A suprapubic tube (SPT) is a medical device designed to drain urine directly from the bladder. It is a thin, flexible tube inserted through a small incision in the lower abdomen, serving as an alternative when other drainage methods, like a urethral catheter, are not suitable. The SPT provides a continuous pathway for urine to exit the body, preventing bladder distension and associated complications.
Understanding the Suprapubic Tube
A suprapubic tube is a hollow, flexible tube that connects the bladder to an external drainage bag, allowing urine to bypass the urethra. The tube has a small balloon at its tip, inflated once inside the bladder, to keep it from accidentally falling out.
Suprapubic tubes are used for various medical reasons, particularly when individuals cannot empty their bladder independently. Common conditions necessitating an SPT include urethral obstruction, such as severe benign prostatic hyperplasia (enlarged prostate), or damage to the urethra from trauma. Spinal cord injuries, neurological disorders like multiple sclerosis or Parkinson’s disease, and pelvic organ prolapse can also impair bladder function, making an SPT a suitable solution. Additionally, an SPT may be placed after certain gynecological surgeries or prostate procedures to facilitate bladder recovery and drainage.
Placement of a Suprapubic Tube
The insertion of a suprapubic tube is a surgical procedure performed by a medical professional. This minor procedure typically takes about 15 minutes to complete. It can be carried out under local or general anesthesia, depending on the patient’s condition and provider preference.
During the procedure, a small incision is made in the lower abdomen, usually a few inches below the navel and just above the pubic bone. The tube is then carefully guided into the bladder. Imaging techniques like ultrasound may be used to ensure accurate placement and to confirm no bowel loops are present. Once in position, the balloon is inflated with sterile water to secure it.
Daily Care and Management
The insertion site on the abdomen should be cleaned daily with mild soap and water, then gently patted dry. Dressings around the catheter site should be changed every 1 to 2 days, or whenever soiled, using a sterile technique. Gently roll the catheter between the thumb and forefinger once a day, preferably after showering, and move it in a cross (+) shape to help the stoma form properly.
The drainage bag should be emptied when one-half to two-thirds full, typically every 4 to 8 hours. The bag should be cleaned daily and changed every 5 to 7 days, or as recommended by the manufacturer. Keep the drainage bag positioned below the bladder to prevent urine backflow, and secure the catheter to the abdomen to avoid tension or pulling. The suprapubic tube usually needs to be changed by a healthcare provider every 4 to 12 weeks, depending on the material, with silicone catheters lasting longer than latex ones.
Addressing Potential Issues
Signs of infection at the insertion site include increased pain, redness, swelling, or pus. A fever above 100.5 degrees Fahrenheit (38 degrees Celsius) or cloudy, foul-smelling urine can also indicate a urinary tract infection.
Leakage of urine around the catheter site can occur, which might signal a partial or complete blockage of the tube or bladder spasms. If the tube stops draining urine into the collection bag, it could be kinked or blocked. Accidental dislodgement of the catheter, though uncommon, requires immediate medical attention as the opening can close quickly. In any of these situations, or if there is severe pain, a feeling of fullness in the abdomen, or blood clots in the urine, a healthcare provider should be contacted promptly.