What is a suprapubic catheter? It is one of the two kinds of urinary catheters used to drain urine directly from the bladder into a drainage bag outside the body. The other kind – the more common one – is a urethral catheter, which (as it sounds) goes up through the urethra into the bladder.
Why would anyone need a suprapubic catheter? Basically you need one if the medical pros can’t put in a urethral cath for some reason. In my case it was due to a blockage in my urethra called a urethral stricture (more on what THAT is in another post here).
The docs had thought I had an enlarged prostate because I was having trouble urinating. So the day I woke up (on a weekend of course!) and couldn’t pee at all, I went into the emergency room expecting them to put a urethral catheter in until my appointment with urology the following week. I’m a guy and knew that they were going to try to stick a rubber tube up my willy (for lack of a more descriptive term:)). And so they tried.
But in the end, the stricture made it impossible to pass a tube through the urethra. So the next alternative, which is more invasive, is to poke a hole through your abdominal wall below you belly button and into your bladder, and to thread the tube into you that way. Thank goodness I had some little bit of sedation for that, because in the end, the insertion of the suprapubic catheter was much less painful than the attempts to get the urethral cath into me.
So now I have a flexible tube sticking out of my abdomen instead of coming out the end of my willy. I think that all things considered, I’d rather have the SP cath than the other kind anyway. This tube connects to two different types of drainage bag, depending on what I’m doing. The leg bag straps to my lower leg and allows me to wear long pants and go out into the world like a normal person. The bedside drainage bag has a much longer and tougher tube and allows me to sleep while the bag lay on the floor.
So that is what a suprapubic catheter is – a tube stuck through your abdominal wall and into your bladder.
Here is a video showing some diagrams of an SP catheter and giving some instructions for caring for one.
For more information on living with an SP cath, check out: https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000145.htm
Below is an example of an anti-flux (pee wont flow back from the bag) bedside drainage bag. Click the picture to purchase or for more info on it.
Curity Dover Anti-Reflux Drainage Bag 2,000 mL
suprapubic catheter changes are painfull really painfull even with morphine and seadation. I have had mine for 10 years and the changes are are painfull and are getting more painfull each time. If they say have one my advice is don’t. stick with a normal foley not painfull when changed.
Parker – I agree that they are painful the first couple of times (have to be changed monthly). But for me, the 3rd time was no pain almost at all. That’s because some scarring had occurred around the opening and they didn’t need to drop a wire in “to keep it open,” since it would be safely open for several minutes by then. It was the wire that caused all the havoc! If you have an SP tube, and have had one for many months (or even years), then maybe they are still using a guide wire? Ask if they can NOT use one next time. That might help. My advice for folks who are only going to need a cath for less than a month is go for the SP. That way they never have to get it changed, and that whole issue is moot. Sorry to hear you have such pain each time. Maybe this will help (if they don’t use a wire)?
Hi Ken …. Do you still have suprapubic catheter? How long do or did you have it… I may be getting one as my bladder does not function very well…. When you had it did you have a lot of painful spasms? How long did they last and how many did you have a day….. Did moving your bowels make the spasms worse or painful to go?
Hi Tom. No, I had my SPC for 6 months and my urethral cath for 2 weeks. with the SPC, I did not have painful spasms very often. It was just occasional little “pinches.”. But nothing like some of the pain I had BEFORE the cath went in (I had a urethral stricture). After a couple of weeks, those pretty much went away. I never had any trouble with bowel movements at all in the entire 6 months.
I am just one person. But that was my experience. And I didn’t have bladder problems. My trouble was in the urethra. I hope that helps!
Ken
yes Ken . bowel use is a problem for me .. I get on Movicol softening but still have to strain usually . And I have blood filling the cath tube . for the next 24 hours . Blood stops then a poo and blood starts again . —– DRs ans cath nurses say to drink more water . —yeah, that gives a gap in the blood flow but only temporarily .
good luck to you —not everyone is the same .
Thanks for commenting, Jeff. Absolutely – not everyone is the same. There are so many variables, not only in why you need an SPC to begin with (the underlying problem), but in how the body reacts. Hope you feel better soon!
I used to use self admitted catheter but one night it wouldn’t go the urethral structure I’m wondering will it heal and I can go back to using self admitted catheters I find them better than having this stuck out of me
Derek, a urethral stricture won’t go away by itself. It needs to be removed surgically. See my post here: https://livingwithacatheter.com/the-treatments-for-stricture-of-the-urethra/
I hope that answers your question.
Ken
Thanks for that Ken I just hope I can go back to using self admit tent catheters. Would it affect me lifting stuff as I’m a carpenter and I also have to bend a lot doing flooring and stuff.
Derek, if you are talking about after having urethroplasty surgery, there would be no need to do self-cath after that (unless something is very different with your case). And if you have that surgery, if you’re like most folks, you can go back to normal activity within weeks or sometimes months. Hope that helps.
Ken
Great stuff thanks ken it’s good to talk to someone who has gone through it. I used to self-catch due to spinal damage from a motor cycle crash but getting back doing that again will do me fine.
I have got a bad case of overactive bladder on tablets but do not work that good thinking of haveing a surper pubic catheter need help
i gaot a superpic for overactive bladder and its much better thsn going to the tollet all the time
anybody here s guadraplecic or a paraplegic I know someone who had autonomic dysreflexia has a regular foley Dr
wants to do superpubic please any ideaa?
Hi Pamela. I was never in the position to have paralysis. But I did have both types of catheter at various times. Though it seems a bit counter-intuitive, I MUCH preferred having the suprapubic catheter to the regular urethral kind. It was more convenient and less painful day-to-day. the only exception was the first 2 catheter changes. The sire they used to keep the incision open caused my bladder to spasm and THAT was painful. But after those first 2, there was enough scarring around the “hole” that they didn’t need the wire to keep it open. Then the changes were painless. I hope that information helps at least a little.
Hi Ken,
I have a question please:
Is it possible to use an SP catheter without ever using a bag? I don’t mind going to the bathroom every 3 hours or so to drain my bladder (during the day or night) through the SP catheter. Do I need to let the doctor know this request in case this is a special type of SP catheter?
Hi Andy. Yes, it’s totally possible. But you SHOULD check with the doctor first. My surgeon did NOT want me to do that prior to the surgery because i was supposed to be on bladder rest and put no pressure on it pre-surgery. But if that’s not a problem, all you need is a valve cap to put on the end of your tube where it would attach to a bag. I did it for awhile (before my doc said to stop) using the valves off of leg bags. You can just pull them off. So you don’t need a special catheter.
also, when I was doing that, I found I could only go about an hour or maybe an hour and a half. I THOUGHT that I’d be like that after they took out the cath too. but as soon as it came out, I was able to hold it for 4 hours again. So having the catheter in somehow shortened how long I could hold it.
Anyway, I hope that helps.
Thank you for your thoughtful answer. I think you mentioned on another page (sorry if I have this wrong) that you had a catheter in your urethra (the “usual” catheter) AND an SP catheter too. Why did you have both?
Also, I think you said (but I’m not sure) the urethral catheter was removed after a few weeks and the SP tube remained. If that is correct, were your able to urinate “the normal way” while you had a SP cathether?
Hi Andy. I had the SPC for 6 months while waiting for my urethroplasty, much longer than most people do. Then after the surgery, they removed the SPC and placed the urethral catheter for 10 days until the surgery site healed up.
I did not urinate “the normal way” when I had the SPC. There was no need. The catheter kept me drained. There were times when I was sitting down for #2 that some dribbled out. But that was all. 99.99999% of the pee came out from the SPC.
Okay, got it, thanks.
Did they remove the SPC immediately after the surgery (like during the surgery itself)? Why would they do that instead of continuing with the SPC while the surgery site healed?
Also how many days after the surgery were you urinating in the normal way? 10 days?
That is actually standard – putting a urethral catheter in after urethroplasty. Once they stitch the urethra back together, a catheter in that space makes sense to aid in healing and to prevent any urine going down that way, rushing over the site of the wound several times a day. It would never heal. So since there needs to be a catheter in place anyway, it doesn’t make much sense to have BOTH an SPC and a urethral catheter. Though some people here have said their doctors left theirs in, going with one in both ways. I don’t see the benefit there, but it isn’t uncommon.
to answer your other questions – yes, they removed the SPC during the surgery. And it was 10 days with the catheter in (the urethral one) after the surgery. The minute it came out, I was peeing normally. Hope that answers your questions.