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Thread: New Placement of Suprapubic Tube

  1. #1

    New Placement of Suprapubic Tube

    I had a partial sphincterotomy done 31 years ago when I got injured. I have been dealing with chronic bladder infections for quite a few years now. Going to finally bite the bullet and go with a suprapubic tube. Just a couple of questions:


    1. Will I still continue to void through my urethra or will the suprapubic tube keep my bladder emptied enough so I will not void through my penis?


    2. Being that this tube will be permanently inserted through an opening in my skin, will I experience increased bladder infections because of this?


    3. Is there any specific catheter that works better than others for the suprapubic tube?


    Thanks for all of your help.

  2. #2
    Quote Originally Posted by weelz58 View Post
    I had a partial sphincterotomy done 31 years ago when I got injured. I have been dealing with chronic bladder infections for quite a few years now. Going to finally bite the bullet and go with a suprapubic tube. Just a couple of questions:


    1. Will I still continue to void through my urethra or will the suprapubic tube keep my bladder emptied enough so I will not void through my penis? You won't continue to void urethrally. That said, you may experience urethral leaking if you develop a urinary tract infection or if you have a lot of bladder spasms. You should take an anticholinergic, like oxybutynin, to help curtail bladder spasms. In addition, some sources say that taking an anticholingeric helps to maintain bladder size.

    2. Being that this tube will be permanently inserted through an opening in my skin, will I experience increased bladder infections because of this? Sterile insertion of replacement catheters, keeping the stoma area clean, and good securement technique should reduce your risk of developing urinary tract infections.

    3. Is there any specific catheter that works better than others for the suprapubic tube? I prefer the Duette catheter made by Poiesis. I have found this catheter more comfortable and less irritating. Instead of one balloon, the Duette has two balloons and the drainage eyelets are between the balloons instead of at the end of the catheter. http://www.poiesismedical.com/products/duette/

    Your doctor will place your initial catheter at the time of the surgery. He will probably have you come to his office to replace that catheter in about 4 weeks, and he will give you instructions for subsequent changes. My personal preference is for the smallest catheter to be placed initially, say a 16Fr. Your doctor may want to upsize the catheter to an 18Fr., but I wouldn't like to go any larger. Larger French size catheters are stiffer than smaller ones and difficult to secure and manage.
    Poiesis will send you free samples of the Duette catheter, once you know your permanent size.


    Thanks for all of your help.
    Good Luck!

  3. #3
    Actually, the fact that you had a previous sphinterotomy does increase your risks for voiding through your urethra, unless the sphincterotomy has scarred down and is now more like a stricture (a common problem). You should discuss this specifically with your urologist prior to having the SP tube placed.

    (KLD)

  4. #4
    Senior Member goldnucs's Avatar
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    Quote Originally Posted by weelz58 View Post
    I had a partial sphincterotomy done 31 years ago when I got injured. I have been dealing with chronic bladder infections for quite a few years now. Going to finally bite the bullet and go with a suprapubic tube. Just a couple of questions:

    Some background: I'm a c5-6 complete quad 39 yrs post-injury. I used an external Texas cath for 30-ish years before switching to a foley. I always had issues w/ UTIs and I can't even count the number of sphincterotomies I've had (including one bladder neck stent placement). I had a SP installed about 4 rs ago and wish I'd done it sooner.

    1. Will I still continue to void through my urethra or will the suprapubic tube keep my bladder emptied enough so I will not void through my penis? No.


    2. Being that this tube will be permanently inserted through an opening in my skin, will I experience increased bladder infections because of this? No, in fact, UTIs should become less frequent.


    3. Is there any specific catheter that works better than others for the suprapubic tube? I tried the Poesis Duette as it seemed to work well as a foley but ithas a softer tip and we were not able to push it through into my bladder. Ended up in the OR and have since returned to a straight 16F.


    Thanks for all of your help.
    Drink a LOT of water!
    Rick Goldstein
    GO! Mobility Solutions
    facebook.com/goes.anywhere

  5. #5
    Quote "goldnucs:"

    Yes the Poiesis Duette catheter can be a bit tricky to insert. Two things can help with this.

    One, it helps to know the direction of your stoma. You might think that a stoma is a straight shot into the bladder, so you may be inclined to push the catheter straight down. In fact, your stoma is probably biased in one direction or another. I found that insertion is easier, in my case, when the catheter is angled down toward my pubic bone. If you have difficulty getting the Duette in, try upward toward the navel or downward toward the pubic bone or even to one side or the other.

    Two, get a 4Fr stylet, usually available where you purchase urinary supplies. The stylet slides down into the catheter and stiffens the tube, making insertion easier. Suggest having a urologist or nurse teach you how to use the stylet properly.
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