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Has Pubic Catheter And Needs To Change Tubes As White Floaters Keep Clogging And Stops Urine Flow. Suggest?
Question: My Father, age 76 has a pubic cathetor and is constantly going to ER to have tube changed out as "white floaters" keep clogging it up and stops the urine flow. What causes these floaters? How can we keep the tube from clogging. He now has a 22 size tube in place. Could an iron supplement be the cause?
Brief Answer:
Proper care of catheter may reduce the frequency.
Detailed Answer:
Hi XXXXX! Good evening. I am Dr Shareef, a general surgeon answering your query.
Indwelling urinary catheters are notorious in getting clogged with white encrustations around its openings. These are the crystals of magnesium phosphate and calcium phosphate which develop in alkaline urine. Alkaline urine occurs usually due to infected urine with bacteria which produce an enzyme called urease which breaks up the urea of urine into ammonia increasing the pH of urine. Once the urine becomes alkaline, at some point of time, crystals of ammonium and magnesium phosphate will precipitate out in the urine, and along with bacterial colonies will gradually clog the lumen of the pubic catheter.
The only way to prevent clogging is to ask the patient to drink more water (at least 3 lts a day), so that the alkaline nature of urine gets diluted and prevents further precipitation of the crystals, at the same time flushing the bacteria out of the urine. In addition to this, one has to also take a course of antibiotics, and as these are prescription drugs, and you may have to do a urine culture sensitivity before starting the antibiotic, you are required to see your treating family physician/Urologist. These efforts will at least prolong the time of frequency with which the catheter is changed.
Apart from this, you should give proper hygiene like cleaning the penis with soap and water or any antiseptic, and also clean the catheter to prevent this infection leading to encrustations.
I hope I have cleared your doubts. If you have any other query, please do not hesitate to ask.
Thanks for using healtcaremagic forum for your health query. Take care.
Proper care of catheter may reduce the frequency.
Detailed Answer:
Hi XXXXX! Good evening. I am Dr Shareef, a general surgeon answering your query.
Indwelling urinary catheters are notorious in getting clogged with white encrustations around its openings. These are the crystals of magnesium phosphate and calcium phosphate which develop in alkaline urine. Alkaline urine occurs usually due to infected urine with bacteria which produce an enzyme called urease which breaks up the urea of urine into ammonia increasing the pH of urine. Once the urine becomes alkaline, at some point of time, crystals of ammonium and magnesium phosphate will precipitate out in the urine, and along with bacterial colonies will gradually clog the lumen of the pubic catheter.
The only way to prevent clogging is to ask the patient to drink more water (at least 3 lts a day), so that the alkaline nature of urine gets diluted and prevents further precipitation of the crystals, at the same time flushing the bacteria out of the urine. In addition to this, one has to also take a course of antibiotics, and as these are prescription drugs, and you may have to do a urine culture sensitivity before starting the antibiotic, you are required to see your treating family physician/Urologist. These efforts will at least prolong the time of frequency with which the catheter is changed.
Apart from this, you should give proper hygiene like cleaning the penis with soap and water or any antiseptic, and also clean the catheter to prevent this infection leading to encrustations.
I hope I have cleared your doubts. If you have any other query, please do not hesitate to ask.
Thanks for using healtcaremagic forum for your health query. Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You had said cleaning the penis area will help, but he has an pubic catheter which is inserted into his lower abdomin and they do flush it from time to time but that only pushes the clog back into the bladder where eventually will clog again. Just wondering if an iron supplement may be causing the "white floaties". He was also diagnosed with a staph infection but that has been cleared up for over a year now but they say he needs to be on anitibiotics for the long term, which is fine but that is why we cant figure out that he would have an infection of some sort in the bladder being he is treated with antibiotics daily. One ER Dr said the white stuffs is just because his bladder wants to reject the catheter? But a stroke makes it so that he can not release urine on his own...
Brief Answer:
Any foreign body precipitates infection and crysta
Detailed Answer:
Hi Lup ! Good morning. My regrets for the delay in responding as your mail reached here during odd hours of night.
My intention of writing about cleaning the penis area was about a general hygienic measures as anything sticking to the glans can also give rise to ascending infection through the urethra. I hope the nurses must be taking proper care to clean the area from where the catheter comes out during flushing.
No- I do not consider Iron supplement to be responsible for the blockage of supra pubic catheter. There are already crystals in the urine, which are precipitated due to infection specially with bacteria producing urease splitting urea causing the urine more alkaline. One such bacteria is Proteus and this has to be excluded. Also the Proteus infection is difficult to eradicate even with repeated antibiotics, specially with a foreign body inside the bladder like the catheter. Also due to immobility , the problem compounds on itself.
I am not aware about the progress in the condition of stroke in your father. But a long term antibiotic may also not give much relief till the foreign body is inside the bladder which may also be a compulsion in his case. So it is a difficult situation to control this aspect by the treating doctors. This has to be cleaned regularly , and the only way is to try preventing it by more diuresis with plenty of liquids being fed.
I hope this information clears your doubt. However, you may ask me again in case of further clarification. Thanks and good luck. Dr Shareef.
Any foreign body precipitates infection and crysta
Detailed Answer:
Hi Lup ! Good morning. My regrets for the delay in responding as your mail reached here during odd hours of night.
My intention of writing about cleaning the penis area was about a general hygienic measures as anything sticking to the glans can also give rise to ascending infection through the urethra. I hope the nurses must be taking proper care to clean the area from where the catheter comes out during flushing.
No- I do not consider Iron supplement to be responsible for the blockage of supra pubic catheter. There are already crystals in the urine, which are precipitated due to infection specially with bacteria producing urease splitting urea causing the urine more alkaline. One such bacteria is Proteus and this has to be excluded. Also the Proteus infection is difficult to eradicate even with repeated antibiotics, specially with a foreign body inside the bladder like the catheter. Also due to immobility , the problem compounds on itself.
I am not aware about the progress in the condition of stroke in your father. But a long term antibiotic may also not give much relief till the foreign body is inside the bladder which may also be a compulsion in his case. So it is a difficult situation to control this aspect by the treating doctors. This has to be cleaned regularly , and the only way is to try preventing it by more diuresis with plenty of liquids being fed.
I hope this information clears your doubt. However, you may ask me again in case of further clarification. Thanks and good luck. Dr Shareef.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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