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Thread: Supra Pubic and Underwear

  1. #1
    Senior Member
    Join Date
    Jun 2005
    East Bay/San Francisco

    Supra Pubic and Underwear

    I have searched these forums, done a lot of Googling, and read a lot about supra pubic tubes, but as much as I have searched, I haven't read anything definitive on how men deal with underwear and the SP tube. The tube exits about midline, just above the pubic bone. What do you do with the tube? Do you run the tube down the leg of your underpants? Do you thread the tube through the underwear placket? Do you alter the underwear to accommodate the tube, if so how? Are there sources for underwear that is made to be worn with an SP tube. (I've seen some, but what I have seen have the bag worn on the thigh and others are made for men with mobility, not wheelchair users).

    I have read about anchoring the tube and have checked out some of the websites provided by the SCI nurse. Where is the best place to use the adhesive backed anchors, on the belly close to the exit spot of the tube or somewhere else? I will be wearing a 1000 cc leg bag on my calf, in a Urocare leg bag holder, should I use a leg strap to keep the extension tube to the bag in place?

    My urologist is allowing me a trial of the SP tube and I want to get this right to try to avoid more invasive procedures. After 29 years, I have done my share of reinventing the wheel, and hope that those of you who have SP experiences can be a great resource.

    I am am a 65 year old male, 29 year post injury C-6/7, who started SCI life spontaneous using an external condom and leg bag. 12 years ago, I went to CIC after having a Urolume stent implanted, that did not accomplish its goal of holding the sphincter open. When I started experiencing lower volumes, I tried several attempts at Botox injections. There were not terribly effective. I am experiencing low volumes (cathing at 100 - 200 cc), which means too many caths per day (and autonomia). Also experiencing frequent UTIs. Have had cystoscopy with retrograde pyleogram, urodymanics, ultra sounds all with the last 6 months. The current plan is to take baby steps to new bladder management techniques, trial of Supra Pubic for 4 months, if I don't tolerate it or have frequent UTIs, my neuro-urologist suggests an ileovesicostomy (ileal chimney leaving the bladder in place). During the urodynamics study, the urologist found neurogenic bladder characterized by low pressure filling, but very high urethral pressure despite the UorLume, and detrusor sphincter dyssynergia involving the internal and external sphincters. Autonomia at relatively low bladder pressures. These findings baffled him somewhat because this isn't typical of the neurogenic bladder. Fortunately, this condition protects the kidneys because I don't have back pressure through the ureters. He consulted with several neuro-urologist at major rehab centers and the consensus was the ileovesicostomy as the ultimate solution. I argued for a less aggressive approach and he agreed to have me try the SP before going to a big surgery and recovery.

    Thanks for your help.

  2. #2
    Hi gjnl, There is a thread somewhere about people wearing underwear. It had some practical advice and some funny things. Maybe someone can find it.
    My husband has had a suprapubic since Jan 09 and so far only one UTI that was treated with antibiotics.
    He does not wear underwear, but some people do.
    Good luck!

  3. #3
    Senior Member
    Join Date
    Sep 2007
    Fithian, IL
    My husband also has a supra pubic cath but weres Depends Adjustable underwear, so there is no flap like real underwear would have. We just run his down his leg.

  4. #4
    men's soft cotton boxers?

  5. #5
    Very few of my clients (men or women) wear any type of underwear at all. It can cause wrinkles and create skin problems, and is another thing to have to put on and take off every day. Go commando!

    As far a securing, it is best secured to the abdomen so you don't get tension on the tubing with hip or leg flexion or extension.


  6. #6
    Hmmmmm, i've worn boxer briefs for most of the time since my injury about 18 years ago and it's never caused me a single problem related to having a SP catheter.

    I simply run the catheter under my boxers down my leg where to connects to an extension tube that then connects to my leg bag if i have on pants. To keep the extension tubing from going under my leg, i put it in a leg bag strap.

    When i want to wear shorts, i put two of these on my thigh about 16 inches apart and button the straps of the leg bag over them to protect my skin.

    In both cases of wearing pants or shorts, i also wear boxer briefs and they never get in the way. I used to go commando style and wear no underwear, but it caused a few issues.

    1. I got way to many boners with my pecker totally free to flop around.

    2. When doing pressure reliefs, my nads sometimes moved to much to where i'd end up sitting on them. That's not pleasant given i still have sensation. The boxers keeping the nads a bit more in place.

    3. When my aide comes in the morning, first thing she does is range of motion. Well, this sometimes leads to Mr. Happy standing up at attention. It's less awkward for the aide if he's standing at attention inside my boxers instead of just sitting out there and bouncing around with each leg stretch. In fact, my second aide ever after getting home from the hospital was a new aide and i was her first client. So she starts stretching my legs and bam, it's boner time and i didn't wear underwear then. Even after i explained that hey, i have no control over this, she had a look on her face like what the hell am i getting into here.

    4. Sometimes my pants or shorts slide down/off a bit when i transfer into cars. With boxers on, at least if i need a bit of help getting into certain cars, that person isn't staring at plumber crack as they grab a belt loop to help a bit with the transfer.

  7. #7
    I've never owned underwear with a Plactet(1st time I ever heard the term) either pre or post injury. I've had an sp tube since 1977. I find underwear with cotton covering any elastic on the leg openings(Hanes for Her). I find putting the tube through this opening keeps the sp tube in place. "Commando' tends to let the tube move around too much. I also hate the strap holders. Somehow, sometime during the day some position will pull on it. The sp tube gave me my independence.

  8. #8
    Senior Member
    Join Date
    Jun 2005
    East Bay/San Francisco
    Thanks for reading my question and offering suggestions. For Linda T, TheDuder, and you have any trouble with the SP tube kinking when you direct the tube through the leg opening of your briefs?

    SCI nurse...For me "Commando" has a big eewww factor. TABs (temporarily able bodied) wear undergarments to protect their clothing from perspiration, body fluids, etc. I think it is just more hygienic to wear underwear. For 19 years I worked in a corporate environment wearing wool trousers, suits, ties....and I always wore underwear. It protected my clothing, reduced friction, and saved me a lot of $$$ in dry cleaning bills. In 29 years I have not had any skin breakdown due to underwear (once airline personnel dropped me while transferring me from airline straight back chair to the airline seat). When I began using Jay and Roho cushions I found I was perspiring more than I did with the foam cushion ordered for me in rehab. I use the heat/moisture exchange cushion covers, but still had a lot of perspiration. Wet skin is not healthy skin, so I experimented with the sports underwear that wicks moisture away from the body. Worked great!!! In rehab, I was told that SCIs don't wear underwear, but I just wasn't comfortable with that. I would avoid typical boxer shorts (too much extra fabric) and go with cotton briefs or long leg briefs or the sports underwear.

  9. #9
    Quote Originally Posted by dash View Post
    I've never owned underwear with a Plactet(1st time I ever heard the term) either pre or post injury.
    Dash, probably because you are a woman. Normally we call that placket a "fly". Rarely found in women's underwear for a reason (even for "boy shorts")!


  10. #10
    Quote Originally Posted by gjnl View Post
    Thanks for reading my question and offering suggestions. For Linda T, TheDuder, and you have any trouble with the SP tube kinking when you direct the tube through the leg opening of your briefs?
    Not a single time has it kinked because of my boxer briefs in the roughly 15 years wearing them while having a SP catheter. If anything, the boxer briefs help keep the tubing from going under my ass where i could sit on it and prevent flow.

    In fact, i all these years having a SP catheter, it has kinked only 5-6 times and each instance was caused by the straps on the bag accidentally coming unbuttoned from my legs and thus the bag balled up as it filled and i never noticed it had come unbuttoned. Maybe a few times now that i think of it the catheter itself got kinked and that simply was from not paying attention when getting dressed. When my aide helps pull up my pants or shorts i roll from side to side as she pulls them up and once up, she zips them up, but i never have her button the top button. Before she zips, i always reach in my pants/shorts to feel and be sure nothing is kinked or that i'm sitting on any tubing. Once i'm sure that's all good, i almost never have any issues.

    BTW, the few times the catheter itself has kinked, it's really been no big deal anyways. I tie a string into a loop on all zippers of my pants or shorts and never button the top button on them. So if there was a kink, i just stick my thumb in the zipper loop and unzip them. Then i feel around for any kink and get it unkinked, problem solved in about 10 seconds and i can also zip right back up.
    Last edited by TheDuder; 06-16-2010 at 12:20 AM. Reason: .

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