Will a catheter improve Dad's quality of life?

Aef asked...

My 81 year old father has been working with a urologist to address his overactive bladder. He has other health issues, including a history of strokes, seizures and a colostomy. None of the drugs tried (Sanctura, gelnique, oxytrol patches, vesicare, etc) have improved his quality of life. He still needs to urinate multiple times at night (about every 2 hours) and can't necessarily control his bladder during the day. This lack of control has made him house bound and exhausted. His urologist recommends installing a suprapubic catheter. I'm concerned about the initial procedure (particularly the anesthesia) and then the daily upkeep of the catheter. Will this improve his quality of life? Is this just trading one problem - incontinence - for another - UTI's?

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

Reading your letter, I agree with you. Having him go through an invasive surgery to have a suprapubic cathether is not a easy solution to his incontinence problems. With his seizure disorder, surgery is especially risky. Also, catheters can have their own set of problems, like urinary tract infections, bleeding, and daily maintenance.

Many people with a history of strokes have a neurogenic bladder (not overactive bladder), and bladder medications do not always help this type of incontinence. You did not mention if your father has any prostate issues that could be contributing to his bladder urgency, but he should be checked to make sure that is not a problem. He also needs to be checked to make sure he empties his bladder fully.

What I would recommend is to take him to another urologist for a second opinion. He needs to see if surgery is the only option for his incontinence.