A suprapubic catheter (SPC) is a urinary drainage device used when the urethra is unsuitable for catheterization. The duration of SPC use depends entirely on the underlying medical condition, meaning it can be either a temporary measure or a long-term fixture. Understanding the device and its required care helps clarify its role in bladder management.
Defining the Suprapubic Catheter
A suprapubic catheter is a thin, flexible tube inserted directly into the bladder. Unlike a standard urethral catheter, the SPC accesses the bladder through a small incision in the lower abdominal wall, just above the pubic bone. This placement bypasses the sensitive tissues of the urethra, often increasing patient comfort.
Once positioned, a small balloon at the tip is inflated with sterile water to prevent the catheter from slipping out. Urine drains continuously through the tube into an external collection bag or is managed with a catheter valve. The opening in the abdomen through which the catheter passes is called the stoma or tract.
Temporary vs. Long-Term Use
The duration of SPC use is entirely dependent on the medical need. Temporary use is common to divert urine flow during recovery from surgical procedures, such as gynecological or complex urethral reconstruction. It may also be used short-term to manage acute urinary retention. The goal is to remove the catheter once the underlying issue is resolved and normal urination is re-established.
For other patients, the suprapubic catheter is considered a long-term or indefinite solution. This is often the case for individuals with chronic conditions like neurogenic bladder dysfunction or severe urethral trauma that prevents urethral catheterization. While often described as “permanent,” this means the need for catheterization is ongoing. The device itself must be routinely replaced, not removed, to prevent blockages and infection.
Daily Management and Site Care
Living with an SPC requires routine site care and device maintenance to prevent complications such as infection and blockage. The insertion site, or stoma, should be checked multiple times daily for signs of irritation, including redness, swelling, pain, or discharge. The area around the catheter should be washed daily with mild soap and water, then gently patted dry.
The catheter tube must be routinely replaced to maintain function and hygiene. The replacement interval typically ranges from every four to twelve weeks, depending on the catheter material and the patient’s tendency to develop mineral buildup or encrustation. Clinicians or trained personnel perform this replacement quickly to prevent the tract from closing.
Proper management involves handling the drainage system correctly. The collection bag must be kept below the level of the bladder to ensure continuous drainage and prevent urine backflow, which could lead to infection. The drainage bag should be emptied when it is about half to two-thirds full and requires daily cleaning with a water and vinegar solution to reduce odor and bacterial growth.
The Removal Process
When the underlying medical condition has resolved and the decision is made to discontinue the suprapubic catheter, the removal process is typically straightforward and non-surgical. The first step involves deflating the small retention balloon inside the bladder by withdrawing the sterile water through the inflation port with a syringe. Once the balloon is deflated, the catheter is gently pulled out of the stoma tract.
After the tube is withdrawn, the stoma site begins to heal immediately. A small dressing is applied over the site for at least the first 24 hours to keep the area clean and to manage any initial leakage. The tract typically closes on its own within a few days. Minor leakage of urine from the stoma is common during the initial healing period, which may require frequent dressing changes until the tract fully seals.