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Thread: Superpubic Catheter Help Please!

  1. #1

    Superpubic Catheter Help Please!

    Hello. I Brooke my next 30 years ago and I'm a C-5 C6 quadriplegic. I was using a condom catheter to void up until about four years ago when after numerous problems the doctor put in a super pubic catheter through the belly. That did solve many of my problems, although I still got urinary tract infections. However, four years later, I am now finding that I'm voiding not only through the super pubic catheter, but through my penis into my pants now, making a mess. Spoke to my urologist and he didn't seem all too concerned. We'll, I am! Has anyone else experienced anything like this? Long story short, I have had more lives than a cat with nine, and have been told by doctors and lawyers and many others that I am theee most complicated case/person they have ever met usually. Any help from anybody would be appreciated. Thank you kindly. Take care

  2. #2
    Senior Member pfcs49's Avatar
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    That happens when I get a UTI!
    Sometimes, it's the first sign I get.
    69yo male T12 complete since 1995
    NW NJ

  3. #3
    Yes, leakage through the urethra in the presence of a supra pubic catheter can be an initial sign of a urinary tract infection. It may also indicate that your catheter is clogged with tiny stones, sediment or mucus, and the catheter needs to be flushed. You should be evaluated for bladder stones or "sand" (tiny bladder stones).

    Flushing and instillation of fluids can help unclog the catheter while you are awaiting evaluation to give you some relief from leaking. Some people use sterile saline. I prefer to use Microcyn Technology instilled into the bladder and maintained in the bladder by plugging the catheter for at least 5 minutes, then draining the urine/Microcyn from the bladder by gravity drain or removing the urine/Microcyn from the bladder with a syringe. A daily Mircocyn instillation can help to prevent urinary tract infections. Some people use Gentamicin, instilled into the bladder, much the same way that I described Microcyn.

    If you think you might be getting a bladder infection, make sure to doctor writes an order to include a UA (urinalysis) and a C&S (culture and sensitivity), no matter what the UA reveals about a bacteria count. All urinary tract infections in people with spinal cord injury should be considered complex urinary tract infections, which means treating the infection with 10 to 14 days of the most effective antibiotic as revealed by the C&S.

    http://sci.rutgers.edu/forum/showthr...light=microcyn
    http://sci.rutgers.edu/forum/showthr...light=microcyn
    http://sci.rutgers.edu/forum/showthr...ght=Gentamicin

    While you are trying to find the root of the leakage problem, you could wear something like an absorbent pouch to collect urine leakage. Do an internet search to find several types and brands of these pouches.

  4. #4
    Agree with posts above
    a cystoscopy should be ordered with frequent infections to rule out stones in bladder

    pbr
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  5. #5
    "use Microcyn Technology instilled into the bladder and maintained in the bladder by plugging the catheter for at least 5 minutes, then draining the urine/Microcyn from the bladder by gravity drain or removing the urine/Microcyn from the bladder with a syringe. A daily Mircocyn instillation can help to prevent urinary tract infections. Some people use Gentamicin, instilled into the bladder, much the same way that I described Microcyn." what? how?

  6. #6
    Why with my problems only start three years after I had the Super pubic put in? I have had several UTIs already and this is never happened thus far

  7. #7
    Quote Originally Posted by BurninBud View Post
    "use Microcyn Technology instilled into the bladder and maintained in the bladder by plugging the catheter for at least 5 minutes, then draining the urine/Microcyn from the bladder by gravity drain or removing the urine/Microcyn from the bladder with a syringe. A daily Mircocyn instillation can help to prevent urinary tract infections. Some people use Gentamicin, instilled into the bladder, much the same way that I described Microcyn." what? how?
    "What? How?" I'm not sure what you are asking here. The links I provided give a great deal of information about how these remedies are used. If you have a specific question, I could address, but "What? How?" is a very broad target.

    Quote Originally Posted by BurninBud View Post
    Why with my problems only start three years after I had the Super pubic put in? I have had several UTIs already and this is never happened thus far
    Who is to know why? What you are asking is like saying, I haven't had a cold in 5 years, but this winter I caught a bad cold. Why?

    But, just as your bladder changed over time requiring you to switch from a condom catheter to a supra pubic catheter to manage your bladder, you bladder will continue to change with time or problems will occur. Our bodies are dynamic, not static. We age, we change our diets, we take medications, our doctor's don't follow protocols and prescribe antibiotics without the benefit of knowing which antibiotic is effective for a urinary tract infection, we drink more water, we drink less water, and on and on. There is a saying "Shit Happens!"

    The SCI nurse suggested a cystoscopy. Generally speaking, getting a cystoscopy is a good idea every 3 to 5 years. You are noticing a problem that has not occurred before, sounds like you are due for a cystoscopy. You probably haven't had a renal ultra sound in three years either. Time to set that up, usually once a year or every other year. Have you had any blood tests or urine studies done in three years, i.e., creatinine level in the blood and creatinine clearance to monitor kidney function? Have you thought about changing the type of catheter you are using?

  8. #8
    Greetings. I do thank you for responding, however I checked out some of those pages I still did not see it exactly what it was, the dosage and exactly what they're doing with it. So please excuse me if I ask what it is that you were talking about. I have enough issues and I certainly don't need for you to present an attitude when I am asking a simple question to solve a problem. The fact that I am now urinating out of my penis, which has not happened at all since I have the super pubic tube put in is nowhere near analogous having caught a cold after not having one for five years and then asking why. Not even close. My bladder did not change before, it was the opening through the urethra I kept getting clogged up, and once it was finally totally clogged I had the super pubic tube put in. Never had any leakage for over three years until now. So that's not just a matter of "shit happens". I've had several times where the catheter was clogged or did not trained properly and I did not urinate through my penis at all. Only now four years later. I have a a cystoscopy done a few years ago. Blood test and urine studies were done last month after I suffered a seizure, was found by my roommate and was sent to the hospital last month due to a bacterial infection. Thank you all once again for your input.

  9. #9
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    Bladder spasms have caused those same problems for me. Several years after the supra-pubic catheter surgery I had the same situation, usually during the over night. I now take Oxybutynin. aka Ditropan. This has completely eliminated the problem for me.

  10. #10
    Quote Originally Posted by BurninBud View Post
    Greetings. I do thank you for responding, however I checked out some of those pages I still did not see it exactly what it was, the dosage and exactly what they're doing with it. So please excuse me if I ask what it is that you were talking about. I have enough issues and I certainly don't need for you to present an attitude when I am asking a simple question to solve a problem. The fact that I am now urinating out of my penis, which has not happened at all since I have the super pubic tube put in is nowhere near analogous having caught a cold after not having one for five years and then asking why. Not even close. My bladder did not change before, it was the opening through the urethra I kept getting clogged up, and once it was finally totally clogged I had the super pubic tube put in. Never had any leakage for over three years until now. So that's not just a matter of "shit happens". I've had several times where the catheter was clogged or did not trained properly and I did not urinate through my penis at all. Only now four years later. I have a a cystoscopy done a few years ago. Blood test and urine studies were done last month after I suffered a seizure, was found by my roommate and was sent to the hospital last month due to a bacterial infection. Thank you all once again for your input.
    BurninBud, I did not intend to trivialize your problem. Perhaps my example was not a good one. The point I tried to make is that what may be causing you to leak through the urethra, managing your bladder with a supra pubic catheter might not be the same for someone else who is leaking through the urethra, managing their bladder with a supra pubic catheter.

    There can be many reasons that you may be experiencing leaking. I and others have posited guesses from mucus to sediment to small ("sandy") bladder stones to spasms to a lurking urinary tract infection. Why now...because changes in our bodily functions occur over time with spinal cord injuries. That you went for 4 years without experiencing leaking and you had a cystoscopy "done a few years ago," means that in some way your urinary tract has undergone some change that now need to be investigated with recent tests, ultrasound imaging, a cystoscopy and/or possibly even CT or MRI scans.

    You used a condom catheter for years, but then your body experienced a change. Your urethra kept clogging up (did anyone ever discover why that happened?) and you had to try to find a way to prevent the clogging or change the way you managed your bladder. Your doctor suggested the supra pubic and now here you are. You have a supra pubic catheter and have had it for four years with no difficulties. But, now without a perceivable reason you are experiencing urethral leaking. I'd call that another change with your urinary tract that needs to be diagnosed and a solution found. Change Happens...Shit Happens.

    I didn't intend to present attitude either. If you read all the threads I suggested, you know that the discussion about the use of Microcyn runs well over 100 pages. Within all of those posts it has been discussed multiple times that there is not a one size fits all prescription for Microcyn usage. If establishing a one size fits all prescription were easy, clinical trials would have probably been done by now. The use of Microcyn to help prevent urinary tract infections (and anecdotally clear up mucus and sediment) is off label. Anyone trying Microcyn has made their own decision to try the product to see if it helps them. The posts are replete with examples of all the different ways people have found to administer the product, i.e., how much to instill, how many times a day to instill, and how long to retain it. I did not answer you question of "Why? How?" because there is no one and only answer. Turns out your question is not all that "simple."

    The use of gentamicin to prevent urinary tract infections has been studied and trialed. Within the thread on gentamicin, a member with the screen name of "fuentejps" posted a reference to a medical paper, which discusses dilution of gentamicin, dosage etc., in more of a one size fits all prescription.

    I am sorry for your frustration.
    Last edited by gjnl; 02-12-2019 at 02:16 PM.

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