My name is Steve, and I’m a Patient Advocate at 180 Medical. For over 30 years, I’ve lived with quadriplegia as a result of my spinal cord injury. I know firsthand how difficult it can be to relearn how to navigate life from the new perspective of a wheelchair. It wasn’t always easy to learn how to do a lot of things on my own, including learning how to self-catheterize after my spinal cord injury.
However, I can tell you that the journey and the hard work were all worth it. I have confidence, and I regained my independence. I even participate in contact sports like adaptive wheelchair rugby. With some practice and time, I believe that you, too, can regain some independence and find new hobbies and interests after your spinal cord injury.
A big issue that affects many people with severe spinal cord injury is limited hand dexterity. Many people who live with limited hand function may feel that learning how to self-catheterize is not an option for them. However, that’s not always the case.
In this post, I’ll be sharing my personal experience and tips for learning how to cath independently after my spinal cord injury.
Catheter Options for Paraplegics and Quadriplegics
After your spinal cord injury, you typically have a couple of options for bladder management. There are three main types of catheters that people with spinal cord injuries tend to use.
Foley Catheters
One option is a Foley catheter, also known as an indwelling catheter. These are designed to remain in the bladder for longer periods. After insertion, the Foley catheter’s balloon is typically inflated with sterile water. This balloon acts almost like an anchor to keep the catheter inside the bladder so urine continually drains from it into a collection device, such as a leg bag.
The pros of using Foley catheters after a spinal cord injury include not having to follow a self-catheterization schedule and being fairly hands-free. However, because they remain in the bladder for extended periods, Foley catheters may increase the risk of bladder and urinary tract infections (UTIs) due to bacterial overgrowth.
External Catheters
External catheters roll onto the penis similarly to a condom, which is why they’re also known as condom catheters. They work by collecting urine leakage throughout the day, typically through a tube that leads to your preferred collection device, such as a drain bag or leg bag.
External catheters may work well for people with a flaccid bladder or a lot of leakage between intermittent catheterization times.
However, you may also have to use intermittent catheters. This is because, after a spinal cord injury, your bladder’s nerves no longer function in quite the same way. You’ll probably need to empty your bladder regularly to reduce your risk of urine backing up into the kidneys and other complications, like bladder infection from bacterial overgrowth.
Intermittent Urinary Catheters
The other option for draining your bladder after a spinal cord injury is using intermittent catheters, which are also sometimes known as in-and-out catheters. You insert a new intermittent catheter to drain the bladder, then withdraw it and throw the catheter away. So, the catheter never stays inside the bladder, and it also allows your bladder to fill and empty at regular times.
There are multiple types of intermittent catheters, including straight catheters with lube, hydrophilic catheters, ready-to-use catheters, pocket catheters, and closed systems, just to name a few.
I wrote a guide to some of the best catheters for people with a spinal cord injury and share some of my firsthand experience with trying out different features that may be good, whether you’re paraplegic or living with limited hand function due to quadriplegia like me.
How I Chose Which Type of Catheter to Use After My Spinal Cord Injury
After my spinal cord injury, I initially used a Foley catheter. First, it seemed like the easiest option for me physically since I had limited hand function due to my level of spinal cord injury. However, that didn’t last long because I began getting frequent and severe urinary tract infections (UTIs). I dealt with constant fatigue and high fevers from the infections. This began negatively impacting my process of rehabilitation and recovery, as well as my long-term health.
After my experience with Foley catheters, I talked to my doctor. That’s when I switched over to an intermittent catheterization program. This was a somewhat difficult transition because my bladder had become flaccid at that point. It did not hold much volume, and I constantly dealt with bladder leakage between catheterization times in my cathing schedule.
However, after about a month of taking anti-bladder spasm medication and building up my bladder volume tolerance, I began having much more success with using intermittent catheters. I was no longer voiding in between cath times. Then, eventually, I figured out how to cath independently after some trial and error.
Learning How to Self-Catheterize After My Spinal Cord Injury
After a spinal cord injury (SCI), you essentially have to relearn everything, even how to brush your teeth and handle eating utensils. In addition, you’ll have to relearn how to go to the bathroom in a new way after becoming paralyzed.
To be honest, I remember that process being quite overwhelming at first. I struggled to find ways to become more independent as a newly-injured 17-year-old quadriplegic, but at first, my mom had to do everything for me. That included dressing, bathing, personal care, bowel and bladder management, driving, cooking, and more.
Although my rehabilitation therapists worked hard to help me learn to do things, I waited until I got back home before I really began to get the courage to start trying to do things on my own. Most of the time, I tried this when I was alone. I didn’t want anyone to see me fail or struggle.
However, about a year after my injury, I took regaining my independence much more seriously. Truthfully, I think my spinal cord injury hurt my mom as much as it both physically and mentally affected me. She just wanted to make it as easy as possible for me. Still, I knew if I wanted to become more independent with my spinal cord injury, it was time to “cut the cord.”
Learning From Peers with Spinal Cord Injuries
Around that time, I started getting more involved in wheelchair rugby. Adaptive sports became a great way to meet other quadriplegics and people in wheelchairs. I was surprised when I realized many of them were functionally similar to me but far more independent.
A big part of finding my own independence was seeing others and learning from them. Eventually, I just asked how they could self-catheterize independently. Before I knew it, I had 3 to 5 intermittent catheter product options to test.
I tried each catheter and did not have success with most of them at first. However, the more I practiced self-catheterization, the better I became at developing new techniques that worked for me.
At first, I really struggled with needing to use both hands to advance the catheter while also securing the tip of my penis. Ultimately, I started using the elastic waistband of my underwear to hold my penis in place, which allowed me to use both my hands to catheterize.
The biggest takeaway from my experience learning to cath independently is this: Don’t be afraid to practice and fail. Above all, do not let momentary failure deter you from working at it and figuring it out.
My Tips for Learning How to Self-Catheterize After a Spinal Cord Injury
1. Always practice good hygiene.
This is a big part of caring for yourself and preventing complications and infections. You’ll want to follow basic hygiene rules, like not directly handling your catheter tube (the part you insert into your body), to help prevent hand contamination. Plus, you’ll always want to wash your hands or use an alcohol-based hand sanitizer gel before self-cathing.
180 Medical can provide more detailed information on how to self-catheterize hygienically after your spinal cord injury, including our online step-by-step instructions at HowToCath.com.
2. Use your clothes or other adaptive tools to aid you if you have limited hand dexterity.
When you have limited limb mobility or hand function, you can use adaptive tools or even features of your clothing to help you self-catheterize.
For example, if you’re a male with limited hand dexterity, try using the elastic waistband of your underwear to secure your penis as you self-cath. Alternatively, you may try cathing from the top of your pants instead of fighting with your zipper.
If you prefer to self-cath through your pants opening, use an adaptive device like a zipper pull.
Women who self-cath may want to use a mirror to aid in self-cathing, especially at first. You can slide your hips out to the edge of your chair and use a mirror to find your urethral opening.
3. Use an extension tube if you prefer not to transfer from your wheelchair.
Catheter extension tubes, such as the Cure Catheter® Extension Tube at 180 Medical, can be helpful aids, especially for those who prefer to self-cath from their chair into a toilet or another receptacle.
You may also be able to use your catheter package as an extension. Most catheter packages open from either end. You can pull the catheter through, then wedge the funnel to reach the toilet from where you’re sitting.
4. Try a closed system catheter.
If you experience frequent UTIs, you may prefer using a closed system catheter, especially in public or shared restrooms. Closed system catheters may help make the process of self-cathing more hygienic. Each catheter is typically pre-lubricated and ready for insertion, and it’s housed inside its own connected collection bag. This ensures your hands and external surfaces will never directly touch the part of the catheter you insert into your bladder, which may help reduce the risk of infection.
Plus, most closed system catheters also include an introducer tip, allowing the catheter insertion tip to bypass the highest concentrations of bacteria in the first few millimeters of the urethra. This helps you avoid pushing that bacteria further inside the body during insertion.
Also, many closed system catheter kits include insertion supplies, such as gloves and antiseptic wipes, which can help ensure a more hygienic cathing process.
5. Don’t give up. Keep trying.
If you do not succeed in learning how to self-catheterize after your spinal cord injury at first, try again.
As with most things, once you figure it out, it will get easier with time and repetition.
6. Remember that no single catheter brand or type works best for everyone.
It took me some trial and error, experimenting with multiple brands and types, before I found the catheter that worked best for me. Depending on your insurance plan, you should try different catheter types and brands to find one that best meets your needs.
180 Medical is an unbiased catheter company that gives you freedom of choice. Contact us to discuss your cathing challenges and your available catheter options. We supply all brands and types of catheters.
Disclaimer: This article is for informational purposes only and is not intended as medical advice. Information provided on 180medical.com should not be used as a substitute for medical advice, diagnosis, or treatment from a qualified healthcare professional. Please consult your healthcare provider with any questions about your condition, treatment, or medical supply needs.
