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Thread: Suprapubic Catheter still seeping after 2+ months

  1. #1
    Senior Member dbassman's Avatar
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    Question Suprapubic Catheter still seeping after 2+ months

    I had a suprapubic catheter put in on 4/19/2007, after using an external catheter for almost 29 years. The last couple years I had problems not being able to urinate after sitting up and it was determined that I occasionally had a kinked urethra.

    It's going on three months now and I'm still getting a lot of seepage from my stoma which is a little bloody. Is this common? If not, what should I be doing to help it?

    Here's a couple pic's showing the gauze with the seepage & stoma.

    Gauze

    Stoma

    Thanks!

  2. #2
    Are you keeping the catheter secured with tape or a device like a Statlock to prevent it from rubbing in and out throught the stoma? This is advised.

    For you, I would also recommend folding a piece of gauze and taping it in place next to the stoma, then taping the catheter to this for a few days. This is serve as a cushion for the catheter and prevent it from being pressed on the edges of the stoma.

    If that does not improve the condition, then see your urologist. They may want to put a little silver nitrate on that raw area to see if it can be dried up and better epithelialized.

    How is the SP working out for you otherwise?

    (KLD)

  3. #3
    CSI-Nurse shoulden he have A small balloon at the tip of the catheter by now
    i had changed from the rubber hose to a catheter with a balloon 30 days after
    operation

  4. #4
    Senior Member dbassman's Avatar
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    I don't really have the catheter secured, I've just been cutting two - 4 x 4 gauze pads down the middle and putting them around the catheter over the stroma and then taping one other 4 x 4 over the two. (Which is what is in the "Gauze" picture, after I removed them.) I figured this would be giving it the padding you're referring to. I will try taping it in place and see if that helps. I didn't know what statlock is, so I did a google search on it, but don't see any big enough for a 24 Fr. Catheter most of what I saw was for IVs.. My urologist never mentioned anything like that.

    I saw my urologist about a month ago, and he put silver nitrate on it and gave me three other sticks to use. I've used all three of them up, and it's still there. I'm guessing when I get transferred and stretched in my chair, it could be moving enough to keep it raw.

    Other than all the excess seepage, the suprapubic is working great, wish I would've done it years ago as I no longer have to worry about my external catheter coming off and getting wet! I did have one episode about a month ago, where it didn't drain after I sat up, even though it was straight (not kinked) from my belly to the leg bag. I laid down and started draining fine, got back up for a few hours and again it didn't drain until I laid back down. Haven't changed anything and it's been working fine since.

    jryprt - I'm not sure exactly what you're referring to, but there is a balloon on the tip of the catheter in my bladder.

    Thanks for the advice!

  5. #5
    Hi dbassman,
    I don't remember how long Dan's sp cath was irritated looking, but I have a question for you....it looks like it is quite a large catheter (diameter) to start with. What size is it? Could be that the size is causing an issue??? Dan started with a 14fr.
    C

  6. #6
    I assume you have a foley catheter in there (one with a balloon on the tip). We put these in from day #1, but only the urologist changes it the first 1-2 months.

    Yes, the catheter should be secured, and a dressing alone is not sufficient. This is a CDC guideline (ask your urologist about this) to both prevent accidental dislodgement and to keep the catheter from pistoning in and out of the stoma, which increases the risks for infection. You should also keep any hair around the stoma trimmed back at least 1 inch.

    Here is the Statlock Foley. We use these where I work, and they will work on a 24 Fr. foley catheter:

    http://www.medexsupply.com/list-prod...-pid-7531.html

    You can leave these on the skin for up to 5 days.

    Also, I forgot to ask. Is that catheter latex? If so, you may want to look into a non-latex catheter. That could be keeping that area raw too.

    (KLD)

  7. #7
    Hi,
    I just looked at the photos you posted of your SP site. Mine is still the same over a year later, except mine has a green tinge to it. I have has it swabbed for infection twice and have had it looked at and am told it is fine. I use either aquacel and put a slit in it and let it sit around the site or a piece of rolled up gauze (length wise) and just tie it around the cath at the site, atleast it mops up any leaks.
    Hope this helps.

  8. #8
    Senior Member dbassman's Avatar
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    Quote Originally Posted by cathy j
    It looks like it is quite a large catheter (diameter) to start with. What size is it? Could be that the size is causing an issue??? Dan started with a 14fr.
    Hi Cathy,

    It's a 24 Fr. My urologist said it's what he always uses from the start on a SP. I don't know what's most common, it's all new to me!

  9. #9
    Our urologists usually use either a 22 or 24 Fr. for indwelling SP catheters.

    (KLD)

  10. #10
    Senior Member Spadfan's Avatar
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    Quote Originally Posted by SCI-Nurse
    . . . Snip. . .Also, I forgot to ask. Is that catheter latex? If so, you may want to look into a non-latex catheter. That could be keeping that area raw too.

    (KLD)
    The 24fr latex SP catheters I have used for years have been Silicone coated and I have no problems. Does the coating get worn off after the tube is in place for awhile and cause the rawness? This has not been my experience.
    William M.
    T 6/7 Complete - 4/20/74

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