Suprapubic tube

[gjnl]

Hi Linda,
Welcome to the Care Cure Community.
Here are some thread for you to read and study:

http://sci.rutgers.edu/forum/showthr...yn+open+letter
http://sci.rutgers.edu/forum/showthr...wash+vetericyn
http://sci.rutgers.edu/forum/showthr...wash+vetericyn
http://sci.rutgers.edu/forum/showthr...ericyn+summary

Many of us in the Care Cure Community have adopted this technique with very good results.

Here is another thread you may find helpful:

http://sci.rutgers.edu/forum/showthread.php?t=93494

Try using the search feature on this website. Search for supra pubic catheter or SPC. You may need to look at your technique of care for the supra pubic catheter.
How often does your boyfriend change the catheter? Does he use sterile technique
How often does he change the urine collection leg bag?
How does he clean the leg bag? the night drain bag?
How does he clean the stoma are?
Does he secure the tube to avoid movement of the tube in and out of the hole?
How much water does he drink every day?

All the best,
GJ

[SCI-Nurse]

Originally Posted by Linda Sowder

I am asking this question for my boyfriend. How do you keep from having uti's? He has one every 3 or 4 weeks. He has a supra pubic catheter. We assue those little germs are making there way in through the whole where the tubing goes. Urologist is not helpful at all.

When you say UTIs, do you mean a positive culture without symptoms (which is normal with an indwelling catheter, called "colonization" and generally not to be considered a UTI or treated), or a real UTI with fever, chills, flank pain, malaise, bad AD, etc.??? The former should not be treated with a few exceptions. Only the latter should be treated with antibiotics, and then with a 10-14 day course. Of course it is also critical to rule out stones, which are more common in those who use urinary catheters. Has he had recent tests for these (anywhere in the urinary tract)?

Does he have a spinal cord injury or what is his disability? Is his urologist an expert in neurologic urology?

(KLD)

[white]

hi Tim, i found this site...no bag system http://www.truflovalve.com/default.html

[gjnl]

Originally Posted by white

hi Tim, i found this site...no bag system http://www.truflovalve.com/default.html

This is not a good idea at all for people with a neurogenic bladder. This valve is like clamping a catheter and it is a dangerous practice.

Here are two responses from one of our SCI nurses about clamping indwelling catheters.
Originally Posted by KLD
It is not safe to clamp off either a urethral or a suprapubic catheter. Because these are foreign bodies inside the bladder, you are much more likely to be colonized with more and larger numbers of bacteria in your urine than someone who does intermittent cath or uses only external catheters. Clamping off the catheter significantly increses the risk of reflux of urine from the bladder to the kidneys. This can make bacteria travel to the kidney, and can cause bladder damage through hydrostatic pressure (a condition called hydronephrosis). If you are subject to autonomic dysreflexia, it can definately cause AD too.

Anticholenergic drugs are often recommended with indwelling catheters (either urethral or SP) as they reduce bladder shrinkage, reduce bladder spasms that can cause leakage, and also reduce the risk of reflux of contaminated urine up to the kidney.
(KLD)

and

Clamping of catheters to increase or maintain bladder capacity when out in the 1980s and has been shown to be ineffective and actually potentially dangerous. It can cause AD, and worse yet, reflux of contaminated (colonized) urine up the ureters to the kidneys, significantly increasing the risks for major UTIs with kidney infection.
(KLD)

All the best,
GJ

[mike b]

I certainly agree that clamping is not a good idea for some people, like with SCI. However for myself, aside from using a night bag at bedtime, I use a catheter plug. Now before I receive negative response, I have the ok to do this by not just my urologist, but the opinion of two others as well. For more than 2 1/2 years I have received an annual bladder scan, a urinary cat scan with contrast, and have had 1 uro flow test. Up to this point, test results have been fine. I can safely hold more than 450 cc's, and I empty far before that point, so reflux has not been an issue. I did have reflux and flank pain before I was relieved first with an indwelling catheter . I couldn't self cath due to discomfort and I could never do that at work (I work in a shop environment and wear paint suits most of the day and covered in sanding dust as well). Since going to a SP, my ureter dilation and kidneys have healed with little permanent damage. I empty every 2 hours or so, have had very few uti's, I weight lift 2 to 3 times a week, and take good care of myself. I know I have been debated over clamping, and I agree with the nurses and others here, but aside from most here that have SCI, not all have to leg bag. I did have to where a leg bag the first three months of the SP catheter though, and the month and a half before that, but not since. I'm not trying to disagree, just giving another side of the coin.

[SCI-Nurse]

Mike - I appreciate that you have a different opinion. My concern is that while you may have done fine so far, the kidney and ureteral damage that can be done happens silently - and by the time you know it, you may have other issues to deal with. Please just keep that in mind.
CKF

[smashms]

Mike your practice is extremely dangerous, take it from me i now have permenant kidney damage because i hated to cath so never did, when i actually would void it was because it was from overflow not because i was actually emptying all the way.

[Phil Bishop]

It seems like a lot of catheter problems are being mentioned lately. I have used a 24(Fr) silicone SP catheter for years with not too many problems other than an occasional blockage from sediment. I change the catheter every 6 weeks. Last week it quit draining, so it was changed. New one did the same, as did the 3rd. No gunk, blockage, or anything was found in them. We found that if the balloon was not filled with water (5cc) it drains fine. Could this possibly be a bad batch of catheters? I am seeing my Dr. on Thursday. I do take oxybutinin for bladder spasms. Any ideas would be appreciated.

[mike b]

smashms, voiding from pressure is absolutely dangerous. I'm sorry you had to find out the hard way. And to CKF, I know you have everyone's well being in mind, and I respect your opinion.