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Thread: Suprapubic catheter

  1. #1
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    Suprapubic catheter

    I'm a c5/c6 quadriplegic and going in for surgery May 24th for a suprapubic catheter insertion recommended by my urologist. For the last 5 months I've had a in dwelling catheter which has worked great and I prefer but my urologist said it is not a long term option and the suprapubic is my best option. Can anyone give me views and experiences about the suprapubic catheter? It seems very extreme to have a hole straight to my bladder plus I hate surgeries. Thanks!!

  2. #2
    For long term the SP is really the way to go. I had it done after 10 years of using a foley, which was giving me a lot of problems due to frequent blockages, mostly at the worst time.

  3. #3
    Long term use of an indwelling, urethral catheter has the potential to damage to the urethra, erosion of the glans, and skin. So the supra pubic catheter is usually preferred.
    .
    I had the SPC (supra pubic catheter) placed about 6 years ago. Looking back on it, I wish I had done it sooner. I used intermittent catheterization to manage my bladder for a long time and at the end, my bladder was not able to hold enough urine to allow me to go between caths for more than about 2-3 hours. I was getting non stop infections and life was pretty much centered around bladder management.

    I think you will be very happy with the decision to go with the SPC. For the first few weeks it does seem weird to have this tubing coming out of your belly. But, quite quickly, you will hardly notice it. I would suggest that you speak with your urologists about the size of the catheter that he will place. I think that most people would tell you it is best to start out with the smallest catheter (usually a 16FR) and then if necessary step up the size incrementally if you have problems with sediment or clogging. I started with a 16FR and am still using 16FR. Ask your physician what type of catheter he will use latex (do you have latex sensitivities? If so steer clear of having a latex foley catheter placed), silicone, coated etc. Ask his advice regarding leg bags and night drain systems, maintaining a closed system. Discuss how to care for the stoma, secure the catheter tubing to stabilize the catheter, and how often to change the catheter. Discuss learning to change your own SPC or having a caregiver trained to change the catheter at home. Ask for prescriptions for catheters and leg bags so these supplies can be considered for coverage by insurance, medicare, medicaid. Ask your urologist where he is going to place the stoma. Do you wear an abdominal support that needs to be accommodated and considered? The surgeon has some latitude in placement on your belly.

    About 4 weeks after the supra pubic catheter is placed, you will go back to your urologist, who will do the first catheter change. At that time, a nurse or nurse practitioner will teach you and/or your caregiver how to change the catheter, usually every 4 to 6 weeks.

    There is a relatively new catheter that was designed for supra pubic use. It is called the Duette by Poiesis. (http://www.poiesismedical.com/products/duette/) Most of us who have tried it seem to find it a better catheter. It is soft silicone, but it has two balloons, a retention balloon and a cushioning balloon, with the drainage eyelets positioned between the two balloons.

    If you have other questions, I know all of us and the SCI nurses will do our best to answer them. And when you have had the placement surgery, check in with us and let us know how things are going.

  4. #4
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    Quote Originally Posted by Ty12 View Post
    I'm a c5/c6 quadriplegic and going in for surgery May 24th for a suprapubic catheter insertion recommended by my urologist. For the last 5 months I've had a in dwelling catheter which has worked great and I prefer but my urologist said it is not a long term option and the suprapubic is my best option. Can anyone give me views and experiences about the suprapubic catheter? It seems very extreme to have a hole straight to my bladder plus I hate surgeries. Thanks!!
    no surgery here they just stuck me with a long steel thing pulled it out put cath e in had 15 years piece of cake

  5. #5
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    Thanks for the info I really appreciate it I hope it is a change for the better like most sci we are always dealing with something lol.

  6. #6
    I got my suprapubic put in a little over two years ago. Best thing I have ever done. I was doing straight cathing before. It has given me way more independence. I don't have to worry about cathing when I am in a public place or at someone's home. I haven't had an UTI since switching over. I have a nurse put in a new one every month. The process is quick and easy. I do get a little discharge of fluid around the stoma but it isn't much. I wish I would've had the surgery 20 years ago.
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  7. #7
    Once you have your surgery I would recommend a duette catheter like gjnl said
    C5/C6 Complete since 08/22/09

  8. #8
    Senior Member dnvrdave's Avatar
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    Quote Originally Posted by gjnl View Post
    I think that most people would tell you it is best to start out with the smallest catheter (usually a 16FR) and then if necessary step up the size incrementally if you have problems with sediment or clogging. I started with a 16FR and am still using 16FR.
    Why is a smaller catheter better? I was given 24 FR (30 years ago) and I never considered that a smaller diameter would be better. I don't plan to change to smaller, but I just wonder what the advantage is. Less invasive? Less risk of bacteria entering?

    I see that 16 FR has >50% smaller circumference than 24 FR. That's a big difference.
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  9. #9
    A smaller catheter is less irritating to the bladder, but for some, a smaller size does not drain sufficiently.

    By the way, both indwelling urethral catheters and indwelling suprapubic catheters are "indwelling" and Foley is only one type of catheter that can be used for either. There are others, such as the Duette, mushroom catheters, Malecotts, etc.

    For both men and women, a significant advantage of the use of SP vs. urethral indwelling catheters is avoiding the damage to the urethra that commonly happens with long term indwelling urethral catheters. This can include strictures and urethral diverticuli. In women, a patulous (stretched out) urethra can occur, esp. after menopause. For men especially, a SP makes genital sexual activity much easier, as well. The rate of UTI, stones, and other indwelling catheter complications is roughly the same between SP and urethral indwelling catheters.

    (KLD)

  10. #10
    Quote Originally Posted by dnvrdave View Post
    Why is a smaller catheter better? I was given 24 FR (30 years ago) and I never considered that a smaller diameter would be better. I don't plan to change to smaller, but I just wonder what the advantage is. Less invasive? Less risk of bacteria entering?

    I see that 16 FR has >50% smaller circumference than 24 FR. That's a big difference.
    As stated by KLD, smaller catheters are generally less irritating to the bladder than larger ones. In addition, smaller catheters are more pliable/flexible and easier to secure. If you don't have trouble with sediment and clogging, it really doesn't matter that the 16 FR catheter is ">50% smaller circumference than the 24 FR."

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