Son will need cath after surg-PLEASE dont retract!

[squirrelletta]

My son needs a MAJOR surgery on his skull and will need a catherer for sure. I'm so sad because I know they will retract him and the last thing he needs is an infection or some complication because staff has no idea how to cath intact boys.

Any ideas or help?!?!?! I know if I ask for them to be careful the message will get blown off and/or the person doing the cath willnever hear the message. Im going to talk directly to his neurosurgion but Im so heart sick over this.

[tammylsmith]

how old is your son?

[jessafina]

"A catheter can be inserted when the foreskin is retracted just enough to see the meatus (urinary opening). if the foreskin's opening is too small to retract far enough to see the meatus, a catheter can be inserted through the foreskin's opening and into the meatus "by feel." The foreskin should never be retracted by force for any reason"

This is from the nocirc website. Hopefully you can effectively get this point across. Is it possible to have some sort of advocate present during the surgery?

[Night_Nurse]

I guess it really depends on the age of your son but I don't see why the catheter can't be placed before surgery and you can be there to witness it. This is what I'd say I wanted to happen and then even while you are there witnessing the insertion, make sure the nurse know no retraction, and that you mean it!
Good luck to you and your son during this stressful time!

[squirrelletta]

Originally Posted by tammylsmith

how old is your son?

Sorry...he just turned one.

[dkenagy]

My son has a serious kidney anomaly and had to undergo an xray test involving catheterization at just 6 months old. I requested to be present for the catheterization and was careful to mention and remention that he was uncircumcised and should NOT be retracted. I cannot tell you how relieved I was when a foreign-born male nurse showed up to do the cath! He did not retract my son's foreskin at all and was able to get the catheter placed very quickly.
I understand your concern and I second the others' comments that you should definitely ask to be present during the cath and just keep mentioning the non-retraction issue, eyerolls or no!!

Good luck and I hope all goes well with your son's surgery!

[feminist~mama]

You could also request attempting a "condom cath" instead of an indwelling cath- it might not work out, but it's worth a try!

[squirrelletta]

Good idea, they are called a "Texas cath"...I dont know if they have them for babies though? hummmm...I'll ask

[Bea]

Originally Posted by squirrelletta

Good idea, they are called a "Texas cath"...I dont know if they have them for babies though? hummmm...I'll ask

I'm pretty sure that won't work. Not just because I doubt they make them that small, but as part of his monitoring post surgery they'll probably want to monitor hourly urine volumes to keep an eye on his hydration status and kidney function. This needs an indwelling catheter.

I'd talk to his surgeon.

Personally, and I'm not suggesting this is what you do, but I'd threaten to sue the arse off everyone present in the OR if my son's penis was in any way manipulated that caused even the slightest damage to his foreskin.

I'd put it in writing. I'd shout it from the rooftops. I'd be the nuisance, foreskin obsessed, weird mother in room 6 who you have to watch out for

[eepster]

Can you request either a NICU nurse, or a nurse who went to school in a non-circ'ing country. Most of the world doesn't circ so that would be most places outside the US. Around here there are many nurses from Ireland and Russia, as well as many other countries.

[feminist~mama]

Originally Posted by Bea

I'm pretty sure that won't work. Not just because I doubt they make them that small, but as part of his monitoring post surgery they'll probably want to monitor hourly urine volumes to keep an eye on his hydration status and kidney function. This needs an indwelling catheter.

Well, if the cath was working and catching the urine, why wouldn't they be able to monitor the urine output????

[an_aurora]

I'd talk to the pre-op nurse and make sure you write on his diaper in Sharpie "intact don't retract!". They will probably remove the diaper (and insert the cath) after anesthesia so it will be a reminder

((HUGS)) for you and your DS!

[squirrelletta]

I talked with the surgeons nurse today (They called for some info) and she was VERY cool about it. (a good sign, but Im still weary)

[Bea]

Originally Posted by feminist~mama

Well, if the cath was working and catching the urine, why wouldn't they be able to monitor the urine output????

A condom cath requires you to actively pee, whether through incontinence or consciously urinating.

A one year old would only pee when his bladder was full every few hours. Post major surgery there is a chance as part of the post op monitoring, they will want to monitor the mount of urine being produced hourly (as an indication of kidney function and hydration)and the only way to do this is with an indwelling catheter that drains urine as it's produced.

The hours that it takes to fill the bladder till it empties on it own could allow a patient to become dangerously unwell without any interventions because no one would know.

[mnnice]

Originally Posted by dkenagy

My son has a serious kidney anomaly and had to undergo an xray test involving catheterization at just 6 months old. I requested to be present for the catheterization and was careful to mention and remention that he was uncircumcised and should NOT be retracted. I cannot tell you how relieved I was when a foreign-born male nurse showed up to do the cath! He did not retract my son's foreskin at all and was able to get the catheter placed very quickly.
I understand your concern and I second the others' comments that you should definitely ask to be present during the cath and just keep mentioning the non-retraction issue, eyerolls or no!!

Good luck and I hope all goes well with your son's surgery!

DS2 was cathed to have probabily the same test (VCUG) as dkenagy is talking about at just 8 weeks of age. He was not retracted and the whole insertion took just a couple of seconds and didn't appear to hurt. I would stay and remind them not to retract, but I would not think it would be an issue.

[CalaRei]

I'd write it on his belly, even, in addition to the diaper. I'm not sure what the procedures are like, so I don't know when his dipe would be removed.

[feminist~mama]

Originally Posted by Bea

A condom cath requires you to actively pee, whether through incontinence or consciously urinating.

A one year old would only pee when his bladder was full every few hours. Post major surgery there is a chance as part of the post op monitoring, they will want to monitor the mount of urine being produced hourly (as an indication of kidney function and hydration)and the only way to do this is with an indwelling catheter that drains urine as it's produced.

The hours that it takes to fill the bladder till it empties on it own could allow a patient to become dangerously unwell without any interventions because no one would know.

Oh right- of course! Lol! I obvious don't have tons of experience with them as I work in L&D and well, we don't "do" men! Thanks for clueing me in!

[squirrelletta]

Thanks so much for all the ideas, but most of all, encouragement to stand up for my and my sons convictions and health.

I've talked with both doctors (that will be working on him) staff today about the issue. Both were great and supportive and said I will be called tomorrow by the nurses that will be working with the doctors during the surgery and to discuss it with them and stress several times how you feel and what your needs are. Pretty cool so far.

He's going to All Childrens in St. Pete Florida and Ive heard that everyone at this hospital is amazing and loving. Please send them all love and wisdom for us! Thanks for your help!
Nicole & Family

[Sharon, RN]

Wishing you good luck with your little one!

I'm a few days late, but if there is still time- request a nurse who is experienced with intact children. If that's unavailable, see if they would have a pediatric urologist stop by and insert the cath.

I hope things go well and your baby is home to you soon!

[squirrelletta]

FANTASTIC IDEA! Thank you! I see the doc's tomorrow and we go up for pre surg stuff. I will ask about the intact nurse of ped uroligist! Great plan!

I can barely breathe...It all starts tomorrow after 8 weeks of waiting.

Thank you all for your help, I will be using all your suggestions and strength!

With love,
Nicole