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  1. #1

    Supra pubic cathater 101

    Okay so next Thursday I am getting a new supra pubic catheter. Need some people with personal experience for some advice here. Basically how common is it too leak? am i going to be wet all the time at first?, what is the daily routine morning and night? Is dysreflexia pretty common?

    Any additional advice you think I need is much appreciated thank you.

  2. #2
    Senior Member darty's Avatar
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    Everyone is different but I have had mine for 24 years. My uro doc did the surgery and it was uneventful. They put 1 stitch to hold the first one in and used gauze around it to catch any blood or drainage from the surgery. He changed it the first time at a post surgery office visit, cut the stitch and replaced it with a new one. They instructed my family how to change it and it has been a huge success/life changer for me.

    I use Bard all silicone infection control catheters instead of the Teflon coated one's they first had me on. I found the Teflon coated one's to be dirtier with more crusty drainage around the stoma. I drink 4 quarts (1 gallon) of filtered water a day and take 1000 ml of vitamin C every morning. We change it every 2-3 weeks and wash around the tube and stoma every am and pm with soap and water. I have had a few episodes of leakage in the past but they were due to UTI'S.

    Some of the things I do to stay healthy:

    Drink lot's of water, not coffee, tea, soda or beer, filtered water 1 gallon a day
    Take Vitim C daily
    Clean the stoma/catheter site twice a day
    Change the catheter every 2-3 weeks
    Mine will sometimes stick in my bladder so we twist and move it in and out slightly every morning to make sure it moves freely
    Use sterile procedures at every catheter change and every bag change (from leg bag to night drainage bag)
    Rinse all bags every time with bleach and water solution then flush with water.
    Change leg and night drainage bag every 2 weeks

    This is controversial but:

    I irrigate or back flush my catheter with saline solution and a flush kit on occasion if it feels funny or I suspect it's clogged

    If I feel bad or suspect a possible infection I will dissolve a Cipro pill in a large bottle of saline, shake it up then use a flush kit to fill my bladder and clamp it off with a hemostat for 10 minutes or so then release it. I may do this 2 X a day and really push the water for a few days then if I don't feel any better I will bring a urine sample into the Doctor for treatment.

    These are just suggestions and your own experience may be very different but it has worked well for me

    My .02
    ^^(A)^^

  3. #3
    Hi James,

    You will need to take an anticholinergic to help reduce bladder spasms that can cause leaking. Just how much is hard to say. The balance with anticholinergics is to find the dosage that works with the least dry mouth side effect. If you are worried about leaking for the first month or so, you can get drip collector pouches to keep you dry until you heal and get the right dosage of medication. I have had leakage with urinary tract infections, but thakfully, I've only had a handful of those in 4 years.

    I use a Bard latex foley catheter. Latex is not recommended, but that is what my doctor started me on and I don't have a reaction. I know, I know...at least not yet. Some suprapubic users on CCC like the Duette catheter with two retaining balloons. http://www.poiesismedical.com/products/duette/

    Discuss with your doctor the size of the catheter he will be placing. Many doctors place an 18Fr size catheter and then try to size up to 20Fr or 22Fr. My doctor started me with a 16Fr and after 4 years, I still use a 16Fr. Smaller catheters are not as rigid in the silicone or Teflon as larger size tend to be.

    My routine runs pretty parallel to Darty's. I have my catheter changed every month. Leg bag changed every two weeks. I cleanse my leg bag with alcohol, swishing it around the bag and through the closed loop, catheter collector end to drain tube, draining and rinsing with water. I use a rigid plastic night drain bottle (Urocare product) that I cleanse with bleach and water. The bottle is quite durable and it isn't necessary to change it as often as a bag, if you keep up the cleaning routine.

    I drink about 2 quarts of water a day. I have to manage how much water I drink, otherwise my blood sodium levels drop too low. Many of us who drink great quantities of water never think about checking our blood sodium, nor do our doctors.

    You will need to stabilize the catheter to avoid having the catheter moving in and out (piston action) of your bladder. If you don't have adhesive sensitivities or allergies you can use tape. Micropore tape is probably the most gentle of the medical tapes. There are stabilizing devices for catheters. Bard Statlock is one: http://www.bardmedical.com/products/...zation-device/

    Of course, I instill Vetericyn once a day retain it for 5-10 minutes.

    All the best,
    GJ

  4. #4
    Senior Member WPDaggy's Avatar
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    James,

    My approach is very similar to darty's, with some of gjnl's thrown in--like instilling VF daily. Unlike gjnl, I don't require an anticholinergic, and you may not either. I never wanted to have a bag of piss strapped to my leg, so I was reluctant to even consider an indwelling. Five years ago that changed when my ID doc suggested I go to an indwelling to break the cycle of recurring UTIs that required hospitalization, this after 14 years of primarily ICing. Best decision I've made since being in this god-awful condition! I can drink to my heart's content and not be a slave to a bladder in need of a tap. I did have some major problems for about the first week, though. My catheter would continually clog, which was causing AD because my bladder was filling up. I attribute the problem to debris from the surgery because after that first several days it's been smooth sailing.

    I believe if you follow the protocols on cleansing mentioned above by our compatriots, you should be fine. Welcome to the cub! ;-)
    2010 SCINet Clinical Trial Support Squad Member
    Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature.

  5. #5
    Senior Member darty's Avatar
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    I use a 22 with 5 cc bulb and have never taken any type of anticholinergic medication.
    ^^(A)^^

  6. #6
    I've had one for about 4 years now and wish I had it done a long time ago. I have a 16fr and don't take any medication. I only drink water, and a small amount of coffee and beer.

  7. #7
    As you see James everyone has a slightly different experience with the suprapubic. But hope our responses have helped demystify this bladder management method.

    Good luck on Thursday. Let us know how it goes.

    All the best,
    GJ

  8. #8
    And silicone is better than latex then? It's annoying because a lot of places don't shit to Canada.

  9. #9
    Quote Originally Posted by JamesMcM View Post
    And silicone is better than latex then? It's annoying because a lot of places don't shit to Canada.
    Lots of medical supply stores can order them for you, I don't know what you have in your area, we have lots of independent ones, but one of the most known - if you can find a Shoppers Home Health Store even in Toronto or nearer, just call em' and they can order boxes of them and ship them to you. That way, you can get an official receipt and claim it on insurance or taxes (vs. ordering some random place online). And from experience they usually only have latex in stock, any else you have to order. Mine actually has a couple boxes in stock my name on it (so that I didn't have to buy the whole box in one shot and just pick up a few when I needed when I didn't have insurance). Give em a call and shop around!

  10. #10
    Quote Originally Posted by JamesMcM View Post
    And silicone is better than latex then? It's annoying because a lot of places don't shit to Canada.
    Generally speaking, people are warned against using latex because of allergies and sensitivities. I think most of our SCI nurses would recommend avoiding latex. That said, latex is what my doctor placed and I've not had any problems to date. I like latex because it is soft or softer than other materials, especially in larger catheter sizes. Doctors use larger catheter sizes when sediment is a problem.

    All the best,
    GJ

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