Catheter for Koch Pouch

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ravibhalla
Posts: 3
Joined: 2009-12-12 19:15:57

Catheter for Koch Pouch

Post by ravibhalla »

I had surgery for Koch Pouch in 1996 and have neen using a Medena Catheter (first the Curved one) and then a Straight one with a Flare End (30 FR 12 inches). I leave the Catheter inside all the time except when I take a shower. I irrigate 5/6 times a day.
Medena now has stopped making a Straight Catheter with a Flare End. I am looking for a replacement.
Leaving the Catheter in all the time I allow myself to drain the pouch without irrigating when I am not at home.

Any help would be greatly appreciated

Ravi
bcirray
Posts: 76
Joined: 2009-07-13 18:04:05

Re: Catheter for Koch Pouch

Post by bcirray »

If by flared end, you mean three holes at the tip, Medena still makes the 12" 30fr straight cath. The Mentor 18" 30fr was discontinued. Why do leave the cath in all day? I have that BCIR (Koch variation) and wouldn't think of that, simply because of the same reason the cir pouch gives me the freedom from an appliance. What about the valve, are you damaging it in anyway? If I hade to do this short term I would use a foley cath. They are cheap in comparison. ($8).

Ray
Ronb
Posts: 69
Joined: 2008-04-24 21:42:00

Re: Catheter for Koch Pouch

Post by Ronb »

I also wonder why you would leave your catheter in. That seems to be defeating the purpose of the internal pouch. I have the BCIR and I might irrigate once every 4 to 6 months. There is one guy that mentioned that he has never irrigated his pouch, of course we don't know all facts so please let us know, but most of us with an internal pouch have a different schedule than you do.
ileostomy 5/77
BCIR 9/97
Flemmart
Posts: 119
Joined: 2008-04-30 19:34:07

Re: Catheter for Koch Pouch

Post by Flemmart »

I'm curious too! You shouldn't have to leave the cath in to irrigate. I hope your valve is okay, maybe that is why you leave it taped in? And, you don't have to irrigate with each interbation - although some pouchers like the feeling of a completely empty pouch.

I used to think the flared end helped the tip of the syringe go inside easier especially as eyesight gets poor as we age, but the straight end works fine. Other then that, I can't recall the reason for the flared end of the cath. Plus, I cut off the end of my cath as I don't need it so long, so the flared end came off anyway.

Bummer the cath you like isn't manufactured anymore.
Ileo 1979 Kock pouch 1980
User avatar
mrsjt
Posts: 11
Joined: 2010-03-01 13:51:40

Re: Catheter for Koch Pouch

Post by mrsjt »

Hello new to forum. I have a urinary Kock Pouch, my urine seem to have a very very strong odor, an odor I can not bear. Any suggestions to eleviate that or to control it?
Permanent Ileostomy 1968
Urostomy 1968 then change urinary Kock Pouch 2002
apgreen
Posts: 4
Joined: 2010-03-13 13:49:08

Re: new Koch pouch & ca

Post by apgreen »

I'm new to the forum. I had a J-pouch for 15 yrs-problems on & off, but ca showed up on last c'scopy. Just had surgery to remove the rectum and J-pouch and have a Koch pouch done (by Dr. Launer's new associate, Dr. Salvanig. 3 week hospitalization-had infection-abscess-drain -1 readmission for dehydration

I am getting the knack of inserting the catheter-must lie down to get it in the pouch)- (Medina, slightly curverd) & am down to 4 insertions/day. I definately feel the pressure (pain?) when it needs to be emptied

a few ?'s

I have lots of air that is expelled during intubation-little bullbles etc-also belchj a lot.

Do you think this is food allergy (none in the past) or intestines settling down or what? My belly is still a bit sore-sonmetimes blows up with gas-am being careful to have lo-residue diet-have to drink lots of water- and fruit juice so stool is liquid eno to flow without irrigations

any tips for a newbee? any advice would be appreciated

plus, do you ever get accusopmede to this?? does it get to be easier to find the pouch with the catheter, with time?

what do you recommend as a cover-I tape on 4X4's & paper tape-presently-most adhesives irritate my skin

am seeing a g-i cancer specialist next week to see if they recommend any treatment. The month prior to the c'scopy, I had just completed chemotherapy and radiation for breast cancer. The 2 are not associated, but it's made my recovery difficult as I was weak to begin with..
Anyone out there whgo has dealt with colon or rectal ca?

Thanks. .am glad to have found some virtual support...........apg
Flemmart
Posts: 119
Joined: 2008-04-30 19:34:07

Re: Catheter for Koch Pouch

Post by Flemmart »

Hi - welcome! It takes time to get the hang of interbation but eventually you'll do it quick. You will always feel pressure when it's time to empty, even after the pouch is mature in size. air, gas and cramping is normal as the pouch matures. Some folks take Gas X, but sometimes time will just need to go by. When you say, is it easier to find the pouch, not sure what you mean. When inserting the cath, use alot of lube, aim straight in and it should glide past valve into pouch. Once it's in the pouch, you can wiggle or move the cath in and out a bit (not all the way out, just around) to find gas pockets. And, if you notice nothing is coming out, you may have a food chunk stuck to the side of the hole in the cath. Manually pull out with tissue and you can reinsert cath and usually alot more poo will continue to flow out. You'll almost always have gas come out of the pouch during interbation. More with gassy food and less with non-gassy food.

Alot of people use nursing pads to cover stoma, I use an overnight maxi pad cut in half with a little paper tape. I rotate the tape so my skin is not irritated. And, if I have on tight enough undies or pants, I can use the sticky side of the pad against my undies and it'll hold in place over the stoma.

Keep asking questions. You're doing great!
Ileo 1979 Kock pouch 1980
LARRY BROWN
Posts: 1
Joined: 2010-03-30 14:55:21

Re: Catheter for Koch Pouch

Post by LARRY BROWN »

hello---i need some help and advice-----i have been using an ASTRATECH curved ileostomy catheter REF 68732 G 30-30cm M8732 for 25 years for intubating the koch pouch; recently i tried to re-order and it is no longer produced since 2004; from what i've read most are using a straight catheter? but can this be curved to reach the bottom of the pouch such as a curved one does automatically? i'm afraid of damaging soemthing trying to do this with a straight one; or does there exist a super flexible/soft tube tube that can be curved; or does a curved one exist form another company?
i would be interested in knowing where i can order the best of this type of product also - internet site, address or phone number;
as i'm living for the moment in belgium i would appreciate the name of a surgeon in belgium who does koch pouch proceedures in case i need help one day.
thanks in advance for any help or advice ------ Larry Brown
Flemmart
Posts: 119
Joined: 2008-04-30 19:34:07

Re: Catheter for Koch Pouch

Post by Flemmart »

Hi Larry...looks like they stopped making them. Marlen caths are extra long and very flexible and curve easy into the pouch. They are much more pliable then Medina's.
Ileo 1979 Kock pouch 1980
User avatar
LindaAukett UOAA Advocacy
Posts: 1603
Joined: 2005-11-06 12:29:31

Re: Catheter for Koch Pouch

Post by LindaAukett UOAA Advocacy »

Larry,

There are ostomy associations in Belgium ... they may be better able to tell you of reliable surgeons there than we could.

You can find their contact information at http://www.ostomyinternational.org/European.htm - one serves Antwerp and one serves the entire country.
LadyTay97
Posts: 3
Joined: 2011-04-22 11:00:32

Re: Catheter for Koch Pouch

Post by LadyTay97 »

I had my K pouch surgery in June. At first I had a lot of gas and now not as much (maybe 1/4 what I did have). to put on the weight I lost I was told to have some milk shakes. I had a lot of gas after and I told the doctor I don't ever remember being lactose intolerant. He said because I had not eaten (no food after surgery and then liquid diet for a week after discharge) that it should calm down. I took some lactaid at first. But the last time I had a soda float I didn't take the lactaid and the gas was not so bad. I had an ice cream sandwich last night and didn't seem to have any problems.

I do have questions.

What supplies do you carry around with you? I assume the catheter and band aids to cover the stoma. I was told by my doctor to flush at least once per day. But sometimes it seems a little thicker (mostly in the AM after I wake) and flushing seems to help. What other supply items do you use that you think might be useful?

I also have some splattering. How do you keep that to a minimum? Or eliminate it?

Also when I empty the pouch, I rinse the catheter. So far I've emptied the pouch at home or a couple of times at work (no one there) but so far I've haven't been in a busy public bathroom. How do other people in the bathroom react to that? Or how do you handle that?

Any suggestions would be greatly appreciated a lot. Thank so much for your help. Have a great day. Mary
Flemmart
Posts: 119
Joined: 2008-04-30 19:34:07

Re: Catheter for Koch Pouch

Post by Flemmart »

Hi Mary, yes gas is very normal and takes time for the pouch to adjust to the diet. It's a trial by error...and some days you'll be able to tolerate food when another day it's gassy. But, keeping a journal helps to avoid the major culprits.

I keep my catheter, some lube, a syringe and stoma covers (band aids for me aren't big enough, I have alot of moisture from stoma, some kpers are dry others are most). You can irrigate more often if once a day is not enough to help with thickness and/or pouch empty fully.

For splashing, I place tissue at the end of the toilet draping down so that when I aim the cath down the poo sort of slides along it. But, sometimes I just gotta wipe down the sides of the inner toilet afterwards.

When at work or public restroom, I sometimes don't rinse cath. I tap as much out as on can and then wrap in seat liner or tissue and put into zip lock bag and rinse later. I reinsert even if I haven't rinsed it out yet if gone a long time. Or, you can bring a water bottle in with you and use it to rinse out cath into toilet. But, if you have to rinse - so what - just avoid the looks.

Keep asking questions! Janice
Ileo 1979 Kock pouch 1980
LadyTay97
Posts: 3
Joined: 2011-04-22 11:00:32

Re: Catheter for Koch Pouch

Post by LadyTay97 »

Janice Thank you so very much for the information. I really appreciate it. It's nice to know others are there to help me adjust to this. Have a fantastic day. Mary
bcirray
Posts: 76
Joined: 2009-07-13 18:04:05

Re: Catheter for Koch Pouch

Post by bcirray »

Where did you hear that Dr Schiller has retired?

Ray
PamSue
Posts: 5
Joined: 2014-04-27 03:51:30

Re: Catheter for Koch Pouch

Post by PamSue »

The catheter that I originally used was discontinued a good 20 years ago. I have been using the Medina 8730 Continent Catheter 30Fr for continent ileostomy (still available from Torbot) ever since. Recently I've been having trouble inserting the tube due to a narrowing of the passage just before the valve.
I've just had a procedure to dilate the area; the physician gave me a 16Fr tube with a pointy tip to insert into the Medina catheter just to get it past the narrow spot. It seems to work with a lot of lubricant but is a little awkward. I have been searching the net for a smaller gauge catheter (24Fr) without success. Medina used to make a 24FR. Does any one have a source for a smaller gauge catheter.
Pam
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