"It was the angle, not the height”, says Arne, describing how he fell from a tree. As an active young man of 22, a game of football in the park with his friends had seen the ball get lodged in a branch, and Arne climbing to retrieve it. The resulting fall left Arne with a spinal cord injury, unable to walk or control his bladder.
That was 1990, and since then, Arne has travelled the world with work and had a fulfilling career. He enjoys spending time with his kids and has never stopped being active. But he only started with Intermittent Catheterisation (ISC) in 2013. Why the delay?
"Stubborn” says Arne. “I am very stubborn.”
I had been using a uridome – a sheath that covers the tip of the penis, with a collection bag strapped to my leg. It was like having two bladders, I didn’t have to think about going to the toilet, and travel was easy.
But the smell, and the infections! I had so many Urinary Tract Infections – UTI (if left unchecked, a UTI can be life threatening) and it affected my sex life.
I was given a stark choice, either surgery or ISC.
I had a scan of my bladder during a standard check-up, and it was shocking! The bladder’s muscle tone had declined considerably; it’s why I was able to retain so much urine. The walls had expanded, and it looked hideous. The reason being that the uridome just takes care of the leakage, not emptying the bladder and hence resulting in over-expansion of the bladder.
Two years later, my bladder had returned to normal size and healthy functioning.
I had to relearn the habit of going to the toilet again, which was odd as I’d spent years never having to think about it.
I was active before, but there are some sports you can’t do with a urine bag strapped to your leg. Now, with intermittent catheterisation, I can enjoy swimming with my children, something I could never do with the bag in the same way.
Knowing what products are available
It isn’t a one–size–fits–all when it comes to intermittent catheterization. I wasn’t given a choice of the catheter I was offered when I started, and the nurse did not know what was available. The first was a catheter that you lubricated yourself. And while I was overjoyed that there was no longer any smell, it wasn’t always comfortable to insert, because I have penile and bladder sensation.
The frequency of UTI’s went down, but they still occurred due to strictures (scarring that restricts the flow of urine) resulting in increased risk of infection. I’ve since learnt that the charrière size ( the diameter of the tube inserted) wasn’t big enough, and this affected how effectively I could empty the bladder.
I would have probably stayed with this type of catheter and size if I hadn't been introduced to a catheter with a different type of coating:
• First up – the surface, it’s slippery at insertion and removal, and for someone who has sensation, that’s incredibly important. Urotonic Surface Technology means that the catheter has a surface coating with a salt concentration similar to urine, it is a different surface from catheters that need lubrication.
• And crucially, the smoothness of inserting and removing the catheter means I haven’t experienced the friction and urethral trauma which is associated with an increased risk of UTIs – that’s peace of mind from the danger of infection.
Finding the right charrière size reduces risk of UTI
I’ve also been able to avoid UTIs because I have a larger charrière size (Arne uses CH16) – a larger charrière size allows me to completely and more efficiently empty the bladder. With the smaller size, it was coming out very weakly, and the bladder needs to force it out for a better, more fuller emptying.
Residual urine in the bladder can cause infection, so the incidence of experiencing a UTI has dropped to nothing so far, and I’ve been using a catheter with a urotonic surface for 6 years.
Maintaining hygiene – the non-touch technique
Hygiene can be such a worry, so as well as having a urotonic surface, my catheter has everything contained in the packet, including a saline solution that activates the Urotonic surface with a squeeze of the packet – I’m never going back to having to lubricate the catheter myself.
It has a rubber handle that makes it so easy to angle the direction of the catheter when inserting it, and it maintains hygiene with the “non-touch” technique; you’re never touching the tube that enters the body.
The experience is as hassle-free as possible and has resealable packaging for easy and discrete disposal.
And because my genito-urinary health is so much better, my confidence and sex life have improved. It’s something I no longer need to worry about when I am intimate. If you empty your bladder before having sex you don’t have to worry about leakage.
If I could change one thing in the years since my accident, I would have started with catheter with a urotonic surface immediately. I could have avoided all those infections and poor health because it’s an easily learned, convenient and safe therapy.
It’s made a huge difference to my health and well being.