what to do if urinary catheter is blocked
Ane of the common complications of long-term catheter use is encrustation past mineral salts, leading to catheter blockage. Crystalline deposits tin can class on the retention balloon, obstruct the center holes and cake the urine drainage channel. Bacterial infections brand the urine alkaline, so that crystals form on the catheter surface. These obstruct the menses of urine so that the bladder steadily distends. This can get very painful. Urine retained within the bladder can either leak effectually or bypass the catheter causing incontinence, or it tin menses back or 'reflux' to the kidneys, which tin lead to serious kidney and bloodstream infections, pyelonephritis and septicaemia. Nigh half of all long-term catheter users experience catheter encrustation and blockage at some time (references: Kohler-Ockmore and Feneley, 1996; Getliffe, 1994). Sudden catheter blockage can exist sad. It tin occur at whatever time and is a mutual emergency for district nurses.
A consultant explains how catheters get blocked. Blockages are a common complexity of long-term...
A consultant explains how catheters get blocked. Blockages are a mutual complication of long-term...
I of the most common complications with a long term catheter is recurrent blockage of the catheter.
Now this is in an interesting trouble considering at that place are sure bacteria, specially one known as proteus mirabilis which contains an enzyme termed urease. At present urea is the finish product of poly peptide metabolism in the body and urease hydrolyses urea to form ammonia.
Under these circumstances the acidity, the pH of urine rises from about, normally nigh 7 and it rises up to 7.iii, 7.5 fifty-fifty vii.8 and equally the pH rises and then the phosphates in the urine come up out as solution and they form crystals. Calcium hydroxyapatite and calcium struvite crystals are formed on the catheter and inside the catheter, and this blocks the catheter and the drainage. And so recurrent blockage with proteus infections is a major problem for the patient.
Blocking of catheters and past-passing of urine effectually the catheter equally a result of blockages are the most common complications and they proceed the commune nurses actually quite busy. iv% of the commune nurses duty, so to speak, is spent dealing with catheters and that'due south quite a high pct for but i trouble.
Some people we interviewed had rarely had a blockage. Peter Y had had none while he had good intendance with high standards of hygiene, but had lots of blockages when his intendance changed.
Charles has never had a blocked catheter and puts this down to drinking lots of fluid. He...
Charles has never had a blocked catheter and puts this downwardly to drinking lots of fluid. He...
Age at interview: 57
Sex: Male
Have you lot e'er had a blocked catheter?
Never.
Practiced.
Specifically because I potable so much. I launder it through. I will talk about my recent situation in a minute considering there's a story behind it. But, no, in the by I haven't had a blocked catheter. Yes, and it's nifty because I haven't had to do one of the flush-outs [bladder washouts] or anything like that. I think that's, and it'southward totally down to drinking.
But the friend I was telling you lot about who died in the last yr who had MS didn't drink enough. He regularly had blocked catheters and would accept, y'all know, blue flashing low-cal jobs to infirmary because he needed to exist unblocked. So, water, drink lots of water.
Melanie panicked when she felt pressure level in the bladder and was leaking. She realised the catheter...
Melanie panicked when she felt pressure in the bladder and was leaking. She realised the catheter...
Age at interview: 55
Sex: Female person
Have you ever had a blockage?
At that place was one evening when I suddenly realised that my float was under incredible pressure and that I was leaking. I panicked and started phoning my friends, a friend who is a nurse. Information technology was quite late at night. Then I moved the tube, once more it'south a learning experience. I moved the tube on my leg and it must have been kinked and, you know, past my knickers or kinked to my groin or something, and all of a sudden information technology cleared itself and the leg bag filled up. Simply you only larn these things by them happening. Information technology'south a difficult learning curve.
So you've never had a blocked, a really blocked tube or annihilation like that?
No, touch wood, I've never had that.
Peter Y started getting blockages when his care inverse. He had to have his catheter inverse...
Peter Y started getting blockages when his care changed. He had to take his catheter changed...
Age at interview: 65
Sex: Male
Everything went fine probably for two and a one-half or three years. I had very skilful care. I changed catheters every twelve weeks, on the day and there was never any consideration of doing dissimilar. I was plainly free from infection of whatever kind for two and a half to three years, and that was a period of good care.
Then I had to change my care system. I just couldn't afford to pay for my own care all the time. Which I've non, because I had been given supplemented, a little bit for four or five years, just I'd been paying the full amount basically. And every bit my business organisation had stopped, I couldn't afford to do it anymore.
I then went onto local authority care, and so there was no continuity of care. The standard is very depression in terms of hygiene and, within 6 weeks, I started to get blockages. The first time it happened I had no idea what had happened. I but knew I needed a nurse very quickly 'cos it hurt, you know, headaches and so on.
Then I went, only got worse and worse and worse. So then I was having catheters changed every week, every ii days. And it got and so that the situation became untenable. I did have acetic acrid float washes, a series of six for 6 weeks, and that did work. And that demonstrates that perhaps what the nature of the infection was I recall.
This catamenia of intendance concluded in November of that year which was nigh eight months, nine months, and that basically nearly killed me. I ended upwardly with a twelve-hour blockage of the catheter. And because I was unattended overnight, all I tin can say about that is I don't recommend it to everyone. And secondly, apparently it's not enough to kill you merely my God it feels like information technology. And I think such events do leave you a fleck mentally scarred, you know I had to fight pretty hard to get rid of the nervousness it might crusade.
The adjacent twenty-four hour period I started, through the National Wellness Service continuing intendance, to have a full time live-in carer. And that'southward why information technology lasted nine months considering it took and then long to get approved then on. Immediately we were able to remember sensibly about the situation and the situation improved. It did take xviii months, and now we're in nearly 2009/2010, 2009 really. Information technology took, generally speaking, begetting in mind a twelve hour blockage causes problems for kidneys, bladder, everything in that area. And it took about 18 months to go dorsum to some sort of normality.
Having a blockage can be frightening and several people said that the first one they had was particularly so because they didn't know what was wrong. A few too said that regular blockages can take over a person'due south life. Emlyn and Sharon said they had hurting whenever their catheter was blocked. Jack tried to phone the commune nurse before he got whatsoever hurting. Urine leaking from his penis told him that his catheter was blocked. Michelle knew when her catheter was blocked because her leg pocketbook stopped filling up as normal.
Some people with a spinal cord injury said that their catheter blocking could be serious considering it could crusade autonomic dysreflexia, which tin can be life threatening. Information technology occurs when the blood pressure level in a person with a spinal string injury above T5-half-dozen becomes excessively high. The almost common symptoms are sweating, pounding headache, tingling sensation on the face up and neck, blotchy skin around the neck and goose bumps. Not all the symptoms always announced at once and their severity may vary .
Dave realised he had a blockage when his urine wasn't draining properly. Some other time he had...
Dave realised he had a blockage when his urine wasn't draining properly. Another time he had...
Age at interview: 31
Sexual activity: Male
Do you always take to wash the float out with anything?
Yes, occasionally I wash the bladder out. Certainly if there was any sign of small blockage, a bladder washout would be used. Recently I haven't had too many problems with that. Merely I certainly did have one or two occasions in hospital when the catheter did actually block, would have to be removed and a new catheter inserted considering of debris in the bladder.
How did you know that? Did somebody realise there was nothing draining?
It was realised nothing was draining on 1 occasion. Another occasion I suffered autonomic dysreflexia, which is your blood pressure rise and severe headaches. Which is the body's way, in the case of spinal cord injuries, telling you that there's a pain or, in the case of similar a bladder issue, a blockage, that your bladder's not draining. So it'south the body's way of sort of telling yous that, although you can't have the sensation of the bladder filling up, information technology'southward an indication that something is wrong.
Can you recall what that was like?
Aye, information technology's a splitting headache at the front of your head, sweating and generally feeling very unwell.
So somebody had to come and modify the catheter fairly speedily?
Yes, you accept to change the catheter very quickly.
Did you take to go back to theatre for that or did they do it at the bedside?
No, that was done at the bedside. Subsequently the insertion of the suprapubic catheter, I didn't get dorsum to a theatre for any changes or anything beyond that. It was always done at the bedside.
Some people got a blocked catheter every at present and and then and used a bladder washout to articulate it. This is done by flushing out the bladder with a sterile saline or acidic solution through the catheter into the bladder. It is contentious whether or not to apply these solutions (see 'Float washouts'). Ian, who'd had an indwelling catheter for over xx years, said he had many blockages until he started using bladder washouts to endeavour and prevent them. Michelle said that bladder washouts never worked for her – she gets headaches with them considering her bladder is so modest. Whenever her catheter becomes blocked, she always has to accept it changed.
A few years ago Ian's catheter started blocking every 2 weeks. He started having bladder washouts...
A few years agone Ian's catheter started blocking every 2 weeks. He started having bladder washouts...
Age at interview: 39
Sex: Male person
It was blocking quite a lot and I'd need the nurse to come out sometimes, this is probably about mayhap looking three, four years agone, sometimes blocking every 2 weeks. And then we tried lots of things to help it merely zilch seemed to work. And then they put me on catheter maintenance solutions, these CBG and Solutio R, and I've been having those during, when the nurses come and visit and yeah that'due south sorted all the blockages out. And now it tin can go 10 or twelve weeks before I need a change, then that's helped a lot.
Yes. That's very proficient. How often did it need irresolute before that? Before those solutions?
Sometimes it was every two weeks it would cake, sometimes less.
Tin can you tell me a bit about the solutions for anybody who might desire to know more virtually them?
Aye. I retrieve they are solutions which are slightly citric. Solutio R'southward got more in it that the CBG. And they're fastened to the catheter and drain through just to clear the crust, the crystals that form inside the catheter and at the tip equally well. And yes they've got similar two sections, you lot run 1 in and out and so the other one in and out. And it keeps it clear and running and information technology's really worked for me.
Quite recently, I had a visit from a nurse clinical specialist, which was just the other calendar week to talk things through about the catheter. Yeah and she's coming dorsum again in December then yeah, that'southward been good, yeah.
What kinds of things is she, y'all know, hoping to work with you on, or to amend?
Just, 'cos I haven't seen her before, we just talked how things were going and we talked virtually the catheter maintenance solutions and perhaps reducing their use, since they're doing the job.
Then, every bit they're doing their job, reduce the amount you lot use?
Yes. 'Cos information technology'south all putting things in your body and, if you don't need them to be in that location, if they're working. 'Cos I used to have them used to test the PH of the urine. And, if information technology was a certain alkalinity, and then I would have a catheter solution, sometimes that was three times a calendar week. So the nurse specialist who came said, "Well sometimes its not that reliable testing the pH." So sometimes I was having the wash outs three times a calendar week, but I've gone down to two at the moment, and peradventure downward to one if it's working.
One of the concerns people had was that the catheter could get blocked at whatever time, day or night. Peter Z said his catheter invariably blocked in the middle of the night. He would accept to phone his local emergency number for a district nurse to come up and change it. The nurse ordinarily came round quickly. John Z said he rarely had his catheter changed every 10 weeks every bit intended because it e'er got blocked before then.
Considering of blockages, Peter Z rarely gets through the whole 14 weeks between catheter changes....
Because of blockages, Peter Z rarely gets through the whole 14 weeks betwixt catheter changes....
Age at interview: 76
Sex activity: Male
Ordinarily you used to have the catheter changed every fourteen weeks?
That was the hope but, later on a while, after you've had one change, it was the next change 10 days, and 10 weeks sorry and then information technology gets shorter and shorter.
And now what would exist the boilerplate at present?
Just I go, I don't know it's a flake hard, it's just happenstance, and it'southward a fleck awkward I feel. I would dear them to say, "Well we'll come and practise it again in nine weeks' time." Simply I have to telephone call them out every time now. It'southward non as if they tin put me on a rota and see when it's going to be, it'southward on the 10th February or something,
So you lot call them out now?
Well that seems to have happened all the fourth dimension yes.
Because at that place was no fluid…
Yep. That is invariably the cause of the blockage. I call back information technology's the lady [district nurse] who came this week said, "I've got these fiddling flush things, I'll just…" They're files of h2o in plastic tubes and it never works.
Correct. So
I e'er do them. Try and wash it out. Nothing happens. And it doesn't seem to be the issue of say I've been drinking also much orange squash or something. 'Cos information technology always just seems to be no way I can right it as it were.
It just gets blocked?
It just happens, yeah.
John Z said that a blocked catheter is very painful. He calls out a district nurse who changes information technology...
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John Z said that a blocked catheter is very painful. He calls out a commune nurse who changes it...
Age at interview: 64
Sexual practice: Male
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When information technology'southward blocked upwardly, the pain is horrendous. And that's, what'll probably happen then it'll come out. Or it doesn't come up out, what it does the balloon comes past, oh what'southward that gland there? What'due south that gland men have?
The prostate is information technology? Is it by the prostate?
Prostate that'southward it, so if it's gone past the prostate then information technology'll bypass and that and
And that's when yous need to telephone call the commune nurse?
Yeah.
Does she change the catheter then?
Yeah.
How often does she usually come up to change it?
It's changed, basically it's inverse on a ten week cycle, just I've never managed to become to that ten week cycle. Because it comes out before then.
Because of blockages?
It's probably the amount of sediment.
Almost people phoned a district nurse when their catheter was blocked, or a local emergency heart that contacted a district nurse who would and so visit them at domicile. Rachel, though, said her hubby lived in a residential care home. When his catheter became blocked, staff did non know what to practise so they were told to bring him into hospital where the catheter was changed. A few other people recalled occasions when they'd gone to Accident and Emergency because of a blocked catheter.
A few people felt they'd discovered a way of preventing catheter blockage. Stuart, for instance, said he cleaned his catheter with a pipage cleaner in social club to prevent blockages. Although doctors do not recommend this, information technology had worked very well for Stuart, who now rarely gets blockages. Other people recommended drinking lots of fluid, especially citrus drinks, to try and prevent blockages (see 'Drinking lots of fluids').
Stuart got more blockages when he started drinking less. He uses a pipe cleaner to clean his...
Stuart got more blockages when he started drinking less. He uses a pipe cleaner to make clean his...
Historic period at interview: 61
Sexual practice: Male
I then found that, considering of the book of fluid that I was taking, I was diminishing my salt levels. And then I was told to cutting back on my consumption to nearer to five pints of cranberry a day. I did that, simply found that in that location was greater sediment forming in both the catheter and the leg handbag pipage. So I decided to use a pipe cleaner to clean my catheter on a weekly basis, when I inverse the leg pocketbook, which I do one time a week.
My thinking on this was from my background beingness a builder. It seemed strange that you've got a fairly large bore pipage of the leg bag and the smallest one, namely the catheter, you didn't rod. Yous rodded the larger pipe, only the blockage is likely to occur in the small-scale one. And so, if everything is passing through the catheter to get to the leg purse, why do I need to change the leg pocketbook and non the catheter?
So I got the longest pipe cleaners I could, but they were about four" shorter than the catheter itself. I would sterilise them in an antiseptic solution and merely insert them, or get my carer to insert them downwards the pipe and throw them abroad. And this would immediately give yous a clear pipe instead of it being opaque.
I have just very recently managed to observe a piping cleaner manufacturer who will exercise them to whatever length I require. And and then I have now, I practice the shorter ane first to remove the remainder from the majority of the piping. And there was an anxiety that if I got a total length one, it could button a pellet of sediment into my bladder. In order to check whether that was happening and whether I was forming any stones, I was given a cystoscopy on a couple of occasions and information technology was found this was not happening. And the piping cleaner seems to take very effectively taken away, non just push down the line.
But I would say, from my own circumstances, I've gone with my various activities from beingness re-catheterised three or four weekly to now going the total twelve weeks, which has increased incrementally. It went from 3 or four to six, to 8 and then up to twelve. At twelve weeks, that is the extent of the warranty of the catheter. Just I have done a trial whilst in infirmary and took it upwardly to seventeen weeks without whatsoever problem whatsoever, which I would definitely not be able to exercise without cleaning the catheter out on a weekly basis.
With the piping cleaner because, by the finish of a week, both the inside wall of the catheter and the leg bag have gone cloudy at all-time, or virtually to opaque, depending on the amount you're drinking and what your state of health is. And if that keeps building up, obviously it's just a matter of time before you go a blockage.
Martin rarely gets blockages since he started putting lemon juice in his drinks. He now drinks 3...
Martin rarely gets blockages since he started putting lemon juice in his drinks. He now drinks 3...
Age at interview: 51
Sex: Male
I potable religiously three or four litres a day. A lot more water since I had this terrible kidney infection. Now about 10 years agone, viii/ten years ago, my catheters were, first of all when I had my [spinal cord] injury, my catheters weren't getting blocked upwards. I could, I think the longest catheter I had in was for 11 weeks.
Right
Which, y'all know, is okay. If it's not doing any harm, it'll be alright. And then they started getting blocked up and I recollect that was due to the bone, when you sit downward and it'southward, what is it, osteoporosis is it? That kind of thing, and I was getting certain infections. And I'd read in the SI [spinal injury] magazine, in various places, that people that are on a high citric drink were getting good results and the catheter wasn't blocked up. But they never actually said go and buy a load of vegetables, lemons and grapefruits, oranges, and mush them all up, so information technology wasn't very helpful.
Anyway, a couple of years I came up with a very unproblematic format, 100ml of pure lemon juice that we get a bunch of lemons. Bunch of lemons? Load of lemons, and so we do them in the machine, get all the pith and all that kind of compact bits out, no pips, and and so we put 100ml for every 900ml of liquid.
Of h2o?
Water or, I don't know, apply a little chip of lemon to go far a niggling bit sweeter, otherwise information technology is very sour. But once in the morning and one time at nighttime. First thing in the morning, last thing at night, and my catheters take gone to I think the longest at present is fifteen weeks.
Alok's catheter tin cake at any fourth dimension, day or dark. Drinking fluids seems to brand no difference....
Alok'southward catheter can block at any time, day or night. Drinking fluids seems to make no difference....
Historic period at interview: 37
Sex: Male
Can you tell me a little chip virtually some of the issues that you've had with the catheter?
Yes. The problems with the catheter is, I have experiences that some of the times it blocks very chop-chop. And there's no guarantee that if y'all drinkable more than or if you potable less, then it won't cake. There is no certain formula for information technology that, if you do this it'southward not going to block. I take tried various unlike kinds of lifestyle, similar drinking less or drinking more of the lemon or drinking more of the cranberry juice, this, that and the other. But I didn't detect anything which can ensure that your catheter is not going to cake. Information technology only blocks.
It tin block whatever fourth dimension, that'south the biggest trouble really. It tin can cake now, information technology can block within one-half an hour. It tin block in the day and it tin can block in the middle of the night. And the trouble is, in one case it's blocked, you lot take to handle information technology immediately considering information technology tin cause, information technology'southward kind of an emergency situation and it tin crusade [autonomic dysreflexia], give you a stroke or anything can happen because the claret pressure shoots so speedily and that creates a very big trouble.
And how often would you say that it get blocks?
In my case, I don't go blocks very quickly but, equally I said, it can block any time, you know.
Yes. And what'due south the first affair that you notice when information technology's blocked, what's the first affair that y'all detect that lets you know.
Oh information technology depends from person to person. As far every bit I know, I have read about it specifically in spinal injury cases, if it blocks yous get autonomic dysreflexia, due to which your claret pressure goes upwards and y'all get a headache, sweating, shivering and those kinds of symptoms.
I don't know nearly how and what happens in people who are not spinally injured but are still dependent on their catheters. In my case I just seem to know. I just get a really severe headache and that headache is like, I tell you it's like, it feels like your caput is going to accident up at any time, you know.
Last reviewed October 2018.
Source: https://healthtalk.org/living-urinary-catheter/blockages
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