Brief Answer:
Cather induced UTI , needs management

Detailed Answer:
Thank you for asking!
Indwelling catheters for that long are the very much reasons for your urethritis and UTI and retention episodes. Hydrogel, Aquasorb, DuoDerm, Intrasite Gel, Granugel, Normlgel, Nu-Gel, Purilon Gel, KY Jelly etc all are used in genital troubles. Also sudocrem can be used for its antiseptic properties. So its your or your urologist choice which one to opt for. Also topical lignocaine gels and any other anesthetic gels also relieve the pain. Uribag also called condom catheter wearing does not mean you are incontinent.They are less invasive intervention for urine and advised to prevent instrumental infections of urinary tract.
Catheter-related urinary tract infection (UTI) occurs because urethral catheters inoculate organisms into the bladder and promote colonization by providing a surface for bacterial adhesion and causing mucosal irritation.The presence of a urinary catheter is the most important risk factor for bacteriuria.

Once a catheter is placed, the daily incidence of bacteriuria is 3-10%. Between 10% and 30% of patients who undergo short-term catheterization (ie, 2-4 days) develop bacteriuria and are asymptomatic. Between 90% and 100% of patients who undergo long-term catheterization develop bacteriuria. About 80% of nosocomial UTIs are related to urethral catheterization; only 5-10% are related to genitourinary manipulation.

Long-term catheterization increases patient satisfaction but also increases mechanical complications. Contraindications include bleeding disorders, previous lower abdominal surgery or irradiation, and morbid obesity. Intermittent catheterization is an option, but most patients become bacteriuric within a few weeks; the incidence of bacteriuria is 1-3% per insertion.

It is said that drinking plenty of water is the best way to get rid of the organisms and clearing the pathway of them. SO drink as much fluid as you can, At least 12 to 16 glasses of water a day.
Then comes the role of hygiene, Front to back unidirectional wiping , using hot saline baths, sits baths, Avoiding unnecessary douchings, Not using Beauty soaps or perfumes down there, Good toilet hygiene, Post coital voiding immediately, avoiding unnecessary manual or digital or lingual manipulation of the area to avoid troubles.
Recently Use of Cranberry juices 10-12 ounces daily work like charm. These juices have proanthracyclins in them which doesn't allow organisms to stick to the pathway epithelium and thus decrease the predispositions to infections.
Those who have trouble with pain during micturition can get relief from bladder analgesic like Phenazopyridine if Sulfa allergies are not the problem.
Recent use of Intra bladder Instillations of Hyaluronic acids and chondroitin sulfates have proved very efficient.
Rest the antibiotics like quinolones, cephalosporins an. penicillin, sulfonamides and aminoglycosides with other symptomatic treatment is advised after being prescribed. Symptomatic treatment is used like antispasmodics like phloroglucinols or hyoscine etc and simple analgesics like acetaminophen etc suffice.
I hope it helps.get to your urologist for further guidance.Dont forget to close the discussion please.
May the odds be ever in your favour.
Regards
S Khan

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Brief Answer:
Self catheterization, do as directed

Detailed Answer:
Thank you for asking!
Suprapubic is more intervention and is to be considered when normal urethral pathway is not possible.I would suggest to go with the intermittent self catheterization. That is safest amongst all. If not then yes suprapubic catheter would be next option.
And yes it is fine and nice of your doctor to arrange a cystoscopy exam and is a perfect procedure for the management off such conditions. Toilet training is the best of all techniques.Remember the key, opt for the option which is minimally invasive as the minimal the invasion the less the odds for trouble.
I hope it helps
Take care

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Brief Answer:
:)

Detailed Answer:
Thank you for getting back!
Hygiene care is just i meant simply. Front to back wiping in one direction from scrotum/ genitals to anus direction. Hot saline and sitz baths are sitting in a water warm and salty with some pyodine in it , it keeps the hygiene up to the mark but these two measures are mostly affective for women as their urinary tract is short.
And yes discomfort of the penis is due to the catheter related infections and complications.Anything that helps the pain is worth trying so yes you can use vaseline.
I appreciate your candid response and don't forget to mention me to your friend for sure.
I hope it helps.Take good care and dont forget to close the discussion please.
May the odds be ever in your favour.
Regards
S Khan

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