A suprapubic (SP) catheter a catheter that is placed directly into the bladder through the abdomen, right about your pubic bone. The catheter is placed by a doctor either as an outpatient procedure, or in the office. The catheter may be attached to a standard drainage bag.
A suprapubic catheter may be recommended in people who require long term catheterization, after some gynecological surgeries, and in people with urethral injury or obstruction.
These catheters usually are changed by qualified medical personnel and will be removed when your bladder has healed and you are able to urinate adequately.
About the Catheter
The catheter needs to be connected to a drainage bag to allow continuous and unimpeded drainage. It is important not to block the flow of urine, unless you are specifically asked to do so. The time to block the flow of urine is when your doctor has requested you do a bladder function test.
The drainage bags are the plastic. They vary in design but all of them have an adaptor so they can be connected to the catheter and, at the other end, a spigot, to empty the bag. Some bags have long tubes so they can be attached to the bed or carried. Other bags are attached to your have leg with straps.
Care of Your Catheter
The insertion site (opening on the abdomen) and the tube must be cleansed daily with soap and water and covered with dry gauze. This is the area most likely to become irritated.
Do not place Vaseline or any ointments around the catheter unless specifically instructed to do so by your doctor or nurse practitioner.
To decrease irritation, you can tape the catheter to your skin, so the tubing is not pulled tight. Tape is the best and least expensive way of securing the catheter. That way, if you accidently move or tug on the catheter, it will pull on the tape, not your skin or bladder. Tape the catheter to that it has a gentle curve as it goes towards the drainage bag.
To empty the bag, hold it over the toilet (or container) and open the spigot at the bottom. Let the urine run out until the bag is empty, then close the spigot.
Rinse you drainage bags with warm water and soap every day or two, depending on how dirty they are and how much odor is present. You can use a teaspoon of vinegar in the water to help reduce odor.
What Possible Complications May I Experience?
Blockage: Urine should drain constantly into the bags The more urine flowing, the lower the changes you will get a blockage. If you see no urine flow for more than an hour and feel the need to urinate, you may have a blockage. The most common causes are blood clots. If your tube becomes blocked, you will have to see your doctor or go to the emergency room so the catheter can be cleared out or replaced. To help prevent blockage, drink four to eight ounces of water every hour while you are awake.
Bleeding: There may be a small amount of bleeding with any type of catheter, and this is nothing to be concerned about. If the bleeding makes it impossible to see through your urine, call your doctor.
There is also a low risk for infection of the urinary tract (or kidney), skin breakdown, septicemia (infection in the blood), and/or urine leaking from around the catheter, skin breakdown, and/or urinary stones. Long term use of an in-dwelling catheter (many years), there is a risk bladder cancer may develop.
You may be asked to take a bladder function test before the SP tube is removed, to see if you can empty your bladder. If you can empty it completely (or almost all of it), then the SP tube would not longer be needed and it can be removed.
To Test Your Bladder
- Wash your hands and the catheter connections with soap and water. Block the SP tube so it will not drain. You can do this by placing a catheter plug in the end, bending the tube in half and putting a rubber band to keep the tube in the bent position, or by putting a clamp or screw clamp on the tubing. Note: Place the end of the drainage tubing into a clean plastic bag.
- Once the SP tube is blocked, your bladder will begin to fill up.
- When you feel the urge, try to urinate. If you are successful, measure the amount of urine and write it down, along with the time you urinated. This is called "voided urine."
- After each time you urinate, unclamp the SP tube and allow it to drain, either into an empty drainage bag or jar. This is called residual urine. Measure this amount and write it down next to the “voided urine” amount.
- Keep track of all these measurements. Generally, when your residual urine is below two ounces, the SP tube can be removed, but every person is different. When you can urinate on your own, call us so we can arrange to remove the tube.
NOTE: Do NOT go more than six hours without urinating. If you are can not urinate on your own for six hours, unclamp the SP tube and let it drain. Measure and write down the amount of urine. If you have the urge to go, but can not, open the SP tube and let it drain out. In both of these situations, reconnect the tube to drainage and try the test again on the next day. If you are still unable to urinate on your own the next day, let us know.
At night, leave the tube unclamped and allow it to drain freely.
When to Call the Doctor
Call your doctor right away if:
- you have a fever of 100oF or higher and/or chills
- you have sudden or gradual increase in abdominal pain, back or leg pain
- you have severe bladder pain, bleeding, or pus-like discharge draining around the SP tube
- your tube does not drain
Home Care After Your SP Tube is Removed
Your bladder has been resting while your SP tube was draining. After you can urinate on your own and the catheter has been removed, you will still need to follow some simple instructions for one to two weeks to encourage healing and retrain your bladder.
The usual feelings you had when your bladder was full may be decreased or absent so you need to follow these instructions to prevent your bladder from getting too full.
- 1. Try to empty your bladder every two hours for the next one to two weeks, even if you do not feel the need to urinate. Set your alarm to wake you every two hours during the night.
- 2. Drink normal amounts of fluids. You do not have to drink or force extra fluids.
- 3. Stop drinking fluids at least two hours before you go to bed.
- 4. Limit fluids that have caffeine in them (coffee, tea, chocolate, and certain types of soda) to two servings a day.
- 5. Twice a day, clean the area around where the tube used to be. Take a cotton swab, cover it with gauze, and clean the area with normal saline.
Call us right away if you:
- lose the ability to urinate on your own
- have pain or burning when you urinate
- have an increase in redness, swelling or drainage from the catheter site. (It is normal for small amounts of urine to drain from the site for the first few days after the tube is removed.)