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.

AFTER YOU LEAVE:

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.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Prevent suprapubic catheter-based 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.
    Handwashing


  • 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.

  • 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.

Care of your drainage bag:

  • 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.

  • Position the drainage bag and tubing:

    • Allow gravity drainage: Do not loop or kink the tubing so urine can flow out.

    • Position the drainage bag properly: 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.

    • Place a large container on the floor next to your chair. You may also hold the urine bag over the toilet.

    • Remove the drain spout from its sleeve at the bottom of the urine bag. Do not touch the tip. Open the slide valve on the spout.

    • Let the urine flow out of the urine bag into the container or toilet. Do not let the drainage tube touch anything.

    • Clean the end of the drain spout when the bag is empty. Ask your primary healthcare provider which cleaning solution is best to use.

    • Close the slide valve and put the drain spout into its sleeve at the bottom of the urine bag. Write down how much urine was in your bag if your primary healthcare provider has asked you to keep a record.

  • 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 tap water and household bleach or vinegar. 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.

Suprapubic catheter skin care:

Clean the skin around your stoma every day or as directed by your primary healthcare provider. Do the following:

  • Gather the items you will need:

    • Warm water and soap without lotions or perfumes in it

    • Clean washcloth or sterile gauze bandage

    • Clean towel

    • New gauze bandage for dressing, if used

    • Clean medical gloves

    • Trash can

  • Prepare the site:

    • Wash your hands. Put on clean gloves.

    • Gently remove the bandage, if you use one. Hold the skin around the stoma with one hand. With the other hand, gently pull any adhesive tape in the direction of hair growth. Throw the bandage in the trash can.

    • Look for redness, skin injuries, red spots, drainage, and swelling. Report any skin changes to your caregiver.

  • Clean the site:

    • Throw away your used gloves. Wash your hands, and put on clean gloves.

    • Hold the end of the catheter tube near the insertion site to keep it from being pulled out while you clean your skin.

    • Wash the catheter with a washcloth or sterile gauze bandage as directed to remove blood or other material. Start at the end near your stoma and move up the catheter, away from the stoma.

    • Clean the skin around your stoma by moving your hand in a circle away from the stoma as you clean. Clean off any mucus. Rinse the stoma and the skin around it with the washcloth or sterile gauze bandage.

    • Pat the area gently with a clean towel or gauze bandage to dry it.

  • Dress the stoma site and secure the catheter:

    • Throw away your used gloves. Wash your hands. Apply a new bandage if you use one.

    • Secure the catheter tubing with tape or the device that holds the catheter to your leg or abdomen. Do not kink or block the tubing.

How to change your suprapubic catheter:

Usually a caregiver will do routine catheter changes for you. You or someone who helps take care of you may be taught how to change the catheter if you have it for a long time. You also need to know how to change the catheter in case it comes out accidently. This must be done right away because your stoma can close quickly. Do the following to change a suprapubic catheter:

  • Gather the items you will need:

    • New catheter kit that has the catheter, lubricating gel, skin cleaning supplies, and a syringe and water for filling the catheter balloon

    • Syringe for removing the water from the balloon of the old catheter

    • Sterile medical gloves

    • Clean medical gloves, if used

    • Bandages and surgical tape, if used

    • Anesthesia (numbing) gel, if used

  • Prepare to remove the catheter:

    • Wash your hands with germ-killing soap and warm water.

    • Open the catheter pack as directed on the package or as you have been shown. Fill a syringe with sterile water as directed. Attach the drainage bag to the new catheter as directed. It can be connected to the new catheter before or after the new catheter is inserted.

    • Put on the clean gloves. Caregivers may show you how to use 2 sterile gloves on each hand when you are changing your own catheter.

    • Remove the dressing if one is used and throw it away.

    • Clean around the insertion site with saline or a cleaning solution. Remove the gloves, wash your hands, and put on new clean gloves. Do not remove the sterile gloves if you are changing your own catheter.

    • Get into a position that is comfortable for you, such as lying on your back. Use a waterproof pad underneath you in case any urine leaks out.

    • Remove the tape or device that holds the catheter to your leg or abdomen. Hold the catheter firmly and gently rotate it to loosen it.

  • Remove the old catheter:

    • Attach a syringe to the balloon port on the catheter and remove all of the water inside the catheter balloon. Throw away the syringe.

    • Have a new gauze bandage available as there may a small amount urine coming from the site after the catheter comes out.

    • Hold the catheter at a point close to the insertion site. Compare the old and new catheters by looking at where your fingers are as you hold the old catheter near the stoma. This will show you how far to insert the new one.

    • Keep your fingers on the tube close to the insertion site and gently pull the catheter up and away from you. Stop if the catheter is hard to pull and rotate it more while you press down gently.

    • Pull the catheter until it comes all of the way out and throw it away.

    • If you have problems with removing the catheter, tell your primary healthcare provider. You may need a different type of catheter. A catheter that does not come out easily can damage your stoma and increase your risk for infection.

  • Insert the new catheter: Do this within 10 minutes after you remove the old catheter.

    • Remove the gloves, wash your hands, and put on the sterile gloves. If you are changing your own catheter and wearing 2 sets of sterile gloves, remove 1 glove from each hand.

    • Put the sterile lubricating gel on the new catheter to make it easier to move through the stoma. Use anesthetic gel if directed by your primary healthcare provider.

    • Insert the new catheter.

  • Secure the new catheter:

    • Check to see that urine is draining from the catheter. When urine begins to flow through the tubing, fill the catheter balloon with the sterile water in the new syringe. Use the amount of water as directed or as stated on the catheter kit.

    • Gently move the catheter in or out a small amount if you feel pain or the balloon is hard to fill and try again. If that does not work, remove the catheter and insert a new one.

    • Clean the catheter insertion site again if needed. Apply a bandage if you use one.

    • Throw away your used gloves and wash your hands.

    • Secure the catheter tube with tape or a device. The catheter tube should be secured loosely so it does not pull on the catheter or block it.

Problems that may occur with suprapubic catheter changes:

  • 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 suprapubic catheter problems:

  • 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.

  • Prevent loss of stoma: Your stoma can start to close off quickly if it goes 5 to 10 minutes without a catheter in it. This can happen when your catheter is changed or if it comes out accidently. Make sure you 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 .

  • 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.

  • 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 pain or discomfort when you fill the catheter balloon.

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

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.

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

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

  • 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.

Seek care immediately if:

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

  • The catheter comes out and you are unable to put a new catheter in.

  • 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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