away from the tip/urethra as the goal is to be sure that the catheter doesn't touch anything dirty when it is inserted. I like that Handzies are soap and water-based, as I got skin irritation when I was using alcohol wipes for a while. I count 40 circular wipes. Probably overkill, but I haven't gotten a urinary tract infection in over three and a half years of catheterizing, so I must be doing something right.
(6) I open up the Flex Coude Pro packaging and take out the catheter. Most of the lubricating liquid is supposed to be shaken out prior to use, so I hold the catheter over the sink with the non-insertion end down. I cough while doing this, which (perhaps) helps to relax the muscles that the catheter has to pass through.
(7) I stand in front of the toilet and insert the catheter slowly. My left hand holds the Flex Coude Pro in place, while my right hand pushes the catheter, enclosed in a sleeve so the hand doesn't touch the catheter itself, into my urethra. I hold my penis out at about a right angle to my body, or slightly lower. That works best for most men, given the curvature of the urethra as it connects to the bladder.
(8) After a successful removal of urine, I put the catheter back in the packaging and throw it away. I use a small cotton square moistened with tap water to clean the soap off the end of my penis, to avoid any possible irritation. I take a glance at how much urine was collected before dumping it into the toilet and flushing.