How To Care For Your Suprapubic Catheter

WHAT YOU SHOULD KNOW:

A suprapubic catheter is a sterile (germ-free) tube that drains urine out of your bladder. It is inserted through a stoma (created opening) in your abdomen and into the bladder. The catheter has a small balloon filled with solution that holds the catheter inside your bladder. Suprapubic catheters are used when you have problems urinating because of a medical condition. A suprapubic catheter is also called an indwelling urinary catheter.

INSTRUCTIONS:

Catheter problem signs:

Know the signs of problems related to your catheter:

  • Lower abdomen pain: This can be a sign of infection. You may also have pain if the catheter is in the wrong place.

  • Urine leaking from your stoma or urethra: Wet clothes or a wet bed may be signs that your catheter is not draining as it should. You may get some leaking of urine from your stoma or urethra if you have bladder spasms. A lot of urine leaking is not normal. The catheter may be blocked or in the wrong position. The drainage tubing may be blocked or kinked. Leaking urine can also be a sign of infection.

  • No urine draining from the catheter: No urine drainage for 6 to 8 hours is a sign that your catheter is not working properly. Pain or fullness in you lower abdomen can also be signs of catheter blockage or infection. You may also feel restless. If you have any of these signs, do the following:

    • Check to see if the urine tubing is twisted or bent or if you are lying on the catheter or tubing.

    • Make sure the urine bag and tubing are located below the level of your waist

    • Move to a different position.

    • Contact your primary care provider immediately if there is still no urine draining or if you continue to have pain or fullness or feel restless.

Suprapubic catheter change problems:

Know what to do if you have any of these problems:

  • Unplanned catheter change: Your catheter may accidently fall out or be pulled out. You or a person who helps care for you will need to learn how to put in a new catheter. This must be done right away. Your stoma can start to close up quickly if it does not have a catheter in it.

  • Old catheter does not come out easily: Some types of catheter balloons get ridges on them or may hold their inflated shape after the water is removed. You may need a different type of catheter if this happens. A catheter that does not come out easily can damage your stoma and increase your risk for infection. Tell your primary healthcare provider if you have problems with removing your old catheter.

  • Not able to insert the new catheter: If you have trouble, cover the stoma with a sterile bandage and call your primary healthcare provider right away.

  • New catheter balloon in the wrong place: A catheter balloon that is in the wrong place may cause pain when you try to fill it.

    • Not inserted deep enough: This can cause pain and may damage your stoma if the catheter balloon is in the stoma when the balloon is filled. Damage to your stoma can make inserting a new catheter harder or lead to an infection. Insert more of the catheter and try to fill the balloon again.

    • Inserted too deep: A catheter that is inserted too far into your bladder can pass into your urethra. This can cause pain and leaking urine when the balloon is filled. In women the end of the new catheter may poke out of the urethra. Your catheter will not drain urine as it should if this happens and may damage your urethra. Pull the catheter back several inches and try to fill the balloon again. Tell your primary healthcare provider if this happens.

Prevent infections:

Urinary catheter-based infections are common and can lead to serious illness and death. Proper care and cleaning of the catheter, the insertion site, and the urine drainage bag can help prevent infection. The following are ways you can help prevent catheter-based infections:

  • Drinking liquids: Adults should drink about 9 to 13 cups of liquid each day. One cup is 8 ounces. Good choices of liquids for most people include water, juice, and milk. Coffee, soup, and fruit may be counted in your daily liquid amount. Ask your caregiver how much liquid you should drink each day.

  • Good hand hygiene is the best way to prevent infections . Always wash your hands with soap and water before and after you touch your catheter, tubing, or drainage bag. Do this to remove germs on your hands before you touch these items. Do this after you touch these items to remove germs that may have been on them. Wear clean medical gloves when you care for your catheter or disconnect the drainage bag. This will help stop germs from getting into your catheter. Remind anyone who cares for your catheter or drainage system to wash his or her hands.

  • Ask your primary healthcare provider when your catheter will be removed or replaced with a new one. Your risk for infection is greater the longer you have a catheter.

  • Always do proper care and cleaning of the catheter, its insertion site, and the drainage bag.

  • Keep the catheter drainage system closed.

  • Keep the catheter tube secured to your skin or leg so that it drains well.

Prevent drainage bag problems:

  • Use good hand hygiene: Keep your hands clean and as free of germs as possible. Always wash your hands before and after you touch the catheter or the insertion site. Wear clean medical gloves when you care for your catheter.

  • Allow gravity drainage and position the drainage bag properly: Do not loop or kink the tubing so urine can flow out. Keep the drainage bag below the level of your waist. This helps stop urine from moving back up the tubing and into your bladder.

  • Keep the bag off the floor: Do not let the drainage bag touch or lie on the floor.

  • Empty the drainage bag when needed: The weight of a full drainage bag can pull on and hurt your stoma. Empty the drainage bag every 3 to 6 hours or when it is ½ to ⅔ full.

  • Clean and change the drainage bag as directed: Ask your primary healthcare provider how often you should change the drainage bag. You may buy a special solution to clean the drainage bag, or you may make a solution with household bleach or vinegar and tap water. Wear medical gloves if you must disconnect the tubing. Do not allow the end of the catheter or tubing to touch anything. Clean the ends with a new alcohol pad or as directed before you reconnect them.

Prevent catheter and stoma problems:

  • Stoma site care: Clean the skin around your stoma every day or as directed by your primary healthcare provider. Keep the area clean and dry to prevent skin problems. Look for redness, skin injuries, red spots, drainage, and swelling. Report any skin changes to your primary healthcare provider.

  • Know how far to insert your new catheter: Know how far to insert the new catheter to prevent it from being in the stoma or urethra. Check the catheter position if you have discomfort or pain when you fill the catheter balloon.

  • Prevent stoma damage or loss of stoma: Tell your primary healthcare provider if you have problems removing a catheter. A catheter that does not come out easily can damage your stoma and increases your risk for infection. You may need a different type of catheter. Your stoma can start to close off quickly if you wait longer than 5 to 10 minutes to insert a new one. Make sure you always have enough supplies to be able to change your catheter. Always keep an extra catheter with you. Caregivers may be able to save your stoma if you seek care immediately .

  • Prevent blockage of catheter or tubing: Signs that your catheter or tubing is blocked or kinked include urine leaking from your stoma or urethra or urine not draining at all. Your risk for infection increases if the tube is blocked. Keep the tubing in a straight line when you hang your drainage bag to prevent it from getting blocked.

  • Secure your catheter well: Catheters that are not secured can pull at the insertion site. This causes the stoma to get bigger and urine may start to leak out of the stoma. Make sure the device holding your catheter does not block the tubing. Change how you secure the catheter if you develop an overgrowth of skin at the insertion site. Secure the catheter in a different direction than usual, or secure the drainage bag to your other leg.

Take your medicine as directed.

Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

Contact your primary healthcare provider if:

  • You have a fever.

  • You have changes in how your urine looks or smells, or you have blood in your urine.

  • You have overgrowth of skin at the insertion site that is getting larger.

  • Urine keeps draining out of the catheter insertion site or from your urethra.

  • There is less urine than usual or no urine draining into the drainage bag.

  • The closed drainage system has accidently come open or apart.

  • Your catheter keeps getting blocked.

  • Your catheter came out and you have replaced it with a new one.

Return to the emergency department if:

  • Your catheter becomes blocked and you cannot reach your primary care provider.

  • Your catheter comes out and you cannot replace it yourself.

  • Your insertion site is red, has green or yellow discharge, smells bad, or is bleeding more than usual.

  • You have pain in your hip, back, pelvis, or lower abdomen.

  • You are confused or have other changes in the way that you think.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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