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Thread: SupraPubic Ordeal

  1. #1

    SupraPubic Ordeal

    Hi everyone,

    I thought I would get some feedback on something that has happed to me. I had a SupraPubic placed recently. I went in for the surgery on 1-14-05 and everything went well. I was a bit freaked out by the tube and in ALOT of pain so I stayed in bed for two days after the surgery, got up early on the third day to go potty and as I got up into my chair I had an EXCRUCIATING PAIN in my abdomen. I actually thought it was gas pain BUT I NEVER HAVE THAT, so I was a bit concerned but went ahead to the bathroom. I noticed that my urine was tinged with blood after that and also that the catheter seemed to move more than usual. During the entire previous two days I had NO BLOOD in my urine, a bit surprising to me but GREAT. So the blood was unusual but I though perhaps expected since I had gotten up and moved around. The catheter moving more than before did concern me. About an hour later I got off the toilet and during this entire time my urine was more bloody and about 40cc at most. Got into the shower and became alarmed that I didn't appear to be making more urine during this whole time. I drink coffee and usually pee alot in the AM. Rushed out of the shower to call the Dr. knowing his office wouldn't be open yet. As it happens I called right as they opened up. Talked with the nurse and told her the entire story. She said she would call me back after speaking to the Dr. She, not Dr. called me back and said Dr. was busy with surgery until 1pm. That there was probably nothing to be concerned about and to come in between 1&4 just to "put my mind at ease".

    After drinking a quart of water (which I do every morning) and no peeing for TWO HRS and a strong sensation that I had to pee, I called back to tell them I was going to the ER and to call ahead because something was definitely wrong. The nurse put me on hold to get the DR and came back on the phone and said to come in NOW. Luckily, I had called my partner earlier and told her to come home as I needed to go to the Dr. that afternoon. She got there just as I hung up with the nurse the second time and we rushed to the Dr. All this time I'm in bad pain because I NEED TO PEE and not to mention worried as all getout. Did I mention that there was urine coming out of my cath site? I told that to the nurse as well.

    GOT THE PICTURE?

    So, we get to the Dr. office and I'm left in the waiting room for AT LEAST 20 min. Jonny was fit to be tied and I was in tears. UNBELIEVABLE. Finally I was taken back and the Dr. looked at the cath site and told the nurse to irrigate, because it was probably clogged. Dr. then left the room. Nurse irrigated and got nothing, did this several times. Then she went to get the Dr. who came in to scope my bladder, he found that the catheter balloon had burst and the catheter was in the abdomen wall "no wonder you're in pain" he says. He cathed me and then the PAIN got real bad, I'm moaning and doing my best not to scream. He says I need to go to the hospital and be admitted for several days of antibiotics and pain meds. They called the squad and off I went.

    I was there for 3 days and have been home since Thursday. I have Peritonitis, meaning urine and whatever got into the peritoneal cavity and caused pain and infection. I've read the pain could last for a long time.
    What an ordeal. The hospital stay was just ducky (heavy sarcasm). I never want to go back.

    Would you go back to this Dr?

    Thanks for listening,

    River

  2. #2
    I would go back to him only after having a serious talk with him about his office staff (are you sure it was a nurse and not an aide or clerk you talked to??) and his and their responsiveness to true emergencies.

    Unfortunately the complication you experienced can happen even with the best placement procedure, but pain or lack of drainage of urine in the first several days of a SP placement should be a red flag for this type of complication and it should be addressed immediately. Unfortunately the irrigation probably just made your peritonitis worse. I would not have considered this standard of care for a possibly displaced SP catheter or broken balloon when these can fairly easily be determined to be the problem by inspection of the balloon arm on the catheter, by a pelvic Xray or ultrasound, or a urethral cystoscopy.

    If you don't feel satisfied with your discussion with the physician (which should be a no-charge office visit in his office, not an exam room), then you may feel more comfortable changing urologists.

    (KLD)

  3. #3
    sorry to hear about your experience. i have a sp and have experienced poor medical tretment. my wife and i immediately wrote a letter to the director of the ER and complained. also had some serious conversations w/ my urologist. dont be afraid to keep calling and asking questions. we bug the crap out of them, but you have too, its serious. if you were AD that is a medical emergency. i have heard from other quads w/ sp's and now we always carry a straight catheter wherever we gojust in case we need to cath.

    i have one question.....what is peritontis?

  4. #4
    Peritonitis is infection and inflammation of the lining of the abdominal wall (inside). It can occur anytime urine or the contents of your bowel are spilled into the abdominal cavity (where they don't belong).Before antibiotics, it was a major killer caused by things like a ruptured appendix, perforated ulcer, gunshot wounds to the abdomen, etc. It killed both Presidents McKinley and Garfield as well as Rudolph Valentino. You can get quite ill from this, and nearly always if identified early it can be successfully treated with antibiotics, but often the recovery is slow.

    (KLD)

  5. #5
    Hi SCI Nurse:
    You have no idea how much I appreciate your reply. I have several comments:

    1. How does one tell if the balloon is inflated by looking at the balloon arm?
    2.He discovered the problem when doing a cystoscopy, then he cathed me and of course got lots of urine.
    3. I spoke with whoever answers the "nurse" line at the Dr's office.
    THanks,

    River

  6. #6
    You can withdraw the fluid from the inflation arm (you need a syringe) and then put it back. If there is no fluid there, it is not inflated. If you get back urine, esp. a lot (more than the 5-10cc. that should be inside) then it is likely the balloon is broken. Ask your physician or a nurse (RN or LVN) to show you how to do this.

    Once you have had your SP catheter for 4-6 weeks, changes can be done by you or a caregiver. Learn how to do this the right way so you know what to do if it should clog. There is no reason this needs to be done in a doctor's office or ER and the technique is not difficult to learn. It does need to be done using sterile technique.

    (KLD)

  7. #7
    Thanks SCI Nurse,
    My SP was removed and I have to have another surgery at a later date. That is, if I decide to go through with it.

    River

  8. #8
    Thanks for sharing your story River61.

    I've had a standard in-dwelling catheter for 10 years and my urologist has suggested I switch to a suprapubic (I have a lot of problems with the current one: severe AD when changed, changes triggering UTIs from irritation, epididymitis, and what might be a tumor). I'd like to switch, but hearing stories like this makes me incredibly wary.

    I'm definitely going to ask him about Peritonitis now.

    Thanks.

    "I'm lost. I'm no guide, but I'm by your side." - Pearl Jam

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