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BackTable / Urology / Article
Suprapubic Catheter Indications, Care & Management
Bryant Schmitz • Updated Dec 10, 2024 • 31 hits
A suprapubic catheter is a medical device that is used to drain urine from the bladder through a small incision made in the abdominal wall, just above the pubic bone. It is often utilized when a patient cannot urinate normally through the urethra due to medical conditions or surgical procedures. This article covers the placement, care, and key considerations of suprapubic catheter use.
Table of Contents
(1) What is a Suprapubic Catheter?
(2) Suprapubic Catheter vs Foley Catheter
(3) Suprapubic Catheter Indications
(4) Suprapubic Catheter Placement
(5) Suprapubic Catheter Care
(6) Suprapubic Catheter Change
(7) How Long Can You Live with a Suprapubic Catheter?
(8) Permanent Suprapubic Catheter
(9) Conclusion
What is a Suprapubic Catheter?
A suprapubic catheter is a flexible tube inserted into the bladder through the abdominal wall, typically used for long-term urinary drainage. The catheter is usually placed under local anesthesia and guided by ultrasound or direct vision to ensure accuracy. The suprapubic catheter may be preferred over the more common Foley catheter after pelvic surgery or when the patient has more complex urinary issues, such as urethral obstruction or chronic urinary retention.
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Suprapubic Catheter vs Foley Catheter
Suprapubic and Foley catheters both serve the same purpose—urinary drainage—but differ in their method of insertion and use. A Foley catheter is inserted through the urethra, typically used for short-term drainage, and is more likely to cause urethral trauma, infection, and discomfort if used long-term.
In contrast, a suprapubic catheter is inserted through the abdominal wall, making it a better option for long-term management of urinary conditions, especially when urethral access is problematic. It also carries a lower risk of infection and offers more comfort for patients who require prolonged urinary drainage.
Suprapubic Catheter Indications
This catheter is often used for patients who require long-term urinary drainage but are unable to tolerate a Foley catheter. There are several reasons why a suprapubic catheter may be required, including:
• Chronic Urinary Retention: When the bladder is unable to empty fully, a suprapubic catheter provides a reliable means of urinary drainage.
• Urinary Tract Obstruction: Conditions such as enlarged prostate, bladder stones, or tumors that block urine flow may necessitate a suprapubic catheter for continuous drainage.
• Post-Surgical Recovery: Following pelvic or urological surgery, a suprapubic catheter may be used to bypass the urethra and prevent complications like urinary retention or infection.
Suprapubic Catheter Placement
Suprapubic catheter placement is a minimally invasive procedure typically performed under local anesthesia in a sterile environment. The procedure involves making a small incision in the abdominal wall above the pubic bone, through which the catheter is inserted directly into the bladder. The catheter is then secured in place with sutures or a retention balloon to prevent it from dislodging.
While generally safe, the procedure does carry risks such as infection, bleeding, or injury to surrounding organs. Careful patient selection and preoperative assessment are essential to minimize these risks.
Suprapubic Catheter Care
Proper care of a suprapubic catheter is essential to prevent complications such as infection, blockage, or leakage. Key aspects of catheter care include:
• Cleaning: The insertion site should be cleaned daily with mild soap and water to prevent infection.
• Monitoring for Infection: Watch for signs of infection at the insertion site, such as redness, swelling, or discharge, and ensure the catheter is properly secured.
• Hydration: Encourage adequate fluid intake to help prevent catheter blockages.
• Site Maintenance: Ensure the catheter does not get tangled or obstructed. The dressing around the insertion site should be changed regularly.
Suprapubic Catheter Change
The suprapubic catheter may need to be changed due to wear or infection after extended use. The frequency of catheter changes will vary based on patient needs but typically ranges from every 4 to 6 weeks. A healthcare professional should perform this procedure, ensuring proper technique to reduce the risk of infection and other complications.
How Long Can You Live with a Suprapubic Catheter?
A suprapubic catheter can remain in place for an extended period, depending on the patient's condition and the care regimen followed. With proper maintenance, some patients can live with a suprapubic catheter for several months or even years. However, it is essential to monitor for complications such as infection, blockage, or discomfort and address these issues promptly.
Permanent Suprapubic Catheter
For some patients, a permanent suprapubic catheter may be necessary due to chronic conditions like neurological disorders, spinal cord injuries, or bladder dysfunction. In these cases, the catheter provides ongoing urinary drainage and improves quality of life by offering greater comfort and reliability than intermittent catheterization or Foley catheters.
Conclusion
Suprapubic catheters are a vital tool in urological care, offering a safer and more comfortable alternative for long-term urinary drainage compared to Foley catheters. With appropriate placement, care, and regular monitoring, they can significantly improve the quality of life for patients with chronic urinary issues or patients recovering from pelvic surgery. Understanding the indications, placement, care requirements, and complications of suprapubic catheters is essential for healthcare providers managing these patients.
Additional resources:
[1] Quallich, S. A., Thompson, T., Jameson, J., et al. (2023). Management of patients after suprapubic catheter insertion. Urologic Nursing, 43(2), 61-73. Retrieved from https://www.suna.org/sites/default/files/download/resources/clinical_practice/unj-ma23-03.pdf
[2] Ahluwalia, R. S., Johal, N. S., Kouriefs, C., Kooiman, G., Montgomery, B. S., & Plail, R. O. (2006). Suprapubic catheterization: Indications and complications. British Journal of Urology International, 100(4), 731-734. https://doi.org/10.1111/j.1464-410X.2006.06346.x
[3] Jacob, P., Rai, B. P., & Todd, A. W. (2012). Suprapubic catheter insertion using an ultrasound-guided technique and literature review. BJU International, 110(6), 779-784. https://doi.org/10.1111/j.1464-410X.2012.11151.x
[4] Pires, C. A., & Evans, D. C. (2016). Complications of suprapubic catheters in the rehabilitation setting. Spinal Cord Series and Cases, 2, 16021. https://doi.org/10.1038/scsandc.2016.21
[5] Harrison, S. C., Lawrence, W. T., Morley, R., Pearce, I., & Taylor, J. (2011). Suprapubic catheterization in patients with chronic urinary retention: A comparison with urethral catheterization. British Journal of Urology International, 107(4), 606-609. https://doi.org/10.1111/j.1464-410X.2010.09623.x
[6] Kidd, E. A., & Stewart, L. H. (2013). Long-term suprapubic catheterization: Clinical outcomes and complications. Annals of the Royal College of Surgeons of England, 95(8), 597-600. https://doi.org/10.1308/003588413X13629960045979
Podcast Contributors
Dr. Anne Cameron
Dr. Anne Cameron is a urologist and assistant professor with University of Michigan Medical School in Ann Arbor.
Dr. Suzette Sutherland
Dr. Suzette Sutherland is the director of female urology with UW Medicine in Seattle, Washington.
Cite This Podcast
BackTable, LLC (Producer). (2023, December 27). Ep. 144 – Recurrent UTIs: Controlling Those Nasty Little Bladder Infections [Audio podcast]. Retrieved from https://www.backtable.com
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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