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Thread: Need Advice on Penile Bleeding after Supra Pubic Cath Change

  1. #1

    Need Advice on Penile Bleeding after Supra Pubic Cath Change

    My brother recently had his supra public catheter change out through bladder. He has this done monthly. When RN ran new line through bladder he started bleeding through catheter line - throwing bloody clots. Did this for 2-3 days post. He also was bleeding out his penis, like having a light menstrual cycle (on a woman) for a couple of days, then it quit, started back for a few hours, and has now quit again. His doctor said he had an infection (based on urine samples) and started oral antibiotics. He has also had some unsuccessful sexual activity in days prior to this catheter change (erection without ejaculation). I've read that this may cause bleeding out penis on quads too.

    Has this happened to anybody out there? Could it be urethral or prostate problems? His primary care physician doesn't seem to think he needs a urologist, though one was mentioned early on in this episode.

    Any input from anywhere appreciated.

  2. #2
    Senior Member reedyd's Avatar
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    i did the same thing happen to me when i first got one and had it changed
    it happened several times. those vessels are very easy to irrate at the first few times it is changed

  3. #3
    Happened to me once too like that. I've had mine since 1989 and I've only actually had blood like that once. Yea every now and then I'll get the little 'clots' come out. yes the vessels are thin and can be irritated easily, especially when having bladder cramps while changing it.

  4. #4
    Without more information, I can't say for sure, but what is most likely is that the nurse who changed his SP catheter inserted it too far before inflating the balloon. This can result in the balloon being inside the urethra, and in a man this can cause cracks or tears in the prostate, which can bleed quite profusely for several days. He could also have a hemorrhagic cystitis, but in the absence of other symptoms of a UTI (fever, chills, AD, etc. etc.) and a culture it is hard to say.

    Report this to the supervisor of the nurse who changed the SP. The nurse needs a review of proper SP catheter insertion technique.

    I am not sure what you mean by "unsuccessful" sexual activity. Success is not defined by ejaculation, which is rare in men with SCI, but by the ability to obtain and maintain an erection of sufficient quality to have intercourse. Just because the man does not ejaculate does not mean he had a sexual failure. Also, I have never seen a man with SCI have bleeding with ejaculation or regular sexual intercourse. Ejaculate may be rusty colored in men with SCI, but it is not due to blood in the semen, and this would not make the bladder bleed or cause bloody urine.

    People with SCI should NOT be treated with antibiotics based simply on urine cultures. This is a potentially dangerous practice, esp. in those with indwelling catheters, that will quickly lead to highly resistant stains of bacteria in the bladder.

    EVERYONE with a SCI and a neurogenic bladder needs a good urologist who is experienced in neurologic urology! Anytime there is blood in the urine, a cystoscopy should be seriously considered. Get a urologist...if you need a primary care physician approval, and this physician refuses, ask for a new primary care physician.

    (KLD)

  5. #5

    SCI Nurse - Need ONE more reply from you please

    My brother was found to have a small 1" or less tear in his urethra according to GP. The GP didn't authorize a urology consult. Do you think I need to call him up and request one from him myself?

    Please advise? I will act on your advice.

    Bleeding via catheter line has stopped - urine is cleared up. Bleedine out penis has stopped, but I'm afraid when RN does next catheter change-out, he might do it again. I will report to his supervisor so they can possibly educate him a little further on this. Thanks.

  6. #6
    Not to be a nosy body but can't your brother tell the nurse himself?
    Get involved in politics as if your life depended on it, because it does. -- Justin Dart

    I shall not tolerate ignorance or hate speech on this site.

  7. #7
    Senior Member reedyd's Avatar
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    my sp cath was inserted to far before and was down in the neck of my bladder it would not even drain correctly. always make sure they put in the right size catheter and bulb. make sure they put the correct amount of fluid in bulb.
    i had one for around 15 years i finally had a urostomy done last year
    the urostomy is a lot less problems

  8. #8
    If it heals without problem but he should seeing a urologist anyway. Make sure the nurse uses lots of lubricant and doesn't force the catheter. Tell her once she gets urine to put it in 2 inches more before inflating the balloon.

    CWO

  9. #9
    Senior Member taj2002's Avatar
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    CWO,

    Is this the correct instructions for a SP cath which is what Vickie is talking about here? I always change my husband’s SP just for the reasons Vickie is stating. Many of these homecare nurses have no idea what they are doing when it comes to a SP change. Anyway, my husband’s urologist showed me to mark the old cath that is being removed at the skin line. After removing the old cath, the new cath is inserted through the stoma using the old cath marking as a reference. If you go another 2 inches, you might risk pushing the cath into the urethra, which is what caused the problem during the last cath change for Vickie’s brother. Additionally, I find that not too much lubricant is needed. Certainly more is required for a urethral cath. Your instructions sound like more what I am used to for a urethral cath.

    Vickie, if you feel comfortable learning, you might just want to do it yourself. I have changed my husband’s SP myself for the past 4 years even though we have LPNs and RNs here almost daily for other care. It is sad to say, but I always do the cath and trach changes myself because too many mistakes were made by the homecare nurses.

    Trish

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