Page 1 of 2 12 LastLast
Results 1 to 10 of 13

Thread: Suprapubic Catheter, but still urinating

  1. #1

    Question Suprapubic Catheter, but still urinating

    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 sometimes not being able to urinate after sitting up and it was determined that I occasionally had a kinked urethra.

    Before the suprapubic, I would always get mild AD when my bladder was full and trying to empty itself by urinating. It's a little bit of a chill and tingling feeling that would would start 20 to 30 seconds before I started urinating and last as long as I was urinating (2-5 minutes) and then go away.

    Well now, even though I've got the suprapubic, I'm still getting a lot of mild AD and have been urinating through my penis as well. The other problem is my lower back and abdomen (bladder) get tight and spasm which causes severe lower back pain, this happened before, but not this intense. I have had chronic lower back pain for about 26 years, but this makes it much worse. Also, when I get the mild AD and spasms, it could last for an hour or more go way for a while and then come back again. As I'm writing this, I've had the AD, abdomen and back spasms off and on (more on then off) for about three hours. My back and abdomen have pretty much been spasming the whole time.

    I just saw my urologist on Monday, and he suggested trying Flomax, I started taking it Monday night and I think it's made it worse instead of better. Before Monday, I had urinated in bed three or four different times, absolutely soaking the "Chuck" (nickname for disposable under pad) that I lay on at night. Monday night my pants were mildly wet and Tuesday and Wednesday night, they were soaked as they are right now.

    Being a quad for 29 years, I definitely have the quad gut and my urologist placed the catheter so low it's actually under my gut when I'm sitting up. I was wondering if my gut is putting too much pressure on my bladder or the area of the suprapubic causing it not drain completely? I asked my urologist about this and he said "No that wouldn't happen". Of course he's been wrong before though as he told me my urethra or couldn't be kinking when I'm setting up.

    The suprapubic worked great when I first got it, all this just started happening a week or two ago, with the exception of urinating in bed once or twice. I definitely don't want to have to start wearing an external catheter, along with the suprapubic, that's one of the reasons I decided to go ahead with the surgery.

    Has anybody here encountered the same problem? Any ideas on how I can keep dry and get my bladder to stop spasming? I assume with the suprapubic would work properly in empty my bladder completely these problems would be taken care of.

  2. #2
    dbassman,

    The reason why you may have been unable to void before may not be due to "kinking" of your urethra but due to failure of your bladder sphincter to open.

    Suprapubic catheters may be kinked or the tip be placed in such a position that the tip is occluded and urine can no longer flow.

    When you have continuous draining with a suprapubic cathether, your bladder shrinks in size. This may be the reason why it worked at the beginning but, as your bladder shrinks, the tip is pushed against the bladder wall and it is no longer draining. When this happens, urine will come out through the urethra.

    I am not sure what the solution should be. Perhaps clamping the suprapubic catheter for a period (to allow some urine to accumulate) will result in enlargement of your bladder and the catheter to become drain the bladder. I don't know whether this solution will work.

    Perhaps others have had such experiences?

    Wise.

    Quote Originally Posted by dbassman
    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 sometimes not being able to urinate after sitting up and it was determined that I occasionally had a kinked urethra.

    Before the suprapubic, I would always get mild AD when my bladder was full and trying to empty itself by urinating. It's a little bit of a chill and tingling feeling that would would start 20 to 30 seconds before I started urinating and last as long as I was urinating (2-5 minutes) and then go away.

    Well now, even though I've got the suprapubic, I'm still getting a lot of mild AD and have been urinating through my penis as well. The other problem is my lower back and abdomen (bladder) get tight and spasm which causes severe lower back pain, this happened before, but not this intense. I have had chronic lower back pain for about 26 years, but this makes it much worse. Also, when I get the mild AD and spasms, it could last for an hour or more go way for a while and then come back again. As I'm writing this, I've had the AD, abdomen and back spasms off and on (more on then off) for about three hours. My back and abdomen have pretty much been spasming the whole time.

    I just saw my urologist on Monday, and he suggested trying Flomax, I started taking it Monday night and I think it's made it worse instead of better. Before Monday, I had urinated in bed three or four different times, absolutely soaking the "Chuck" (nickname for disposable under pad) that I lay on at night. Monday night my pants were mildly wet and Tuesday and Wednesday night, they were soaked as they are right now.

    Being a quad for 29 years, I definitely have the quad gut and my urologist placed the catheter so low it's actually under my gut when I'm sitting up. I was wondering if my gut is putting too much pressure on my bladder or the area of the suprapubic causing it not drain completely? I asked my urologist about this and he said "No that wouldn't happen". Of course he's been wrong before though as he told me my urethra or couldn't be kinking when I'm setting up.

    The suprapubic worked great when I first got it, all this just started happening a week or two ago, with the exception of urinating in bed once or twice. I definitely don't want to have to start wearing an external catheter, along with the suprapubic, that's one of the reasons I decided to go ahead with the surgery.

    Has anybody here encountered the same problem? Any ideas on how I can keep dry and get my bladder to stop spasming? I assume with the suprapubic would work properly in empty my bladder completely these problems would be taken care of.

  3. #3
    Senior Member
    Join Date
    Jan 2003
    Location
    Madison,Wisconsin, USA
    Posts
    1,491
    Jim has had a S/P tube for 7 years, the only time he has leaked through the penis is when he has had a UTI or clogged at catheter tip with "grit". I just put a condom cath on til the antibiotics kicked in when he had the UTI (only a day or so) and changing the S/P tube after a few days of antibiotics, and I change the catheter when he had the "grit" problem. So I guess I would make sure you're not having either of these problems first. The "grit" is detectable by changing the catheter, splitting the old one near the eyelets to see if there is clogging there.

  4. #4
    how much of the SP sticks out also can it be clamped for the start so theres no shrinking in size. wise any others

  5. #5
    Quote Originally Posted by joev
    how much of the SP sticks out also can it be clamped for the start so theres no shrinking in size. wise any others
    joev,

    I am not sure that I understand your question. The suprapubic catheter sticks into the bladder and the other end goes into a bag. You clamp it so that urine is not draining out all the time. This may help preserve or increase the size of the bladder. Clamping

    A couple of years ago, I did a review of the literature on the subject (Source). Here is a web site with instructions concerning how to take care of suprapubic catheters (Source). There have been previous discussions of suprapublic catheters here:
    Effects of long term foley use on bladder capacity

    See
    Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

    Wise.

  6. #6
    Sorry i wanted to know how much of the SP sticks out of your body, also can it be clamped form the start meaning once its put in and drian it every few hours so theres no shrinking in size

  7. #7
    Wise,

    I meant to get back to you sometime back, but my computer crashed.

    The sphincter not opening was discussed when I was having my problem of not being able to urinate on setting up, but it didn't explain why I could urinate fine laying down, but had problems when I was sitting up. If you have time, you can check the following post where I better described the problems I was having: Click Here and on page 2 KLD directed me to a few links that talk in detail about a kinked urethra. When reading them, it sounded exactly like my problem.

    I faxed my question above and your response to my urologist, he disagrees with you about the bladder shrinking, although I have heard of that before, so now it's just a question of who's right and who do I believe? He suggested stopping the Flomax and other than that just said, give it some time. That's one luxury I really don't have right now as I'm tired of having wet pants at night and I'm sure it's only a matter of time before I get a breakdown from sitting in urine. It's also a lot more work for my primary caregivers, and also the A/D and back and abdomen spasms are getting rather unbearable. I pretty much had it all day today, and it got very bad this evening. I finally laid down and tried changing my catheter. So far so good, hopefully it will help.

    Before I laid down I emptied my leg bag witch had 450 cc's and immediately after laying down, I had another 350 cc's drain out.. This has been my experience when lying down at night also, that upon lying down, my bladder empties. I just don't understand why it's not emptying through the suprapubic when I'm setting up and actually while I'm sleeping as well. I also don't understand why it worked great for about three months and then these problems popped up. When the new catheter was inserted, it went in about 4 to 6 inches before it stopped, so I don't think my bladder shrunk that much.

    Any other insights you or anybody else have are greatly appreciated!

  8. #8
    Moderator Broknwing's Avatar
    Join Date
    Mar 2004
    Location
    Central Florida
    Posts
    4,743
    dbassman-
    I don't have any answers for you, but I think that you need a better urologist...yours doesn't seem to be fully knowledgable on SCI bladder issues...IMHO he's putting you at risk w/the AD issues.
    'Chelle
    L-1 inc 11/24/03

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

  9. #9
    I would agree about stopping the Flomax. There is no point taking it with a SP catheter. How much anticholenergic medication are you taking (Ditropan, Detrol, etc.)? Most people with indwelling catheters and SCI need to take this. I never recommend clamping catheters for people with SCI as this is a sure way to get reflux, and if you are at risk, AD.

    (KLD)

  10. #10
    Quote Originally Posted by SCI-Nurse
    How much anticholenergic medication are you taking (Ditropan, Detrol, etc.)?
    I meant to put that in my post as well... I'm on Oxybutynin 5mg – 1 Tab 3x daily

    I know everyone's different, but what is the average dose for someone w/ an SP?

    Thanks!

Similar Threads

  1. Replies: 13
    Last Post: 11-04-2010, 03:48 PM
  2. suprapubic catheter and neosporin
    By jade9923 in forum Care
    Replies: 4
    Last Post: 02-07-2006, 06:55 PM
  3. New suprapubic catheter questions?
    By C5_Since_1983 in forum Care
    Replies: 11
    Last Post: 02-16-2004, 04:54 PM
  4. Replies: 9
    Last Post: 11-04-2003, 04:01 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •