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Thread: super pubic cathing

  1. #1

    super pubic cathing

    hey!
    i have a question about the super pubic cathing. does anyone have one in? i am having trouble cathing on my own. it seems like i have to cath every couple of hours, and i still have lots of accidents and leaks. being a woman, i find it hard to cath in any other position other than laying on my bed. does this get easier with time, will i ever be able to cath out of my chair? i have a cath in at the present time, and it allows me to have more of a normal life. its just that i'm so prone to infections with this in. i thought the way to go would be the super pubic. if you have any input on this....good, bad, ugly....i would really appreciate it. i have been in this chair since my accident in november of this year. thanks for all your time.

  2. #2
    I am moving this over to the Care forum.

    Indwelling catheters increase your risks for stones, UTIs, kidney deterioration and bladder cancer, so generally we try to avoid these, esp. in younger people.

    A suprapubic (SP) catheter is an indwelling catheter (like a Foley) that stays in the bladder all the time. It is like an indwelling urethral catheter, but it is placed through a surgical incision in your lower abdomen. You then drain continuously into a bag. You would probably not be able to change this yourself as it must be done with sterile technique (usually once every 4-6 weeks).

    Intermittent cath is the best method of bladder management for many people with SCI as it has the best record with low rates of UTI, stones, and kidney damage, plus you don't have to wear a bag all the time. With medications you should be able to be dry between caths. Most women at T1 and below can learn to do this independently, including cathing in their chair (unless you are very heavy or have poor hand function).

    Perhaps you would be interested in a Mitrofanoff procedure? With a Mitrofanoff, your appendix (or a piece of small bowel) is used to make a conduit from your bladder to your belly button or a stoma someplace on your lower abdomen. The stoma is "continent" so it does not leak urine. You then do intermittent cath through the stoma 5-6X daily. It is much easier to do (esp. for females) intermittent cath this way. Many urologists are not experienced in this surgery, so it is important to have it done by a urologist who has done a lot of them (often a pediatric urologist who sees a lot of spina bifida patients), even if this means having to travel to get the procedure done. There are a number of (mostly) women here who have had Mitrofanoffs. You can do a search using that word and get a lot of information.

    Do you have a good neurologic urologist? Have you had recent urodynamics testing?

    (KLD)

  3. #3
    Im c4/5 3yrs. I like my suprapubic, for me actually there are less uti, but i drink a like a gallon of water, each day. the other stuff...stones etc. cant say yet. I had mine 2 years in may, 1 uti sence \6+ before with intermittent the first 3 mos. and later foley(which caused dmg to my lil buddy). Sp worked better for me, I have no hand funtion, my nurse and wife would have to inter-cath me every 2-3 hrs with the amount i drink.

    You would have to have a bladder scope and ultrasound of your kidneys yearly to check for stones etc. I use a cath strap to prevent pulls, pants hide hose, and had a cover made for the bag. There is more sediment than I used to have, but nothing xtreme.

    You will likely still leak occasionally,or have accidents but maybe less sence your bladder empties as it fills with the sp, suprapubics dont shut down any god given plumbing. My doc suggested ditropan to reduce the accidents but there not often enough for me to add another med.

    always have to keep an eye on the bag during transfer though, + keep it low... yada yada. remember SP's dont have to be permanent if years pass and your having 2 many issues they can remove it, and return to intercathing.
    "Let us endeavor so to live that when we come to die even the undertaker will be sorry." Mark Twain

  4. #4
    Senior Member
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    Marie,

    I don't know your level or anything (you might want to add it to your profile) but Yes, DEFINATELY cathing will get easier over time. A lot of women cath lying down, you are not the only one limited that way. I am 2 years post and have only recently been able to cath in my chair. I had some other issues I needed to deal with in order to manage it. I posted here in another thread and gave a lot of links to more threads ..... there has been a lot of discussion on these boards lately about women cathing.

    I would definately discuss this with your urologist as well, I would think you should be able to control leaking better that you were. Every 2 hours doesn;t seem reasonable to me.
    T7-8 since Feb 2005

  5. #5
    thanks for your help! i am a L1.

  6. #6
    Quote Originally Posted by marielea
    thanks for your help! i am a L1.
    definatly, I'm C7 and I do it in chair. However,its such a pain for me to take off my pants all the time so my mom alters my pants and put zippers for me. Also, I always lean to the wall beside the washroom, that way I feel more secure that my spasm won't flip me back. feel free to contact me

  7. #7
    Senior Member Broknwing's Avatar
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    marielea-

    I would recommend you exhaust the medicinal options to get your bladder leakage under control first. Then you can have a better idea of WHAT you are managing. What are your issues with cathing that make it so you need to cath on the bed? There have been some very helpful discussions about transfers, leg positioning, clothing hints, etc...You said that you are L1, you probably have quite a decent ammt of function that should assist in these things as well...Hold off on the sp surgery until the other avenues don't work for you...your still new & adjusting, but you need a good Urologist that will find the right meds for you...Have you had a Urodynamics test done?
    'Chelle
    L-1 inc 11/24/03

    "My Give-a-Damn's Busted"......

  8. #8
    I have a SP cath and i like how much easier it is,but having on a piss bag 24/7 is a drag.There just have been many times where i couldn't get in a bathroom to cath or somehow bathroom access was restricted,now i can discreetly and quickly empty the bag outside somewhere if needed.

    For me the overall convienence is worth the health risks and bag issues,but that might not be the same for you.

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