Suprapubic Cystostomy And Catheter Insertion

WHAT YOU SHOULD KNOW:

  • Suprapubic cystostomy is surgery to create a stoma (opening) through the abdomen and into the urinary bladder. This opening is where a catheter is inserted to drain urine. Urine is excreted from the kidneys and passes through the ureters. It is stored for a short time in the bladder before it exits through the urethra. If urine is not drained, it may lead to urinary tract infections and other problems. Cystostomy surgery may be done because the flow of urine is blocked. It may be needed for men who have a swollen or injured prostate gland. It may also be needed for people who have an injury to the urinary tract and other conditions.

  • Before the surgery, you may need to drink more fluids to fill your bladder with urine. A stoma is created by making an incision (cut) on your abdomen. Another incision is made on your bladder. A catheter (thin rubber tube) is inserted through these incisions. The continuous opening through which the catheter is inserted is made to heal for long term use of a catheter. Having a suprapubic cystostomy done and catheter inserted may help drain your urine properly and relieve symptoms of urinary retention or blockage.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Suprapubic cystostomy surgery has some risks. You may get an infection or bleed more than expected. You may get blood clots or have trouble breathing. Caregivers will watch you closely for these problems. Your internal organs or blood vessels may be damaged during surgery. Having a suprapubic catheter may cause urinary tract infections and bladder irritation. Long term use can also lead to formation of kidney stones, blood in the urine, and swelling of the bladder. Catheters used over a period of time can also develop problems which make them very hard to remove and replace.

  • If you do not have the surgery, symptoms of urinary retention may become even worse. The symptoms of urinary retention or obstruction will be relieved by having suprapubic cystostomy and catheter insertion. The condition causing the symptoms may need further treatment. Talk to your caregiver if you are worried about these risks and for information about further treatment that might be needed.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.

  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

During your surgery:

  • You are asked to change into a hospital gown. You may be given local or general anesthesia to control the pain during the surgery. A caregiver cleans your abdomen (stomach) and clean sheets are put on you.

  • A small incision (cut) is made on your abdomen (stomach) below your belly button. A caregiver may use a syringe with a needle to get urine directly from your full bladder. This is done to find and identify the bladder. Special devices, such as urethral sounds and retrograde bougies, may be used to prevent damaging nearby organs. Another small incision will be made on the bladder where the catheter will be inserted. Once the catheter is in place, the balloon on the end of the catheter will be filled with sterile water. This balloon keeps the catheter in place inside the bladder. The other end of the catheter will be connected to a clean drainage bag, or closed with a valve. The catheter may be secured in the stoma with sutures (threads) or surgical tape.

After your surgery:

  • You are taken to a room where you can rest. Caregivers will check on you. When they see that you are ready, you may be able to go home. If you are staying in the hospital, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK. A bandage is placed around your stoma to keep the area clean and dry to help prevent infection. A caregiver may remove the bandage soon after your surgery to check the stoma.

  • Medicines: You may be given the following medicines:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

© 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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