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Thread: Question about changing suprapubic catheter

  1. #1
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    Question about changing suprapubic catheter

    Quick history. I have had my SP for 10 years now. The first year there was lots of clogging and I eventually went from a size 16 silicone to a 22 latex/silicone. That is worked for me for the last nine years.


    My caregiver, aka mom does all my catheter changes. We change it about every two weeks. Never had a problem. We would pull it out and put it in with ease. Well a month ago we were doing a catheter change and we couldn't get a new catheter inserted back into me. I don't know if my bladder was tightening up or what, but this is the first time this is happened. The harder she pushed the more pain I felt. We didn't know what to do and there was no way a 22 was going to go down my urethra so we rushed to the ER.


    The ER nurse grabbed a 16 silicone and basically put it right in. Crisis over. I knew I was going to have to keep an eye on it for clogging. I bought myself a few catheters of the same size, and after two weeks I decided to change it using another 16, and again we couldn't get it in. After about five minutes we basically pushed it in much harder and it finally went in. It seems that the tip goes in fine it's just when the deflated part of the balloon tries to pass through is when it gets tight. At least that's what I think is happening.

    So my question is how hard is too hard when pushing a new suprapubic catheter into my bladder through the stoma?
    C4/C5 complete 8/20/91

  2. #2
    you said suprapubic and than "down my urethra" do you mean stoma? If stoma I had that happen and my urologist said the bladder could take it. I'd check with them
    "Yesterday's History,Tomorrow's a Mystery"

  3. #3
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    Quote Originally Posted by Hawk View Post
    you said suprapubic and than "down my urethra" do you mean stoma? If stoma I had that happen and my urologist said the bladder could take it. I'd check with them
    Yeah, I couldn't get the catheter through the stoma but also I wouldn't be able to get it through my urethra either because all we had were 22's so we had no choice but to get to the ER quick. I probably could've worded that better.
    C4/C5 complete 8/20/91

  4. #4
    You may need to see an urologist to peer into your bladder through the sp stoma to check out the condition of the opening and bladder.

    it is possible for sp stomas can tighten over time. The urologist can address that also.

    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
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    Well I ended up doing my catheter change last night and didn't have any problems This time it came out with ease and went in with ease. Strange. I think what was maybe happening was when we would fill the bladder prior to the change, it would cause the bladder to squeeze and give resistance. I see my urologist in two weeks so I will bring it up. Thanks for the replies.
    C4/C5 complete 8/20/91

  6. #6
    You don't need to fill the bladder before changing but leave some urine in so you can be sure it is in. Just a few drops or one ounce is fine. Typically inserted in to an empty bladder but by time we remove the catheter, then set up for sterile procedure, some urine has already been produced. (Then going in several inches to clear the balloon inflate, then gently draw back. While on the subject, we (as nurses) were taught to hook up the catheter to the balloon port and instill, make sure balloon is good, then deflate, keep connected for use, once in-inflate). I quit doing this several years ago because over almost 40 years, especially the past 12 years pretty much using the same manufacturer of catheters (Mostly BARD) I have not ever had an issue..... until one of my family put in the catheter and it wasn't all the way (pain) but couldn't deflate, home care and clinic nurse couldn't either , I tried nothing from syringe, so I cut the port, nothing came out as it should to drain the balloon, I tried to aspirate with the syringe t and nothing. To make a long story short, I had to call the urology resident to cysto and pop balloon. So I am recommending to do this!

    You might try putting some lubricant on cath. And if this continues then see a urologist. Some stomas need dilated due to most likely scar tissue. But using a 22 you are dilating it on your own. We do not typically recommend going above 18-20fr. because the larger the tube the easier the leakage. But their are always exceptions, I just would not go any higher than a 22fr.

    CWO
    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.

  7. #7
    yes i give up inflating the balloon as a test as when you withdraw the water, the balloon part doesnt always shrink back to original size especially those bards, there as hard as ol john wayne
    i prefer to use releen caths, im a 24g, change monthly, leg bag weekly, we dont muck around with it, bag, lube & 10mm syringe are all ready to go before we pull old 1 out
    1 out, quick clean the hole, new job in, fill the balloon & a gently pull back. the only time ive ever had trouble was if im spazming badly from lying flat
    it wont go in, once the body relaxes, np.
    survivor of beijing oeg transplant

  8. #8
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    I always use lube but the ducett cathe sometimes it does not want to go in then my care giver put her hand over mine and pushes in the bard always goes in easy

  9. #9
    Quote Originally Posted by philquad36 View Post
    bag, lube & 10mm syringe are all ready to go before we pull old 1 out
    1 out, quick clean the hole, new job in, fill the balloon & a gently pull back.

    I get a kit along with the each catheter from the supplier...sterile drape, lubrication, 10cc syringe and iodine swabs. Lay the cath on the drape and lubricate the last 2 or 3 inches until the lube packet is empty. Deflate old cath, remove, swab with iodine and insert new cath. The stoma is only open for 30 seconds between old cath removal and new cath insertion. My stoma will start to close within minutes so I never delay getting the new one in.
    "Never turn your back on fear. It should always be in front of you, like a thing that might have to be killed." - Hunter Thompson
    T5/6 complete

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