To Pee or not to Pee?

How to make bladder catheterisation less painful.

A strange title for a web page, but many or most of us will be catheterised or have friends undergoing what is often a very painful procedure. This little gem which I read in a recent medical Journal is something I thought I should share.
We have two muscuar valves leading out of the bladder stopping the urine from leaking, and usually these are closed. They open when we go to the toilet. They are not designed to allow a structure like a small snake to pass backwards up into the bladder, and tend to slam shut. Pushing past these closed valves causes most of the pain during urinary catheterisation.
Doctors, nurses, house surgeons, medical students have been instructed to tell patients to cough or breathe slowly and deeply when the catheter cannot get past the valves - none of these work. Why should they? Why not ask the patient to open the valves by peeing?
Nobody has ever suggested this before, how can we have been so obtuse? In a recent paper in the Journal Urology (April 2017) in just under 100 patients having a catheter inserted, half were asked to lie back and grin and bear it, and half were asked to try to pee while the catheter was being inserted. The pain in the Peeing group was less than half that of the others (41%).

Almost certainly none of the people trying to catheterise us with have read this article, so just share this information if you know that one of your friends or yourself will be having this procedure. While the doctors/nurses/medical students struggle down one end, you just lie there and gently try to pee, they will never know.

To continue Shakespeare's soliloquy – "whether tis nobler in the mind to suffer" – the answer is NO!