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How to Self-Catheterize After a Spinal Cord Injury

How to Self-Catheterize After a Spinal Cord Injury

Learning How to Self-Catheterize AFter a Spinal Cord Injury blog header

My name is Steve Kearley, 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, what I can tell you is 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.

Steve Kearley and his family
Steve with his family

A big issue that affects many people with a 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 Bladder Management After a Spinal Cord Injury

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, which is also known as an indwelling catheter. These are designed to stay inside the bladder for longer periods of time. After insertion, the foley catheter’s balloon is inflated typically 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 are that you’re not responsible for following a self-catheterization schedule, and it’s fairly hands-free. However, because it stays inside the bladder for extended periods of time, foley catheters may raise the risk of bladder and urinary tract infections (UTIs) due to the overgrowth of bacteria.

Foley Catheter

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. This is because you insert a new intermittent catheter to drain the bladder, then withdraw it and throw the catheter away. So it never stays inside the bladder, and it also allows your bladder to fill and empty at regular times.

There are three main types of intermittent catheters: straight, uncoated catheters, hydrophilic or pre-lubricated catheters, and closed system catheters.
click here to learn more about different catheter types

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, it’s very likely you will 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.

 

External Catheter

How I Chose Which Type of Catheter to Use After My Spinal Cord Injury

After my spinal cord injury, I initially used foley catheters. 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.

Steve in 1988 shortly after his accident with his high school principal, Fred Richardson
Steve after his accident with his high school principal, Fred Richardson (1988)

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 at something.

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 on 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.

Steve playing wheelchair rugby

A big part of finding my own independence was by seeing others and learning from them. Eventually, I just decided to ask how they were able to self-catheterize independently. Before I knew it, I had the names of 3 to 5 intermittent catheter product options to test.

I tried each one of the catheters and did not have success with most of them at first. However, the more I practiced self-catheterization, the better I became with new and better 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 of learning how to cath independently is this: Don’t be afraid of practicing and failing. Above all, do not let momentary failure deter you from continuing to work at it and figure it out.

don't be afraid of failing - steve quote graphic

My Tips for Learning How to Self-Catheterize After a Spinal Cord Injury

1. Always practice good hygiene.

This is a big part of taking care of yourself and preventing complications and infections. You’ll want to follow some basic hygiene rules like not directly handling your catheter tube (the part that you insert into your body), which helps prevent hand contamination. Plus, you’ll always want to wash your hands or use an alcohol-based hand sanitizer gel prior to self-cathing.

practice good self-catheterization hygiene

180 Medical can provide more detailed information for learning how to self-catheterize hygienically after your spinal cord injury, including instructional DVDs, booklets, and 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’re dealing with 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.

button pull zipper pull adaptive device for getting dressed after a spinal cord injury
This is my button/zipper pull device.

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.

Other adaptive tools, such as the MTG Eagle Board, may be of help as you start to self-catheterize.

3. Use an extension tube if you prefer not to transfer from your wheelchair.

Catheter extension tubes, such as the 29″ 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 and then wedge the funnel in order to reach the toilet from where you’re sitting.

using a catheter extension tube may be helpful for users learning how to self-catheterize after a spinal cord injury from their wheelchair

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 that you insert into your bladder, which may help reduce the risk of infection.

Plus, most closed system catheters also include an introducer tip, which allows the catheter insertion tip to bypass the highest concentrations of bacteria located 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 aid in a more hygienic cathing process.

In my next blog post, I’ll be going over some of my top picks for catheters for people with spinal cord injuries. However, for now, take a look at these closed system catheters available at 180 Medical, which may be helpful for catheter-users with limited hand dexterity.

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 keep getting easier with time and repetition.

6. Lastly, remember there is no single catheter brand or type that works best for everyone.

It took me some trial and error and experimenting with multiple brands and types before I found the catheter that worked best for me. Depending on your insurance plan, you should try out some different catheter types and brands to find one that will best meet your needs.

180 Medical is an unbiased catheter company that gives you freedom of choice. Contact us if you’d like to discuss your cathing challenges and your available catheter options. We supply all brands and types of catheters.

 

Tips for Learning How to Self-Catheterize After Spinal Cord Injury

 

 

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About the Author
Steve is a 180 Medical Executive Patient Advocate. He visits SCI Rehabs, Children's Hospitals, and Urology Clinics across the U.S. offering mentorship and catheter support.

Outside of work, he loves spending time with his wife and 4 kids, traveling, being outdoors, handcycling, and playing adaptive sports like wheelchair rugby.