I Wear A Foley Catheter Because Of Neurogenic Bladder (Spinal Cord Injury) And It Is Causing Constant Excruciating Bladder Neck Pain, Despite Strong Pain Medicines. What Can I Do? Is It Sediment That's Causing Such Pain?

You might be either developing a urethral sensitivity to the latex in the catheter (assuming it is not a 100% silicone catheter, or the catheter is either too big (creating excess pressure and irritation in the urethra), or too small (causing excessive movement in the urethra resulting in irritation). I find that I am much more comfortable with a 20FR catheter than the typical 16FR catheter. FYI, every 3FR equals 1mm in external diameter of the catheter. If you are not already using a 100% silicon catheter, you might discuss this with your urologist. You can also discuss hydrogel coated catheter. Dover is the only company that I am aware of that makes a 100% silicone, hydrogel coated catheter. You also did not indicate how often your catheter has been changed. From personal experience, I prefer to replace the catheter every 3 to 4 weeks, even though I have no excessive sediment or blockage. Finally, are you on an adequate dose of ditripan or detrol. These are very useful to calm bladder spasms which can be perceived as urethral pain.

Although there is lot of discomfort with Foley Catheter but pain usually subside after insertion. Pain due to Foley Catheter can be due to long duration use. It requires frequent replacements because it cause pain when it is clogged. You have not mentioned how many times you have replaced it since your use. Daily cleaning of point of insertion is also recommended. Foley Catheter should also be cleaned after bowel movements because it can get infection. Also drink lot of water except few conditions when your doctor don't allow to drink.  So from my opinion your catheter needs replacement.

The pain you are feeling is unusual the way you describe it. If you really need continuous bladder drainage for the reasons you describe, you should ask about the possibility of changing to a suprapubic catheter. A suprapubic catheter has a lower incidence of infection, a lower incidence of bladder cancer, and it much more comfortable for long term use. If you do stay with a urethral catheter, (assuming you have ruled out a urinary tract infection as the cause of your pain), believe it or not, a slightly larger catheter causes less pain than a smaller one. This is due to less movement between the catheter and the urethra. Good luck.