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Bladder > Bladder Treatments > Suprapubic Catheter

Suprapubic Catheter

What is a suprapubic catheter?

A catheter is a thin tube which is used to drain urine from the bladder. Catheters are used by people who cannot empty their bladder properly.  A suprapubic catheter is a hollow flexible tube that is used to drain urine from the bladder. It is inserted into the bladder through a cut in the tummy, a few inches below the navel (tummy button). This is done under a local anaesthetic, or a light general anaesthetic.
Why do I need a suprapubic catheter?
Anyone who cannot empty their bladder may need a catheter. A suprapubic catheter may be chosen because it is more comfortable and less likely to give you an infection than other catheters. 
Suprapubic catheters are sometimes used for the following reasons:
  • Urethral trauma (damage that has been caused to the urethra - the tube where urine comes out)
  • People who require long-term catheterisation and are sexually active
  • After some gynaecological operations e.g. Colposuspension for stress incontinence
  • Long-term catheterisation for incontinence. Although this is not recommended, sometimes medical staff feel it appropriate to avoid skin problems or other medical complications.
Who inserts a suprapubic catheter?
The doctor will insert your first suprapubic catheter during the initial operation. A small balloon at the tip of the catheter is inflated to prevent it falling out. A doctor or nurse can change the catheter in your home, or in their surgery or urology department. You, or a member of your family, may also be taught to change the catheter. You must not try to remove it without medical advice.
What happens to the urine?
There are two options:
  1. Free drainage - where the urine drains out from the catheter and is then generally stored in a drainage bag.
  2. Catheter valve - a valve at the end of the catheter used in place of a drainage bag. Urine is stored in the bladder and is emptied through the catheter straight into the toilet or bag. There are two kinds of bags: a leg bag and a bag used while you are in bed. 
A leg bag is worn under your normal clothes during the day - it is held in place by straps or a 'holster'. There are different makes of leg bags available - B&BF has a fact sheet on the different types. 
A night drainage bag is much larger and is attached to the leg bag to hold all the urine that drains from the bladder overnight.
How often does a suprapubic catheter need changing?
The first catheter change is usually carried out after 4-6 weeks. After this it can vary from 4-12 week intervals depending on the type of catheter and your own situation.
If the suprapubic catheter comes out unexpectedly, it must be replaced within a short time.  Contact your doctor or nurse as soon as possible.  Out of normal working hours you should proceed to Accident & Emergency.
How do I look after my suprapubic catheter?
Always wash your hands before and after emptying your catheter bag, or before and after emptying your bladder using the valve. You should wash the area around the insertion site with cooled boiled water.  Some people find cleaning the wound with a sterile saline solution a good method of keeping the area clean.
A dressing will cover the wound after the operation and you should keep it in place until the wound has healed. Although not always necessary, many people prefer to wear a dressing around the wound all the time. The type of dressing may vary. A dry gauze swab is sufficient for some people, but using tape to secure it can be problematic due to pubic hair. Dressings with a hole in them have proved successful for some people. Do not put any creams or talc around the site.
In order to prevent urinary infections and encourage drainage, you should drink lots of fluid (about 2 - 3 litres a day). Water or fruit juice is often recommended, especially cranberry juice as this is thought to help prevent bladder infections. Try to avoid constipation - make sure that you include wholemeal bread, fruit and vegetables in your diet.
It is better to take showers rather than baths as sitting in water for long periods may delay the wound from healing. For the first few days after the operation, you should keep a waterproof dressing on. Once the wound has healed it is perfectly okay to shower normally, although avoid using scented products as these can irritate the skin.
What kind of problems should I watch out for?
Here are some of the problems to watch for:
  • Urine stops draining out of the catheter
  • You feel unwell with pain, fever and abdominal discomfort
  • Urine is leaking around the catheter - this can be normal around a new catheter site
  • The area around the catheter becomes red and sore
  • Bleeding
If you notice anything unusual or feel unwell, contact your doctor or nurse.
Will I still be able to have sex?
Yes. A suprapubic catheter should not get in the way of sexual activity.
Who will provide support when I am at home?
Your district nurse should be informed and, if she is not already familiar with suprapubic catheters, will be given training. Your local continence advisor, doctor and district nurse will manage any on-going maintenance of your catheter with you. 
Last updated: 13/11/2013

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