Michael Owino (pictured) hopes that someday, he will lead a normal life. Today, he continues to nurse a wound that can only be solved by an expensive operation to correct his urethra.
I was involved in a road accident in 2002 when I was 10. I was walking from school, somewhere in Maseno, when a lorry swept me off the road as it sped away. I landed on a huge rock which injured my genitals. A good Samaritan carried me home from the accident scene since I couldn’t walk.
My elderly grandma, who I lived with, did her best to nurse my wounds with home remedies. But I still woke up the following morning with sharp pains in my swollen groin. Though I felt the urge to pass urine, nothing would come out. I was rushed to a hospital where tests revealed that my urethra was twisted and that it couldn’t allow flow of urine. I had to undergo a surgery for a catheter to be inserted to remedy the situation. It wasn’t a permanent solution but it was all we could afford then. I stayed in the hospital for a whole year with doctors changing my catheter and monitoring my condition. My uncles would come to visit me but when it was time to go home, no one came to pick me up. I didn’t want to go back to grandma because I knew she wouldn’t afford the medication. I didn’t want to put it on her. Again, I needed to stay near Kisumu for easy access to the hospital for my clinics.
An aunt who stayed in Kisumu grudgingly took me in but she kicked me out after only a week because my condition was too expensive. So I moved to the streets where I begged for food and money for my medication. Doctors had prescribed medication which cost Sh600 every day. The amount I used to get from begging was enough to enable me to religiously visit the doctor. I also saved some money and started selling calendars and charts on the streets. From this, I secured an affordable house close to town. There are days I skipped taking my medication and endured my pain just to save some money. I shelved the idea of going back to school when it dawned on me that I was on my own in the big cold world and staying alive was more important. I needed to hustle for medication. I needed Sh2,500 every two weeks to have my catheter changed.
I only stopped attending clinics when my doctor taught me how to change the catheter on my own. I later moved to Makadara in Nairobi where I still sell the calendars and charts to buy catheters and pain killers. I spend Sh800 every two weeks.
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Limitations
I empty the catheter at least three times a day and try to take as much water as possible to keep the equipment in good condition. When I don’t drink enough water, my discharge blocks the catheter. I also can’t walk for extended periods because the friction around the catheter causes it to leak. However, my biggest challenge is working when it is raining. In fact, I haven’t sold anything from the time it started raining because I must avoid contact with water as much as possible as the water destroys the catheter.
Meanwhile, doctors at Jaramogi Oginga Odinga hospital have been trying to get a hospital that can conduct urethroplasty to correct my urethra. The doctor that operated on me after the accident has since died and there is no one at the hospital who can conduct the surgery that requires Sh3 million. I have been referred to many hospitals including Moi Teaching and Referral Hospital in Eldoret, Kenyatta National Hospital and now, Kijabe Mission Hospital, but I do not have the money. Hopefully someday I can get it and lead a normal life.
Bladder Outlet Obstruction
Bladder Outlet Obstruction (BOO) is a blockage at the base of the bladder that reduces or stops the flow of urine into the urethra. The urethra is the tube that carries urine out of the body. Research shows that BOO is common in aging men and is often caused by enlarged prostrates.
Causes of BOO
They include the following:
· Narrowing of the tube that carries urine out of the body from the bladder (urethra) due to scar tissue or birth defects
· Pelvic tumors such as those in the cervix, prostrate, uterus and rectum
· Cystocele or when the bladder falls into the vagina
· Foreign objects
· Urethral or pelvic muscle spasms
· Groin hernia
Symptoms
They vary but may include the following:
· Abdominal pain
· Continuous feeling of a full bladder
· Frequent urination
· Nocturia or waking up at night to urinate
· Pain during urination
· Urinary hesitancy or problems starting urination
· Slow or uneven urine flow
· Straining to urinate
· Urinary tract infection
Treatment and management of BOO
Most causes of BOO can be cured if diagnosed early. But if diagnosis is delayed, this may cause permanent damage to the bladder and the kidneys.
Treatment of BOO depends on its cause. Options include the following
· Medications
· Where there is a blockage, a tube, called a catheter is inserted in the bladder through the urethra.
· Suprapubic tube. Here, the catheter is inserted into the bladder through a cut in the tummy. This way, it drains the bladder.
· Long-time cure of BOO sometimes requires a surgery to correct the blockages and damages in the urethra and bladder.
Common challenges to watch out for while using the catheter
· urine may stop draining from the catheter due to a blockage
· abdominal discomfort
· urine may leak around the catheter insertion site
· the area around the catheter may become red and sore
· blood in the urine after changing the catheter. This stops in 24 hours
How to take care of the catheter
· Always wash hands before and after emptying the catheter bag.
· Wash the area around the institution site with cool boiled water at least twice a day
· To prevent urinary tract infections and improve drainage from the catheter, take an adequate amount of fluid every day. At least 1. 5 litres of fluid
· Take showers rather than baths as staying in water for long may delay the wound from healing.
