A suprapubic catheter (SPC) is a flexible tube used to drain urine from the bladder. It is inserted through a small incision made in the lower abdomen, just above the pubic bone, rather than through the urethra. This placement allows urine to collect in an external drainage bag. SPCs are often used for individuals who require long-term catheterization or who have specific medical conditions that prevent urethral insertion. Routine flushing is a standard home care practice necessary to ensure the catheter remains functional and helps prevent complications associated with blockages.
Understanding the Need for Flushing
The primary purpose of flushing a suprapubic catheter is to prevent blockages that can lead to discomfort and serious complications. Urine naturally contains mineral salts and sediment that accumulate inside the narrow catheter tube, a process known as encrustation. This accumulation can be accelerated by certain bacteria that make the urine more alkaline.
If this debris is not regularly cleared, it can form crystalline structures or mucus plugs that obstruct urine flow. A blocked catheter causes urine to back up into the bladder, leading to a feeling of fullness, bladder spasms, or leakage around the catheter site. Retention also increases the risk of developing a urinary tract infection (UTI) or causing pressure that affects the kidneys. Flushing with a sterile solution mechanically washes away these accumulating particles and maintains the catheter’s patency, ensuring effective bladder drainage.
Preparation and Required Supplies
Before beginning the flushing procedure, gathering all necessary items and establishing a clean workspace is important to minimize infection risk. Required supplies typically include a prescribed sterile irrigation solution, most commonly 0.9% normal saline, and a sterile catheter irrigation kit containing a large-volume syringe (often 60 milliliters). You will also need antiseptic wipes (such as alcohol pads), a pair of clean medical gloves, and a protective pad or towel to place under the catheter connection area.
Your healthcare provider will give specific instructions regarding the volume of solution to use, usually between 30 and 60 milliliters, and the frequency of the flushing routine. Achieve a clean environment by washing your hands thoroughly, then setting up the sterile supplies on a clean, dry surface. Open the irrigation kit and put on the clean gloves before handling the catheter or the solution. This preparation ensures the procedure is performed using an aseptic technique to prevent introducing harmful microorganisms into the urinary system.
The Catheter Flushing Procedure
The flushing process begins with meticulous hand hygiene and the application of new medical gloves to maintain sterility throughout the procedure. The first step involves preparing the catheter by temporarily stopping the flow of urine from the bladder. You will need to pinch or clamp the catheter tubing just below the connection port, which prevents the irrigation solution from simply flowing down into the drainage bag.
Next, clean the connection point where the catheter meets the drainage tube using an antiseptic wipe, working outward from the connection to reduce the chance of contamination. After cleaning, the catheter should be disconnected from the drainage bag, taking care to keep the end of the drainage tube protected from touching any non-sterile surfaces. Using the sterile syringe from the irrigation kit, draw up the prescribed amount of sterile saline solution.
The syringe is then gently inserted into the access port of the suprapubic catheter. It is crucial to inject the solution slowly and steadily, using only minimal pressure to push the fluid into the bladder. If you encounter strong resistance while attempting to inject the solution, stop immediately and do not try to force the fluid, as this could damage the bladder wall.
Once the full volume of solution has been injected, the syringe is disconnected, and the fluid is allowed to drain back out of the catheter. The solution, along with any dislodged sediment, should drain by gravity into a clean container or back into the syringe if gentle aspiration is required, depending on the provider’s specific instructions. This outflow should be monitored to ensure the solution drains back freely, ideally with the appearance of any sediment or mucus plugs that were causing the blockage.
After the fluid has drained completely, the catheter connection site should be cleaned again with a fresh antiseptic wipe. Finally, the catheter tubing should be reconnected to the drainage bag, and the temporary clamp or pinch on the tubing must be released to restore normal drainage.
When to Seek Medical Assistance
While flushing is a routine maintenance task, certain signs during or immediately following the procedure indicate a need for prompt medical evaluation. A strong, unyielding resistance when attempting to inject the flushing solution suggests a complete catheter blockage. This situation can lead to bladder distension and requires professional intervention, as forcing the fluid may cause injury.
If the injected solution fails to drain back out, this is a clear indication of a blockage requiring a healthcare provider’s attention. Other symptoms include the sudden onset of severe pain or cramping in the lower abdomen or back during the flush. Persistent signs of infection—such as fever, chills, new blood in the urine, or cloudy or foul-smelling urine—should be reported immediately. Any noticeable leakage, new redness, swelling, or pus at the abdominal stoma also warrants contacting your medical team.