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Thread: New suprapubic catheter questions?

  1. #1
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    New suprapubic catheter questions?

    After 20 years of using a condom catheter I had an operation to insert a suprapubic catheter one week ago. As a new user of this setup I have some questions.

    At some point does the pain go away or does it just become less?
    Does the drainage from the catheter site ever really stop?
    Do people continually secure the tubing to their abdomen or just let it flop freely?

    Are there any dos and don'ts that longtime users wish they knew when they first got their suprapubic catheter?

    Thanks for any and all responses.
    Bruce

  2. #2
    Did you have an open procedure (with a large incision) or just a "stab" wound procedure?

    The pain should be decreasing at this time. esp. if you had the latter procedure. Of course many people with SCI cannot feel there, so many do not have this issue.

    The drainage should gradually reduce as well. Wash the area well with soap and water twice daily. Clean any drainage off the outside of the catheter near the stoma as well. If the drainage is excessive, you can apply a gauze dressing, but for long term use it is better not to cover the stoma at all. The drainage should be clearish yellow with only a little blood at this point. If it is otherwise, call the physician who did the surgery.

    The catheter should be secured to your abdomen with hypoallergenic tape or a catheter securement device. Allowing the catheter to "flop around" will increase your risk of both infection and having it accidentally pulled out.

    You can wear a leg bag during the day, and you can shower 2 weeks after the initial insertion. After this you can shower or swim any time you want.

    (KLD)

  3. #3
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    Originally posted by SCI-Nurse:


    The catheter should be secured to your abdomen with hypoallergenic tape or a catheter securement device. Allowing the catheter to "flop around" will increase your risk of both infection and having it accidentally pulled out.
    How does leaving the catheter unsecured increase the risk of infection? By causing injury to the stoma site?

    Right now I'm not securing the catheter and I haven't had any problems. I've tried using leg straps, but they slide down and pull the catheter. I've also tried tape, but it tore up my skin.

    Is there a particular brand or type of tape that won't irritate or damage the skin after repeated applications?

    Also, what's the best location on the abdomen to secure the catheter?

  4. #4
    leaving the cath unsecured allows outward force to pull on the balloon, which is not good

    it also allows mvmt at the stoma site which can lead to irritation/breakdown

  5. #5
    A unsecured catheter causes trauma to the bladder wall and stoma, making these areas where bacteria can enter your body. In addition, an unsecured catheter can slide in and out of the stoma, dragging the dirty outside of the catheter into the bladder and increasing the risk of infection.

    Urethral indwelling catheters should be secured for the same reason. Ideally men should tape a urethral catheter up to the abdomen. This reduces urethral damage and risks of developing penile or penile-scrotal fistulas.

    (KLD)

  6. #6
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    Okay, I see how an unsecured catheter can increase the risk of injury and infection.

    What is the best way to secure a suprapubic catheter? Should the catheter go off to the side of the stoma or to the top? How far away from the stoma should the tape be placed? Is the catheter supposed to lay flat against the abdomen?

    Sorry to rattle 'em off like this, but I got no post-operative instruction about this. Maybe there's a good post-operative guide online somewhere?

    Thanks.

  7. #7
    i would use hypoallergenic tape to tape it so a loop of slack loop/bend of cath is visible. you'll need to rotate positions slightly to avoid skin irritation. you can also use a skin prep on the tape site.

    as important, you need the correct amount of tubing/extension length so when in the chair, slack is maintained on the site. this involves making sure the bag stays put and doesn't drag down the leg on the tube when full and is remedied by using good wide elastic velcro straps such as those by urocare or sierra.

    the last item to ensure security is a foley strap that keeps the tube pinned to the upper thigh and keeps the tension of the tube as well.

    after all this battening down you should be good to go

  8. #8
    Member guy's Avatar
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    It would be great if there was an online or downloadable care guide that had a diagram of the best way to secure the catheter.

    The next time I see my physiatrist, I'm going to have him or the SCI nurse show me how it's done. My urologist never addressed this.

  9. #9
    the little diaphragm is not necessarily the best way to go because it can cause irritation at the insertion site of the catheeter. Taping the catheter with some slack is the best way to go. Some people I know use a little gauze dressing around the catheter and some do not. It's largely a matter of personal preference. The most important things are to wash with soap and water twice a day and to prevent any tugging on the catheter.

    RAB

  10. #10
    This is for a urethral catheter, but the idea is similar:

    Securing the catheter

    There are commercial products available for this, but most just use hypoallergenic tape. here is one example:

    http://www.mcjohnson.com/cath.htm

    (KLD)

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