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Thread: suprapubic cath

  1. #1

    suprapubic cath

    Saw my uro MD today. He is Chief of Neurourology at a major university medical center and I feel, is competent. Yet he doesn't consider a suprapubic to be a long term option. This despite, reading all the posts of people with an SP tube for 10+ years. I guess it was having an indwelling of any kind that he tries to avoid in relatively "young" (prob < 50 yrs) persons, since the complications of indwelling are well-known. Some of the complications are the same as a Foley, though from what it sounds, folks have seem to have less infection with an SP tube.

    Interesting how different physicians have different views. Another example...Recently, two uro MD's, both SCI knowledgeable, one said high residual vol with low pressure is OK, the other said high residual, regardless of pressure is not a good situation. Can be tough to make a decision with somewhat conflicting views.

  2. #2

    Crags

    Good points. Basically, "to each his own" seems to be the way to approach it.

    Personally, injured 22mos, I've found that the supra method works well for me and affords me independence I wouldn't otherwise have. So far no problems / complications to report.

    Also interesting that at Craig (CO), where I had my rehab, vs Kessler (NJ) the overall approach, at least urologically, is different. Friend of mine (quad) in NJ was never even given supra as an option whereas I was strongly encouraged to go that route.

    Different strokes for different folks I guess. Whatever best suits your lifestyle, imo, should be the way to go.

    Good luck.

    Onward and Upward!

  3. #3
    Member
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    i am a 19+ yr post craig alumni & they were high on the surapubic way back then but i chose to go with IMC...that didnt last long and i had to switch to condom cath,,,did this for years with the usual complaints,,,had the sphynxter snip done, developed strictures, etc,,,finally i gave up and went to the foley but with the strictures i was always in need of urethral dilation(an operation left over from the spanish inquisition),,,,my uro was very negative ie. s-p but i was insistent and he finally relented...he didnt do a very good job of it because it took a long time for the thing to drain properly but it finally did and i discovered which size and style of cath worked best for me...as far as utis, i was at the injectable only point of bacteria resistence when i went to the foley but from that point on i have only had 1 smptomatic uti and only had to do the injectables twice in the last 8 or 9 years...the stoma has beeninfected a couple times but 2 weeks of cipro took care of that,,,,the biggest thing for me is quality of life,,,all those years i was at the mercy of the whims of condom caths,,,always blew off at the worst possible times....i know the risks involved in having the sooper toob in long term but i'll take a shorter possible lifespan where im not a slave to my bladder...no questions asked,,,t-bear

  4. #4
    There are probably as many opinions about bladder drainage as there are urologists. Pros and cons to each and, as stated, is a matter of choice. Docs associated with different centers have different opinions. I work with a doc (PMR-SCI) who did his residencey at Mayo. Believe me, he had his own ideas about what constitutes a good bladder program. He has mellowed through the years though and now sees that a "one size" bladder program isn't for everyone. Urine retention at low pressures isn't without its consequences. Keeping urine in the bladder for any amount of time is inviting an infection. Perfect circumstances.....dark, warm, moist, with a little "food" to grow on. There is some evidence to support the theory that folks with SP catheters have fewer UTI than those with indwelling. Both SP and indwelling have a higher incidence of developing bladder cancer, though this risk isn't a whole lot higher than in the general population. The type of cancer, though, seems to be different than that in the ABs. (EMK)

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