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Anyone with nurse or medical urology experience?


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I'm trying to get my son into a urologist - unfortunately his urologist/surgeon retired and closed the entire practice. I'm getting his medical records switched to a new practice - but in the meantime no one can answer my question or get us in to see a new urologist urgently.

 

My son had a vesicostomy placed 5 years ago for a degenerative neuro condition that led to acute urinary retention. His vesicostomy stoma has been great and we haven't used a catheter in it for years - drains into a diaper. His urine output is excellent and clear. So, for the last 6 months he has been treated for 6 utis. Each time it grows a different bacteria too. We are using a clean catch method after his shower - no catheter.

 

I wasn't worried until today when we followed up with a urinalysis to make sure the uti from 2 weeks ago was clear. It grew a totally new infection - making 6 utis in 6 months! Why would this start now after so many years of a healthy stoma? Anyone know?

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thanks for the reply and bump... maybe the stoma does need to be stretched because of growth or something... It seems like it empties very well - overflows - bc he has plenty of soaked diapers/pads. There isn't really a way to check residuals myself like there I can with his feeding tube...

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thanks for the reply and bump... maybe the stoma does need to be stretched because of growth or something... It seems like it empties very well - overflows - bc he has plenty of soaked diapers/pads. There isn't really a way to check residuals myself like there I can with his feeding tube...

 

You can cath to get the residual. That is invasive. We now use "bladder scanners" which is like an echocardiogram of the bladder.

 

I'm just guessing on this because I have no experience, but it is what I'd try until I could get to the doctor. When it has had a good drain, position the child to let gravity do its best, and then put a little pressure with palm side of your fingers over the bladder area and see how much more comes out.

 

Not draining completely is a common problem for bladder infections. 6 different bugs is usual: klebsiella, e coli, e fecaelis, pseudomonas, strep .. what else? Has there been yeast as well?

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You can cath to get the residual. That is invasive. We now use "bladder scanners" which is like an echocardiogram of the bladder.

 

I'm just guessing on this because I have no experience, but it is what I'd try until I could get to the doctor. When it has had a good drain, position the child to let gravity do its best, and then put a little pressure with palm side of your fingers over the bladder area and see how much more comes out.

 

Not draining completely is a common problem for bladder infections. 6 different bugs is usual: klebsiella, e coli, e fecaelis, pseudomonas, strep .. what else? Has there been yeast as well?

 

Thanks for your post. We used to drain it with a red robin catheter - I still have one. We didn't measure it though. I kind of remember that it was hard to get out bc he is mostly bedridden. The urologist told us we didn't need to do it anymore once the scar tissue built up a nice stoma/tract and no follow up appts were scheduled. I'll just have to wait until the appt. and see if his bladder isn't emptying all the way. I need a fax machine to hurry this up!

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