Good luck

This is a tricky one. I have only ever seen a handful of such cases - have you tried Amitriptyline at night - this worked well for a couple of my patients.

Have you tried to make the urine more alkaline - commercially available sachets are available from most pharmacies. Other options include taking a medication like Cimetidine which acts on the histamine receptor system - this will need to be prescribed. If you have tried simple measures then seek a r...

Not sure about the bowel side of things but for urological nurse education you could look at British association of Urology Nurses or International Continence Society websites.

I don't think it is a risk for anything other than urinary infection and how much this increases risk over and above catheterisation is not known. Blood is a very good culture medium for bacteria so theoretically can increase UTI risk.

I would try a softer catheter as it sounds as if the process of catheterisation is causing a bladder spasm and resulting in the expulsion of urine you describe. The botox effect should wear off after 6-9 months.

There are many different brands of ISC catheter that can be trialled and most people will be able to find one to suit. If you are struggling with insertion then this could be the cause of pain, bleeding and UTIs. I would advise a discussion with your urology specialist nurse who should be able to sh...

Yes there are a number of non-antibiotic alternatives with vary levels of efficacy and supporting evidence. Examples include methenamine Hippurate, D-mannose, cranberry supplements, vaginal oestrogen etc etc. There are a few good summary articles out there - perhaps the best is by Sihra et al in Nat...

The procedure does not necessarily need to be repeated but if your symptoms deteriorate it can be. The risk of repeated urethral manipulation is scarring which can produce further symptoms.

The first thing to do is a bladder diary to see how much urine you are producing overnight - this will help rule out a condition called nocturnal polyuria (excessive production of urine overnight). The treatment for this is different to the treatment for overactive bladder. It is essential to make t...