30cc vs 5cc Foley Balloons

Can anyone explain the differences between 30cc and 5cc catheter balloons? I get that the balloons have different capacities, but wondered if anyone could give insight to the benefits/differences between the two.

During episodes of urinary retention, I have to have a Foley catheter in, and after spasms, my urologist had me try a foley with a 30 cc balloon. Overall, I like it. But I just wasn't sure besides being a bigger balloon, what the difference was.

The simple answer is this. The bigger the balloon the less chance of leaking there will be and less of a chance the catheter can be pulled out with the balloon inflated. Trust me when I tell you, that isn't a very comfortable experience.

Mashie

But we have seen a 30cc foley pulled, not a pleasant experience havent we mashie and susie?

makes me cross my legs to think of it.

Thanks @Mashie

The most common reason to use a 30cc balloon is following removal of the prostate in order to tamponade the bleeding and to fill the space where the prostate used to reside. If a 5cc balloon is properly filled with 10cc of sterile water, it would be very unusual to have a patient pull a catheter out without causing severe damage to the sphincter and urethra. This same damage would be caused by a patient attempting to pull out a catheter with a 30cc balloon. Most catheters with a 30cc balloon have a tip that extends well beyond the balloon (much more than most 5cc balloons). This extended tip tends to poke and irritate the bladder lining which results in discomfort and bladder spasms.

Some people incorrectly think that the larger balloon "seals" the bladder better to prevent leaking. The balloon plays no real role in creating a urine seal, it is simply for retention of the catheter in the bladder.

. . . . The balloon plays no real role in creating a urine seal, it is simply for retention of the catheter in the bladder.

This is true. With a catheter in place, the urine pressure inside the bladder is close to zero because the cath immediately drains it out. However, a too narrow cath will allow some leakage.

I am not sure I agree that the balloon size has nothing to do with leakage. I didn't explain myself well enough because I was trying to be as simple as possible.

If the balloon isn't seated correctly all of them will leak but it's been my experience that the larger balloons leak less than the smaller ones and the larger ones certainly don't pull out as easily.

Keep in mind the type of patients I take care of normally. Patients on a vent don't move much if any, we move them. So the larger balloons provide enough weight to help prevent leakage when we manipulate our patients which also helps prevent skin breakdown from urine leakage.

Mashie

A few years ago a family member needed a larger French because the balloon kept slipping farther up the urethra and into the bladder. It was ever inflated a few times until finally a larger on was used, problem solved.

But this might have been a rare case.

I've had 5 cc and 30 cc Foleys. I HATE all of them.

Hi Mashie, just so you are aware, I am a real MD specializing in urology. If as you say, you are getting leaking if the balloon is not seated correctly, it is not because of any lack of sealing by the balloon. It is most likely due to the tip of the catheter poking and irritating the bladder wall which will cause bladder spasms resulting in leaking.

For Switchable, I agree that if you go way too small (e.g. 10 or 12FR in an adult) that might result in leaking, but I would suggest that the movement of the catheter in the urethra and at the sphincter because it is so small, would also result in spasms and leaking. This would be further exacerbated if the catheter only had a 3cc balloon that is normally associated with pediatric catheters.

Also as a general rule, underfilling a catheter balloon will result in the balloon not filling symmetrically which would cause the tip of the catheter to bend to one side and irritate the trigone in the bladder. As you know, all catheter packaging includes a maximum fill volume and that is what should be used in the vast majority of cases to ensure symmetrical filling of the balloon which will keep the tip straight. 10ml for a 5ml balloon, and for most 30ml balloons, 35ml is indicated except for many Rusch catheters where the fill volume is indicated to be 30-50ml.

Drfistherass, I sure hope that the balloon was in the bladder rather than in the urethra when it was inflated. If a balloon is accidentally inflated in the urethra, lots of pain and lots of blood would be the result. Ouch!

A nurse inserted it in the patient 3 weeks before, I am sure it was in the bladder.

Deke, thanks for that brilliant information and it makes total sense. Thank you for your highly educated information and logical reasoning. You ROCK!

Mashie

Thank you everyone for the info! I guess I'm not entirely sure then why the urologist wanted me to try 30cc balloon, but good to understand the differences!

Aw shucks, Mashie. Thanks! 😃

How does one determine what size catheter they need? Without a professional determination, and not wanting to buy one of every size to try, is there a way to gauge or measure?

Littleamy, catheters really are not "sized" in the sense that you are referring to except for pediatric patients where there are approximate guidelines for the french size based on the age and sex of the child. For adults, though occasionally a 14FR catheter might be used, for both males and females 16FR is by far the most common, closely followed by 18FR. Larger sizes might be used to address clogging due to blood clots, sediment, suprapubic placement, etc. FYI, the larger the french size, the larger the catheter (French size /3 = the diameter of the catheter in mm).

In a previous posting, I provided some details for choosing the correct balloon size. By far and away the most common balloon size is a 5cc balloon (which is typically filled with 10cc of sterile water). BTW, although it is slightly off-topic, saline should never be used to fill the balloon because over an extended time it can cause the fill valve or fill channel to fail to allow the balloon to deflate because of crystallization of the saline.

My take on catheters....the balloon inside has no bearing on "sizing" a persons urethral canal. I prefer the 30 cc balloons because they seat better and don't pull out during activity. I have had 5 cc balloons actually pull out, especially in older women.

As to the fr. size...I always have several sizes and when I play with a woman, I will examine her urethral canal, a q tip...a sound, different size catheters until I found one that slides in snugly. Older women tend to be able to take larger FR. caths...I usually end up with 24Fr. or even 30 Fr. That's 3/8 " in diameter. A 30fr. cath with a 30 cc balloon is snug and sealed...the woman is aware of it inside, but not causing discomfort. total control, indeed

I train nurses & CNAs for a living. During the CNA classroom, I always show them a fully inserted foley catheter balloon so that they will understand the importance of placement of the catheter itself, providing enough slack and proper positioning of the leg band, etc. It's very eye opening. Since I have done this, the only pull-outs in the facility where I work have been with behavioral patients who would tend to pull out anything connected to them anyway; we have not had any incidents due to poor placements/pull outs. A good thing - it's so traumatic when they are pulled out fully inflated, whether with 5mL or 30mL.

Regarding catheter play....I always play on a consensual basis, however, in the heat of subspace or whatever, I want the submissive to be safe and protected even from herself. This being said, generally, when I cath a woman, she is in restraints. This of course serves many situations on many different levels. A woman out of control...helpless...the act of cathing can be very stimulating....in restraints, she is "allowed" to struggle without fear of injuring herself by yanking a cath out of her bladder.

The mere thought of being on display...in restraints...and having that hose extending out from between her lips...very submissive act on her part. Having control of a woman's body functions can put her deep into subspace if she has a med fet fetish....which is the reason she is there to begin with.

Snug fitting caths and 30cc bulbs are the safest and most practical set up I have found. Visually, it's inspiring to look down and see a 30 fr. hose coming out of her urethra....she knows she is being controlled and it's obvious.

My overall favorite is the 30cc balloon. It seals best for me and I have less spasms. I would leak past the 5cc balloon and it would be painful after a short time. The 30cc did not cause any pain and was comfortable for longer times.

Deke said,

"As you know, all catheter packaging includes a maximum fill volume and that is what should be used in the vast majority of cases to ensure symmetrical filling of the balloon which will keep the tip straight. 10 cc for a 5 cc balloon, and for most 30 cc balloons, 35 cc is indicated except for many Rusch catheters where the fill volume is indicated to be 30-50 cc."

OK, now if you use a Rusch catheter, do you inflate the balloon to the 50 cc or do you go somewhere in between the 30 - 50 cc.???

Right now I have a 30 cc balloon catheter in me and I inflated it to 40 cc, although it says 35 cc. I can't tell the difference between 35 cc and 40 cc. I do have some Rusch catheters that I will use and thus the reason for asking if I should inflate them to the 50 cc limit. I can't tell the difference in how much the balloon is inflated once the catheter is inside of me. I just know the catheter is there because it comes out of my penis.

Czorro, the variable fill volume of 30 ml - 50 ml is really designed to address the size of the space left after removal of the prostate. This space is where the larger balloon size would sit to provide hemostasis after surgery. There is no functional difference between 35 or 40 ml in a medical setting. Considering that the capacity of a normal bladder is number of hundreds of ml, you can imagine that a balloon of even 50 ml would be insignificant in the bladder. With that said, there is a down side of going much beyond 35 ml and that is due to the weight of the balloon filled with that much water sitting against the trigone in the bladder resulting in increased discomfort and possibly painful spasms. If you are using these catheters for play, then as long as you are not uncomfortable with the added weight in the bladder, go for it. Just be sure to not significantly overfill the balloon. You'd have to overfill it to the extreme to result in rupture of the balloon (there is a significant safety margin in the design of catheters for balloon fill).

On a related topic, has anyone else had a problem with crystals of something forming on the outer surface od a foley after it has been in for a few days? These crystals adhere to the catheter surface and act like sandpaper to irritate thye inside of the urethyra.

Any tips on dealing with them?

Thank you Deke.

I currently have a catheter in me, I think I inflated it to 40 cc or there about. I have some catheters that are the 30 to 50 cc type, the rest are 30 cc and the package says use 35 cc to inflate the balloon. I can't feel any difference between 35 cc and 40 cc. I will stick to the 35 cc for the one brand and go 40 cc for the other brand.

I have taken used catheters and inflated the balloon to see how much they would hold. I got them up to 120 cc and the balloon was huge. Now I would never do that in my body, I just wanted to see how much they would hold. I think I could have added another 50 to 75 cc to the balloon, but I didn't bother. So there is a big factor built in to the balloon before it would fail.

I still have my prostate and I works fine. So I don't need the balloon to be the 50 cc.

I use the catheters to drain my urine so that I don't pee my pants with my overactive bladder. I am producing about 1000 to 1500 ml of urine each night and about that much, maybe a bit more during the day. I drink a lot of water and so that is what I put out.

I do enjoy a catheter being in me. My wife doesn't care if my catheter shows or not. She says I am happier with a catheter in me than before and to me that is all that counts. She doesn't care to screw anymore, so when I change catheters is when I masturbate. My urologist said not to masturbate with a catheter in me, so I don't. I have done so in the past, I didn't find it pleasurable anyway. Some say it is a great turn on, for me it was not at all.

Again thank you or your answer, I now know what to do in the future.

I forgot to add, I use distilled water to fill the balloon in my catheter. I don't have access to sterile water, but I figure distilled water is good. Hope I am not wrong.

On a related topic, has anyone else had a problem with crystals of something forming on the outer surface od a foley after it has been in for a few days? These crystals adhere to the catheter surface and act like sandpaper to irritate thye inside of the urethyra.

Any tips on dealing with them? Seen it and it hurts

Yup. Ouch. Seen it and it hurts.

Foley’s can be used in other orifices. Have I missed that, I often use air rather than ns 24fr with a 30 makes a pretty fine rectal tube

@Czorro

You can take distilled water and put some in a glass and microwave it until boiling for a few minutes and let it cool. There's your sterile water.

Distilled water is sterile.It is made by boiling water, cooling the condestate and package under sterile conditions. Just like beer which was made because safe water was unavailable.

I just used a 24fr foley. Inflated to about 50cc of water as a rectal tube.

As a not-for-fun Foley user, I never put more than 10 cc’s in.

The Foley package states:

5cc Balloon: use 10cc sterile water

30cc Balloon: use 35cc sterile water

Do not exceed recommended capacities.