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Suprapubic Catheter Care

Topic Overview

What is a suprapubic catheter?

A suprapubic catheter is a thin, sterile tube used to drain urine from your bladder when you cannot urinate. This type of catheter is used if you aren't able to use a catheter that is inserted into the urethra. The urethra carries urine from the bladder out of the body.

An opening between your bladder and your abdomen must be made first. This can be done from the inside of the bladder out through the abdomen or from the outside of the abdomen into the bladder.

Your doctor inserts the catheter into the bladder through a cut (incision) in your lower belly, just above the pubic bone.

When the catheter is in the bladder, a small balloon is inflated to keep the catheter in place.

The urine drains from the bladder into a bag that is usually attached to the thigh. Sometimes the catheter tube has a valve that lets you drain the urine into the toilet or other container.

You may need this type of catheter if you have nerve damage or if you have problems with your bladder or urethra.

How long you have the catheter depends on why you have it. Many people need it for long periods of time.

Having a catheter for a long time increases the risk of getting a urinary tract infection. Home care focuses on preventing infection.

How do you care for the catheter?

  • Always wash your hands with soap and water before and after handling your catheter.
  • Make sure that the catheter tubing does not get twisted or kinked, and that urine is flowing out of the catheter into the urine collection bag.
  • Keep the urine collection bag below the level of your bladder.
  • Make sure that the urine collection bag does not drag and pull on the catheter.
  • You can shower with your catheter and urine collection bag in place unless you have been told not to.
  • Clean the bag every day after removing it from the catheter. Use another container while you clean the bag. To clean the bag, fill it with 2 parts vinegar to 3 parts water and let it stand for 20 minutes. Then empty it out, and let it air-dry.

How do you clean the drainage bag?

Before you start, clean and disinfect the area where you will be working, such as the sink and counter. Then follow these steps:
1. Wash your hands really well with soap and water or use alcohol-based hand rub.
2. Make sure you have everything you need:

· Clear liquid soap (regular dish soap is fine).
· A clean measuring cup.
· 1:1 water and vinegar solution. Mix together 1 part white vinegar and 1 part water (for example, 1 cup of vinegar and 1 cup of water).
· A clean, 60 mL catheter-tip syringe or a squeeze bottle.
· A clean towel or paper towels for a clean workspace.
· Clean gloves (optional).
· Alcohol or chlorhexidine swabs.

3. Put on the gloves, if worn.
4. Empty the drainage bag and disconnect the tube. Connect alternate drainage bag. Wipe all ends with alcohol or chlorhexidine swabs before you reconnect.
5. Add a few drops of liquid soap to 1 cup of water in the squeeze bottle.
6. Squeeze the soapy water into the drainage bag.
7. Gently shake the soapy water around in the drainage bag to loosen anything that might be stuck inside. Rub and shake the sides of the bag. Make sure the whole bag is clean, including the drainage spout and tubing.
8. Pour out the soapy water through the drainage spout and tubing. Flush the drainage bag with tap water, until the water runs clear through tubing and spout. Check to make sure there is no soap left in the bag, spout, and tubing.
9. Put the vinegar and water solution in the syringe or squeeze bottle, and squeeze it into the drainage bag to rinse it out. Shake the bag around and let it sit for 15 minutes. Then rinse the bag out with cool tap water and let it air dry.
10. Empty and wash the squeeze bottle or syringe after every time you use it. Wash it with hot, soapy water, then rinse it and let it air dry. Throw out the syringe or squeeze bottle if it:

· Looks damaged or broken.
· Changes colour (discoloured).
· Feels different than usual (for example, it feels harder, more brittle, or softer).

11. Take off the gloves (if you wore them) and wash your hands.

Important things to remember

When cleaning, check the drainage bag for damage (such as holes or tears) and to see if it’s discoloured.
Throw out the drainage bag and use a new bag every 7 days. Use a new bag right away if the one you’re using is:

· Damaged.
· Discoloured.
· Stiff and brittle.
· Smelly even after you clean it.

Let the drainage bag, spout, and tubing dry on a clean, dry surface after you clean them. Make sure the spout, connector, and tubing don’t touch anything. Wipe all ends with alcohol or chlorhexidine swabs before you reconnect them.

How do you care for your incision?

Clean the area around the catheter with soap and water once a day.

How do you empty the drainage bag?

Empty the drainage bag when it is full or at least every 8 hours.

  • Wash your hands with soap and water. If you are emptying another person's collection bag, you may wish to wear disposable gloves.
  • Remove the drain spout from its sleeve at the bottom of the collection bag. Open the valve on the spout.
  • Let the urine flow out of the bag and into the toilet or a container. Do not let the tubing or drain spout touch anything.
  • After you empty the bag, wipe off any liquid on the end of the drain spout. Close the valve and put the drain spout back into its sleeve at the bottom of the collection bag.
  • Wash your hands again with soap and water.

How do you replace your catheter?

Your catheter may have to be replaced every 29 days. A caregiver may do this for you.

You may be given a catheter kit that has the supplies you need. If you have not received a kit, ask your doctor what you'll need. Some of the things you'll need include a new catheter, syringes, sterile fluid, gloves, skin cleaning supplies, and lubricant.

Here are general instructions for replacing the catheter. Your doctor, nurse, or home health care worker may give you more specific instructions.

Removing the catheter

  • Wash your hands with soap and water, and put on gloves.
  • Fill a syringe with the fluid provided in the catheter kit.
  • If there is a dressing on the insertion site, remove it. Clean the area around the catheter with the supplies from the catheter kit.
  • Use another syringe to take out the water from the catheter balloon.
  • Hold the catheter close to where it goes into your belly. Gently pull the catheter up and away from you until it comes out.

Putting a new catheter in

Don't wait to put in the new catheter. If you wait, the opening can close.

  • Wash your hands and put on a new pair of sterile gloves.
  • Lubricate the catheter tip and push it through the opening in your belly. Push it in as far as the other catheter was placed.
  • When the catheter is in place, urine should begin to flow through it. This may take a few minutes.
  • Inflate the balloon using the first syringe, which you filled with fluid from the kit.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • Your catheter becomes blocked and urine does not collect in the drainage bag.
  • Your catheter leaks.
  • You have blood or pus in your urine.
  • You have pain in your back just below your rib cage. This is called flank pain.
  • You have a fever, chills, or body aches.
  • You have groin or belly pain.
  • Your urine is cloudy or smells bad.
  • You have pain, increasing redness, or bleeding around the catheter.
  • You have swelling around the catheter or in your belly.

Credits

Adaptation Date: 7/30/2020

Adapted By: Alberta Health Services

Adaptation Reviewed By: Alberta Health Services

Adapted with permission from copyrighted materials from Healthwise, Incorporated (Healthwise). This information does not replace the advice of a doctor. Healthwise disclaims any warranty and is not responsible or liable for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.