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Thread: Trouble changing catheter

  1. #1
    Senior Member Fragile's Avatar
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    Trouble changing catheter

    I've been having trouble changing suprapubic catheter, hoping somebody can offer some advice. I've been using a suprapubic catheter for about five years, started using the duette about six months after it was installed. Twice recently (a couple months apart), haven't been able to get the Duette to go through the stoma. When that didn't work, tried a regular catheter which wouldn't go through either. Went to the emergency room, they initially try a regular catheter for about 30 minutes with no luck. Both times, they eventually tried a catheter with a coude tip which went through the stoma almost immediately. I'm assuming because of the stiffness of the tip. The coude catheter is causing mild dysreflexia, which is the reason I started using the Duette in the first place. The only explanation they can give me is that the stoma tries to close up immediately after removing the catheter, but the new one is always attempted to be installed in less than a minute. Is there anything I can do beforehand to keep the stoma open?

  2. #2
    Two things can help.
    1. knowing the direction of your stoma. No they aren't just straight in. I have to insert the catheter at an angle that points toward my belly button.
    2. a stylet is a thin wire that slips inside the catheter and makes the catheter stiffer and easier to insert. You will need instruction from a nurse for use.

    See more about these in the following.

    See this thread, my post #7 and others
    http://sci.rutgers.edu/forum/showthr...tylet+catheter


    See this thread, my post #5
    http://sci.rutgers.edu/forum/showthread.php?257540-New-Placement-of-Suprapubic-Tube&highlight=stylet+catheter


    Last edited by gjnl; 08-02-2017 at 08:20 PM.

  3. #3
    Senior Member Fragile's Avatar
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    Quote Originally Posted by gjnl View Post
    Two things can help.
    1. knowing the direction of your stoma. No they aren't just straight in. I have to insert the catheter at an angle that points toward my belly button.
    2. a stylet is a thin wire that slips inside the catheter and makes the catheter stiffer and easier to insert. You will need instruction from a nurse for use.

    See more about these in the following.

    See this thread, my post #7 and others
    http://sci.rutgers.edu/forum/showthr...tylet+catheter


    See this thread, my post #5
    http://sci.rutgers.edu/forum/showthread.php?257540-New-Placement-of-Suprapubic-Tube&highlight=stylet+catheter


    Is it usually the same direction? The person who changes it tells me they always try it in every possible direction/angle. I'm going to try to get in to the urologist office, I'll ask them about using a stylet.

  4. #4
    Be very careful changing a catheter over a stylet. You can easily perforate your bladder. Most nurses don't know how to change a SP, nor use a stylet...in fact I have never worked anyplace where a nurse was allowed to place a catheter with a stylet in place; that was reserved for a physician only.

    You may also need to talk to your urologist about the need to do a stoma revision. Yours may have scarred down or developed a false passage (yes, that can occur in stoma tracts just as it can in the urethra if catheterization is done traumatically).

    (KLD)

  5. #5
    Senior Member Fragile's Avatar
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    I went to see a urologist today, she got the Duette to work, took a little bit of effort. I asked her about a stylet, she said no, that was for experts only. I'm going back next month to have it changed again, a revision isn't something I can do after all the trouble I had dealing with dysreflexia when they first did the procedure to create the stoma back in 2012.

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