Changing my diaper

Not too sleepy. Actually, our late night talk show hosts here in the US are just too entertaining lately, what with the antics in our nation’s capitol.

Hi, Ava. Of COURSE the newly changed diaper will get wet soon. That’s how I urinate! I believe that my bladder empties BETTER when I pee “on my own” into a diaper, than when using self-cath or a Foley.

www.ncbi.nlm.nih.gov/pmc/articles/PMC4114799/
“Urinary tract infection attributed to the use of an indwelling urinary catheter is one of the most common infections acquired by patients in health care facilities. As biofilm ultimately develops on all of these devices, the major determinant for development of bacteriuria is duration of catheterization.”

www.ncbi.nlm.nih.gov/books/NBK115272/
“Infection is a major problem in LTC [long-term urinary catheterisation] although there are other non-infectious complications associated with LTC, including physiological/structural damage,271 urological cancer61 and psycho-social problems.”

Yes, Lara. I have to be very careful not to put too much pressure on my bladder when I urinate. And, I have to be sure that I focus on emptying my bladder four to five times a day, depending on how much fluid I’ve drunk. I have strong spascity in my stump (i.e., what’s left of my left leg), making it almost impossible to get my hand where it needs to go to cath myself. Those who advocate cathing over peeing into a diaper would be quick to recommend a Foley at this point. I had UTI’s when I used a Foley. Others would advocate having a supra-pubic catheter inserted. Supra-pubic catheters have the same problem with biofilms as Foleys.

“Catheter-associated bacteriuria (CAB) with transurethral catheters is almost inevitable. Suprapubic catheters (SPCs) are widely considered to decrease the risk of CAB. However, SPCs are implants similarly prone to microbial biofilm formation. The spectrum of colonising pathogens has not been investigated. The aim of this prospective study was: (1) to assess the diversity of microbial suprapubic catheter colonisation (MSPCC), (2) to identify risk factors and (3) to investigate its association with CAB and catheter-associated urinary tract infection (CA-UTI)....”
“...CONCLUSIONS:
This study provides the first analysis of MSPCC. Indwelling time increases, whereas antibiotic prophylaxis decreases the risk of MSPCC. The spectrum of pathogens is comparable to the one obtained from urethral catheter biofilms. Urine specimens could not demonstrate the microbial diversity of MSPCC. SPCs are not preferable to urethral catheters to reduce CAB. Whether the risk of CA-UTI could be minimised by SPCs remains to be clarified.”
www.ncbi.nlm.nih.gov/pubmed/22926265

Catheter-associated bacteriuria (CAB)
Suprapubic catheters (SPCs)
microbial suprapubic catheter colonisation (MSPCC)
catheter-associated urinary tract infection (CA-UTI)

I would not trust a doctor to make the “how to urinate” decision for me.