A suprapubic catheter is a flexible tube designed to drain urine from the bladder. Healthcare providers insert this device through a small incision in the lower abdomen, typically a few inches below the navel, directly into the bladder. This method allows urine to bypass the urethra and collect in a drainage bag, providing an alternative pathway for bladder emptying. The primary purpose of a suprapubic catheter is to manage urinary retention or incontinence when other methods are not suitable or effective.
What Indwelling Means
An indwelling catheter is a medical device designed to remain inside the body for an extended duration, facilitating continuous drainage or monitoring. This differs from intermittent catheters, which individuals insert and remove multiple times daily. Suprapubic catheters are considered indwelling devices because they are designed for continuous placement, often for weeks or months. A balloon, typically inflated with sterile water inside the bladder, holds the catheter in place, preventing accidental dislodgement.
When a Suprapubic Catheter is Used
Suprapubic catheters are chosen when individuals cannot empty their bladder naturally or when urethral catheterization is not feasible or desirable. They are commonly indicated for long-term bladder drainage, such as with chronic urinary retention or severe incontinence. They are also used in cases of urethral trauma, blockages, or strictures, where inserting a catheter through the urethra is difficult or impossible. Prostate issues, such as an enlarged prostate, can also necessitate a suprapubic catheter if a urethral catheter cannot be passed. Some patients, including those with spinal cord injuries or certain neurological conditions, find suprapubic catheters more comfortable for long-term management; they may also be placed after specific gynecological, bladder, or urethral surgeries to ensure adequate drainage during recovery.
Caring for a Suprapubic Catheter
Proper care for a suprapubic catheter helps prevent complications and ensures comfort. Daily hygiene of the insertion site involves washing the area around the catheter with mild soap and water, then gently patting it dry. Check the site regularly for any signs of redness, pain, swelling, or discharge, as these can indicate an issue. Creams, powders, or sprays should not be used near the site unless directed by a healthcare provider.
Managing the drainage bag is another aspect of daily care. The bag should be emptied when it is about half to two-thirds full, or at least every 8 hours, to prevent it from becoming too heavy and pulling on the catheter. Wash hands before and after handling the catheter and bag to reduce the risk of infection. The drainage bag should always be kept below the level of the bladder to ensure proper urine flow and prevent backflow. Drainage bags require cleaning daily and replacement weekly, or sooner if they become discolored, damaged, or smelly.
Common Concerns and Solutions
Individuals with a suprapubic catheter may experience issues. Signs of infection at the catheter site include increasing redness, tenderness, swelling, or pus around the abdominal opening. Other infection indicators can be cloudy, foul-smelling urine, fever, or bladder spasms. If these symptoms appear, contact a healthcare provider.
Leakage around the catheter, also known as bypassing, can occur due to bladder spasms, a partially blocked catheter, or constipation. Check for kinks in the tubing and ensure the drainage bag is positioned correctly. If leakage persists, medical evaluation may be needed to identify and address the underlying cause, which could involve adjusting the catheter or treating an infection. Catheter blockages, indicated by little to no urine draining into the bag despite a full bladder sensation, require prompt medical attention. Drinking plenty of fluids can help prevent blockages and maintain urine flow.