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Thread: Suprapubic catheter maintenance

  1. #1

    Suprapubic catheter maintenance

    I am 20 years post spinal cord injury C 4-5. I have always used intermittent catheterization as my bladder management. Due to changes in healthcare, an attendant is no longer able to perform intermittent catheterization. I have thought about a suprapubic catheter over the years, but never really needed to worry about it until now. My question is does anyone have experience with clamping off the catheter and opening it when you would normally cath.? I will use a indwelling catheter for conveniences (social, vacation) periodically and that is how I manage it. Just wondering if anyone has luck managing it this way. Thanks!

  2. #2
    There are a couple people on this forum who do clamp the suprapubic catheter, but many of them are not spinal cord injured and/or have more sensation and awareness of the bladder needing to be emptied than a C4/5 quad might. The SCI nurses and rehab centers would probably discourage the clamping practice.

    I have had a suprapubic for 5 years. I don't clamp and drain mine.

    All the best,
    GJ

  3. #3
    Senior Member ~Lin's Avatar
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    I use a valve at the end of my suprapubic, and flip the lever and drain directly into the toilet as needed during the day. You can also use a clamp on the catheter or extension tubing to choose when to drain into a leg bag, if you can operate the clamp. I have severe nocturia so at night I use some extension tubing to connect the valve to my night bag and leave the lever open for continuous drainage. I have full sensation so yes I know when I need to drain my bladder.

    But I don't see the negative in using this method to drain your bladder if you're coming from IC. As long as you've been correctly managing your bladder with IC there is no negative in not knowing when you need to pee, and lots of positives for maintaining bladder tone and size. The negatives come in with the SCI nurses not recommending this due to lack of maintaining a closed system from most of the responses I've read. I've only had a SP since september 5th, but infection wise every infection I've had so far was caused by incorrect catheter changing procedure on behalf of my physicians office, and no problems from my catheter care and maintenance. In fact my Dr has said that I go well above and beyond in the care and maintenance for infection prevention.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  4. #4
    Have you been satisfied with move to a suprapubic?

  5. #5
    Senior Member ~Lin's Avatar
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    I've been THRILLED with the move. It was rough in the beginning, but that was mostly due to not having experienced bladder spasms prior to the surgery, and some delayed healing issues as a result of my genetic disorder. The thing that stopped the spasms for me really was when I finally started using the valve, which I had theorized about prior. I assumed my spasms were because my bladder was suddenly in contact with a catheter and balloon 24/7, so once my bladder was allowed to fill normally and not constantly in contact it was a completely sudden turn around. I didn't have any leaking as a result of spasms, it was how completely uncomfortable I was the first 2 weeks. After that turning point though the only issue I've had was the infections caused by my Drs office. But we pinpointed the problem, he was incredibly disappointed to hear about the mistakes his nurses had made and said he would take care of things. I've since started changing my catheter at home myself where I can control everything, and no infections yet.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  6. #6
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    I tried using a valve and emptying my bladder that way as well. I liked the idea of maintaining bladder size, etc. The problem I had that made me stop was that, since I have no feeling in my bladder, I would forget to empty it. I would then get leakage and I began to worry about the urine backing up into my kidneys and causing infections and other problems. Of course, this was one of the reasons (curiously not an important one) I stopped IC and switched, first to a indwelling foley, and then a SP catheter.

    I suppose that if you're meticulous about your schedule, or you have feeling, it might work better.

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