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Thread: Suprapubic Catheter 'Stuck' Inside Bladder

  1. #1

    Question Suprapubic Catheter 'Stuck' Inside Bladder

    I had my suprapubic catheter surgery on June 4th. It didn't start out well (9 days of not being able to keep food or liquid down due to spasms etc.) and it has been bleeding and oozing green stuff ever since. It's also still pretty raw on the left side of the catheter site.

    I'm still in rehab due to spasms and the only time anyone besides the nurses even bothered to look at the site since the surgery was back in June when I saw the urologist because a sizable lump had formed on the left side of the opening and it caused quite a bit of AD. At that appointment the urologist ripped the stitch free from the bit of skin that was still holding it and said it 'looked fine'. The hard lump had nearly disappeared during the horrible night before the appointment. The site bled quote a bit and I woke up with severe spasms and AD. When the nurses decided to have a look at the catheter site there was a lot of blood (and dried blood packed in around the catheter).

    The site has healed quite a bit since then, but the left side refuses to. It's still pretty raw and it seems like most of the blood and green stuff comes from that side and the bottom of the site. The doctor here didn't look at it, but changed my dressing changes for once every second day (it had been once a day), but the patient care coordinator got it changed back to once per day after having a look at things. I still need extra gauze and most of the time it soaks through those extra layers too.

    On July 18th I had an appointment for my first catheter change. The urology tech deflated the balloon (all the water came out) and tugged, and pulled and twisted, and pulled harder. The catheter wouldn't budge! It did however make my insides spasms so violently I swear it felt like he was ripping my insides out! He got the urologist to come in and he tried himself with no luck.

    Tomorrow I am booked into the OR so he can have a look and see what's happening. He doesn't seem to know what could cause the catheter to effectively get 'stuck' inside my bladder.

    My urine has been full of what one nurse described as large bits that look like skin that had been peeled off of a sun burn for weeks now. This has pretty much been ignored. There is also some small blood clots in my urine sometimes, but I'm guessing this can be expected.

    Has anyone else ever had a suprapubic catheter stuck inside them like this? The most 'concerning' part is the urologist's reaction. He really didn't have any idea what could be causing this. I'm just really hoping that this doesn't happen with every catheter change...
    Last edited by Kim•and•Duke; 07-22-2012 at 07:21 PM.

  2. #2
    You have had a rough time with this suprapubic catheter...it doesn't have to be this way. First, it sounds as though (since you mentioned stitches) that your urologist used an older technique of making an incision rather than a new technique of a puncture to create the suprapubic hole (stoma). What size catheter did the urologist place?

    Are you wearing your leg bag on the side of the stoma that will not heal? If so, change the side on which you are wearing the leg bag, that way, the catheter won't lay on the unhealed wound area and there will be less tugging on the catheter in that area. You need to secure the catheter to minimize tugging no matter which side you are wearing the leg bag on.

    Are you having fever, autonomia? Have you had any antibiotics at all? It sounds to me as though you bladder is at least colonized with bacteria, if not a full blown urinary tract infection. You need to have urinalysis (UA) and culture and sensitivity (C&S) lab test to find out. As for the infection on the outside of your body at the stoma site, I would have it cleaned with mild soap and water at least twice a day, have an antibiotic ointment applied, and a light gauze bandage applied until that infection clears up and you are healed.

    I have no idea why the catheter is stuck. I suspect the urologist will try a cystoscopy to look inside the bladder to see what is going on with the catheter.

    Once the passage way into to bladder and the stoma site is healed, you should not experience the same problem with each catheter change.

    Good luck with this. Take care.

    All the best,
    GJ

    All the best,
    GJ

  3. #3
    sounds like an infection of some kind both in the bladder and at the stoma site anything that looks green should be cultured if they have not done that already then shame on them, get to someplace that will listen to you and will do the proper testing.
    T6 incomplete due to MS and aortic aneurysm surgery that went bad.

  4. #4
    The same thing happened to me the first time it was changed after surgery, they fixed it in the OR and it has been fine since, a long time ago like 15 yrs.

  5. #5
    Quote Originally Posted by gjnl View Post
    First, it sounds as though (since you mentioned stitches) that your urologist used an older technique of making an incision rather than a new technique of a puncture to create the suprapubic hole (stoma). What size catheter did the urologist place?
    I had a stitch that was tied around the catheter and attached to the side of the 'hole' that was created. It was still connected to my skin when I saw my urologist back in June and he pulled it away so it was only around the catheter. The area it was connected to is still raw. I'm hoping it will heal now that there is no stitch that can rub.

    The catheter is a size 18f. It's a 100% silicon catheter because I have a latex allergy. When my urologist saw me before heading into the OR on Monday he said that sometimes the balloons on silicon catheters don't deflate like they should because they are stiffer.

    Quote Originally Posted by gjnl View Post
    Are you wearing your leg bag on the side of the stoma that will not heal? If so, change the side on which you are wearing the leg bag, that way, the catheter won't lay on the unhealed wound area and there will be less tugging on the catheter in that area. You need to secure the catheter to minimize tugging no matter which side you are wearing the leg bag on.
    I have to keep switching because the spasms and clonus I have makes the catheter rub quite a bit. I do keep it secured, but it still rubs because my legs just won't stay still.

    Quote Originally Posted by gjnl View Post
    Are you having fever, autonomia? Have you had any antibiotics at all? It sounds to me as though you bladder is at least colonized with bacteria, if not a full blown urinary tract infection. You need to have urinalysis (UA) and culture and sensitivity (C&S) lab test to find out. As for the infection on the outside of your body at the stoma site, I would have it cleaned with mild soap and water at least twice a day, have an antibiotic ointment applied, and a light gauze bandage applied until that infection clears up and you are healed.

    I have no idea why the catheter is stuck. I suspect the urologist will try a cystoscopy to look inside the bladder to see what is going on with the catheter.

    Once the passage way into to bladder and the stoma site is healed, you should not experience the same problem with each catheter change.

    Good luck with this. Take care.

    All the best,
    GJ
    I don't have a fever (I rarely ever do, no matter how sick I am), but it does cause quite a bit of AD. The only antibiotics I had was one dose through an IV just before the surgery back in June. A urine sample was sent off the morning of the second trip to the OR. I never heard anything back about it though (then again no one has said anything to me since the catheter was changed. I don't even know why it was stuck in the beginning.

    From the beginning the site has been cleaned with saline once a day and a new bandage put on. After a couple of weeks the doctor at the rehab center changed it to be changed every two days. At this point it was still oozing a lot and bleeding. She never did look at it (not even up to now), but changed it back to being changed daily. I still have to remind nurses to actually clean it and not just take the old bloody, oozy bandage off and replace it without doing anything.

    I do clean the area every second day when I get a shower. Once I'm out of rehab I will be able to shower every day and will clean it more often.

    When I asked my urologist about the bleeding and green ooze he said it was normal and that it might always do that. My question still is, since when is green oozing stuff 'normal'?

    Thank you for all of the information and luck!

    Quote Originally Posted by smashms View Post
    sounds like an infection of some kind both in the bladder and at the stoma site anything that looks green should be cultured if they have not done that already then shame on them, get to someplace that will listen to you and will do the proper testing.
    Leaving infections untreated for long periods of time seems to be what happens here. I've been known to have a UTI for weeks before I finally convinced someone to send a sample off. Every month I'd have at least one infection because when the antibiotics were done no matter how many times I asked my urine wasn't re-checked and the infection that was left would mutate into something new.

    If you go outside for help the rehab threatens to give your bed to someone else and threatens to not do anything else (have home care workers trained, get the equipment you need etc.) and threaten to put you in a nursing home because you went against them. The last time they threatened this was when I phoned the health line number because I was left for nine days after the suprapubic catheter surgery with spasms so violent I couldn't keep any food or liquid down at all. No IV or anything was ever started.

    I'm suppose to be discharged on Wednesday, and will try to get an appointment with an outside doctor to get things looked at then.

    Quote Originally Posted by Cory-M View Post
    The same thing happened to me the first time it was changed after surgery, they fixed it in the OR and it has been fine since, a long time ago like 15 yrs.
    Did they tell you exactly what went wrong? I'm glad it worked out for you, and I hope my catheter changes go smoothly from now on too!

  6. #6
    I have read and been told that a suprapubic catheter stoma may always have a raw appearance and there may be some reddish tinted lymph that dries at the site and on the catheter, but I don't think greenish ooze is normal at all.

    I encourage you to get an appointment with another urologist as soon as you can once you leave rehab. The urologist can have the discharge at the stoma site cultured for bacteria and prescribe appropriate medication. Who will be changing your catheter on a regular schedule? Can you manage your own daily care of the stoma site or will you have an attendant to help you? You need to establish a regime of care for the stoma site. You will find useful information on and various approaches to stoma care on these threads:
    http://www.google.com/search?q=supra...ci.rutgers.edu

    You may also want to review these threads about a product called Vetericyn. Vetericyn is a proprietary formulation of oxychlorine compounds based upon the Microcyn® Technology platform. Vetericyn’s base ingredient, oxychlorine, is similar to that produced by healthy cells in the body. The ingredients in Vetericyn are Electrolyzed Water (H2OSodium Chloride (NaCISodium Hypochlorite (NaOCI& Hypochlorous Acid (HOCI)(0.003%).
    Vetericyn was originally developed for wound treatment. It is not an antibiotic. It may more properly be characterized as an antiseptic. Vetericyn has a safety profile comparable to saline (safety data available in a separate report), it is non-toxic and non-irritating while safe to use around eyes, nose and mouth. It contains no steroids or antibiotics and can be easily applied with no mixing or dilution required. Rinsing after use is not required. It is used in animals and humans. Vetericyn is the name of the product used for animals (tends to be less expensive than the product marketed for humans). The same product is used in humans and is called Puracyn in the United States and Dermacyn in many foreign countries.

    Many members of the Care Cure Community are using Vetericyn for sores and instilled in the bladder and retained there for a period of time and then drained. It is being used by those of us who manage our bladders with intermittent catheterization, supra pubic catheterization, and surgically altered bladders.

    http://sci.rutgers.edu/forum/showthread.php?t=133414
    http://sci.rutgers.edu/forum/showthread.php?t=149966
    http://sci.rutgers.edu/forum/showthread.php?t=143797
    http://sci.rutgers.edu/forum/showthread.php?t=167480

    http://vetericyn.com/technology/faq.php

    All the best,
    GJ

  7. #7
    You say the nurse sees what looks like peeling skin in your urine. There could be a lot of build up on the catheter, causing it to get stuck inside. Green stuff coming from your stoma sounds like an infection, and the stitch that is or was there could be part of the problem. Your doctor and nurses should be more concerned about your comfort and healing then they seem to be. Let us know how thing go.

  8. #8
    Quote Originally Posted by gjnl View Post
    You will find useful information on and various approaches to stoma care on these threads:
    http://www.google.com/search?q=supra...ci.rutgers.edu

    You may also want to review these threads about a product called Vetericyn. Vetericyn is a proprietary formulation of oxychlorine compounds based upon the Microcyn® Technology platform. Vetericyn’s base ingredient, oxychlorine, is similar to that produced by healthy cells in the body. The ingredients in Vetericyn are Electrolyzed Water (H2OSodium Chloride (NaCISodium Hypochlorite (NaOCI& Hypochlorous Acid (HOCI)(0.003%).
    Vetericyn was originally developed for wound treatment. It is not an antibiotic. It may more properly be characterized as an antiseptic. Vetericyn has a safety profile comparable to saline (safety data available in a separate report), it is non-toxic and non-irritating while safe to use around eyes, nose and mouth. It contains no steroids or antibiotics and can be easily applied with no mixing or dilution required. Rinsing after use is not required. It is used in animals and humans. Vetericyn is the name of the product used for animals (tends to be less expensive than the product marketed for humans). The same product is used in humans and is called Puracyn in the United States and Dermacyn in many foreign countries.

    Many members of the Care Cure Community are using Vetericyn for sores and instilled in the bladder and retained there for a period of time and then drained. It is being used by those of us who manage our bladders with intermittent catheterization, supra pubic catheterization, and surgically altered bladders.

    http://sci.rutgers.edu/forum/showthread.php?t=133414
    http://sci.rutgers.edu/forum/showthread.php?t=149966
    http://sci.rutgers.edu/forum/showthread.php?t=143797
    http://sci.rutgers.edu/forum/showthread.php?t=167480

    http://vetericyn.com/technology/faq.php

    All the best,
    GJ
    Wow GJ! Thank you so much for all of the info.! When I'm not so tired I'll have a look at all of the links and prepare myself for yet another doctor's appointment.

    Quote Originally Posted by smashms View Post
    sounds like an infection of some kind both in the bladder and at the stoma site anything that looks green should be cultured if they have not done that already then shame on them, get to someplace that will listen to you and will do the proper testing.
    You were right. I do have yet another UTI. I've probably had it since before the suprapubic catheter because I don't think my urine was re-checked after the antibiotics last time. I only finished them right around the time of the surgery.

    No one is still saying anything about the green, bloody oozing. Well, except for my urologist claiming it's 'normal'.

    Quote Originally Posted by mike b View Post
    You say the nurse sees what looks like peeling skin in your urine. There could be a lot of build up on the catheter, causing it to get stuck inside. Green stuff coming from your stoma sounds like an infection, and the stitch that is or was there could be part of the problem. Your doctor and nurses should be more concerned about your comfort and healing then they seem to be. Let us know how thing go.
    It was confirmed today that I do have another UTI. What you're saying about the build up makes a lot of sense. Especially since the old catheter could be pushed into my bladder slightly, but not pulled out.

    I still haven't managed to convince anyone to check the bloody green ooze for infection. I have a feeling that's something to look into further when I am discharged.

    Now that the stitch is gone there isn't as much rubbing, so hopefully the site will finish healing. The doctor here does rounds every Tuesday. If I ask her too many questions or 'nag' her about anything she just completely skips me. I could be in my room with a UTI, with a huge lump on my head from smashing it against the rail of the bed, while my leg is trapped in the bed rail (becuse of spasms) as I have an AD attack and she will walk right by. (It's actually happened.)

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