Super Supra Pubic Catheters

1,776 thoughts on “Super Supra Pubic Catheters”

1. My husband who is quadriplegic has a spc, the problem we have is the tube running from his stomach smells. He downs water all day. thats pretty much all he drinks. I can’t handle the smell anymore. Do you have any suggestions?

2. Jeff: No! Don’t ever cut the end off a catheter if you intend to use it. Read all the comments above for ways to reduce sediment. Soft water is fine. Spasming can actually be good for sediments sake. You see, when your bladder is dormant sediment builds up as a lining, think of it like an eggshell inside your bladder. Spasming (especially bladder spasm) breaks the eggshell up and away from the bladder wall so you can pass it. Studies show all people have more sediment in their urine of a morning than night. They believe this is due to two main reasons. 1; No fluids for eight hours. 2; When sleeping our bladder like all muscles is dormant. When we wake and start moving around the sediment gets broken and stirred up. I know what you mean though Jeff, some days my legs spasm so bad I want to cut them off. Antispasmodic drugs like Baclofen, Ranitidine and/or passive exercises (someone stretching your legs for you) can help ease spasming. Michelle: It sounds like he has a site infection. Your doctor can take a swab have it tested then prescribe antibiotics if needed. Meanwhile (well always), keep hair trimmed back away from the site. Clean around the Supra Pubic Tube morning and night with a sterile solution or alcohol wipes. Exposure to sunlight, saltwater baths, keeping the site dry and allowing air flow will also help.

3. Hi Graham. My 6 year old nephew had a supra pubic catheter put in about two weeks ago. He is having terrible pain during the night and no problems during the day. Any suggestions, we are flushing the superpubic tube daily or rather nightly when the pain comes and there does seem to be a lot of sediment.

4. G’Day Lori, Can he tell you where the pain is? Avoid flushing, it’s a last resort when all else fails (see comments above for sediment reducing tips). Post op once clear of blood clots most never need to flush and pass sediment just fine. I would look for a different cause of pain like a UTI (Urinary Tract Infection) or medication side effects and cut flushing back to every second night, third, forth until you only do it weekly. Stay weekly for awhile and monitor sediment. If no problems drop flushing all together. I’ve only flushed my catheters maybe 5 times in the last 10 years. That was only because we suspected it blocked and pushed sterile water in to try and clear it. Sediment doesn’t cause pain, a blocked catheter can. If it is blocked he should bypass urine via his penis. Just monitor his output. In short, if it doesn’t require flushing don’t flush it. All your doing is opening up an avenue for UTI. If his pain is at the site (the Supra Pubic Catheter entry point) gently apply some baby’s teething gel or similar Lidocaine based numbing agent around the site at night. Let us know how you get on. Have a great day!

5. Graham, How often should you or is it ok to irrigate the sp catheter?

6. Hi Robin, Yes flushing and irrigating are the same thing. Generally it’s only done post-op for a couple of weeks to prevent blood clots blocking the catheter. Or when sediment is very heavy and blocking catheter, even then it’s not a good long term solution. So as above, I don’t recommend irrigation’s unless you really need to. It exposes you to risk of infection, electrolyte imbalance, cost of supplies and there’s always the possibility you may damage your bladder. Additionally some people especially those with quadriplegia just feel plain awful after irrigation’s. For most drinking 3 liters (6.3 pints) or more per day is enough to avoid the need to irrigate.

7. I am a quadriplegic and my doctor is wanting me to get the super pubic catheter do you think it is a good ideal? I have had a indwelling for 9 years and have suffered with UTI’s and bladder stones off and on the whole time. Will it cut down on these?

8. Hi Michael, I have quadriplegia too, C4 complete and an SPC. Yes I think it’s a good idea. Here are some pro/con statistics. The incidence of Urinary Tract Infections is significantly lower with Supra Pubic Catheterization (SPC) 12% compared to Indwelling Urethra Catheterization (IDC) approx 16% and Clean Intermittent Catheterization (CIC) 26%. However, the incidence of bladder stones and possibly kidney stones increases with SPC 9% compared to IDC 4%. Over a 10 year period approx 36% of people with long term SPC will develop bladder stones. Amongst this 36% a high urinary pH is common. With all three catheterization methods above, in the first 10 years the incidence of bladder cancer tumors increases slightly 3.8% and in 10 to 30 years 9%. While higher, it’s not a significantly higher occurrence rate than that of the general population. Bladder cancer incidence for SPC and CIC at 0.7% compared with Indwelling Urethral Catheterization IDC at 0.17% is also of little significance. Indwelling SPC and IDC catheters do not eliminate the need to take bladder spasticity medication also beneficial in CIC. The anti-cholinergic oxybutinin (Ditropan etc) medication for users of indwelling catheters significantly reduces the incidence of kidney damage at 3% compared to 23% in those not taking oxybutinin. An SPC markedly lowers bladder pressure, improves bladder morphology, and abolishes ureteral reflux. So in short, Supra Pubic Catheters offer many major advantages over indwelling and even intermittent urethral catheterization, particularly for people with cervical spinal cord injury.

9. This site is great! I was doing some general research and stumbled upon it. I’m a quad. Originally on a Foley, now intermittent and thinking about a SPC. I have gotten more into than I thought possible. It looks like a viable option. A couple points – I’m on 2 x 40 Baclofen and still get spasms, which are becoming more frequent, thus checking out SPC. I’m lucky in that my medical team from general to specialists involve me as a primary member. Sorry to see that that often is not the case.
   I have a different question. my 89 yr old mother has just had a Foley put in. From everything I have heard read and experienced, I know the value of fluids. Does the same maxim hold true for an old frail body? Thx in advance

10. I have a comment about the elderly lady wearing the Foley cath, My grandmother was in her 80’s and she wore one and it did help her bc she felt more secure from urinating on herself and they don’t have to make all those trips to the bathroom or risk of falling, although they need to try to drink lots of fluids to keep from getting dehydrated fluids help to flush out the kidneys especially cranberry juice and water. This was my mother that told me to tell you.. And Graham thank you.

11. My bladder has a “burning” sensation. What would be the cause? I have a spc with frequent sediment… Also, I’ve researched Hiprex, should I test my acid level in my urine to make sure its acidic before taking Hiprex? I have to give this a shot cause my spc plugged off last week. I was also wondering if by taking Keflex everyday if that’s killing some good bacteria causing more sediment?

12. BobS: A quadriplegic mate of mine with a Supra Pubic Catheter had terrible spasms, now taking Baclofen 5 x 20mg daily he has none. I can’t take it, destroys my short term memory. Guidelines for an SPC are the same for all whether young old, male female, sickly or healthy. Jeff: You can test pH if you want, just for the benefit of knowing. Hiprex and Keflex can be taken together, Keflex is a course of antibiotics and not meant for long term use. As far as I know Keflex should not cause increased sediment. The burning sensation is most likely due to irritation, an anti-cholinergic like Vesicare can help as they reduce bladder spasm. I would also have an ultrasound to check for stones.

13. Graham/Michael, Thanks for the info. In my own mind I was sure of what you said, however one of the care workers told her that all she needed was about a litre (2 pints) a day as she was elderly. Thx for the validation. Re: Memory – reading used to be a major past-time. Now I don’t have the concentration power – still much better than the spasms!

14. I’ve had my super pubic catheter about 3 weeks – I keep reading about sediment – what is the indication of sediment buildup? What is the best way to prevent it?

15. Read through the comments Josh, your questions have been answered several times. If your urine output is cloudy or has chunks in it that is sediment. Most people avoid sediment build up simply by drinking +3 litres/day.

16. Hey:) Thanks for posting about this! I was doing a search for back flushing the bladder when you have a SP Catheter and came to your page. My son, Bryan, is a C1-2 quad on a ventilator 24-7. So your one comment about quads being able to do ANYTHING, is not quite true in all cases. :( Here’s my question. Someone, and even his recent visit to the urologist, suggested doing a back flush of the bladder to remove sediment, or whatever make it a healthier bladder. He was injured almost 4 1/2 years ago and has had recurrent UTI’s almost consistently. Urologist did put him on the Hiprex and did a renal sono, cystogram and an IVP to check him over. Do you or anyone.. know of a good safe back flush solution routine for him? Thanks again, Sandy :)

17. Thanks for this helpful page – my dad (aged 79) is due to have this operation this week and really i had very ittle information about it – many thanks

18. Sandy: Hi, where did I say people with quadriplegia can do anything? We’re all bound by physical limits and can’t always get what we want. I know handsome wealthy intelligent men who have never found true love. I feel that makes them poor. Bryan might like to be a pilot but simply wouldn’t pass the physical exams to even begin obtaining a pilot’s license. He could however be strapped into the front seat of a light plane and experience what it is like to be a pilot. Sometimes when I feel a strong breeze on my face I close my eyes and feel like I’m flying. Looking deep into my beautiful girlfriend’s eyes I feel ten feet off the ground. It’s all about attitude and perception. Flushing the bladder is not something I recommend as a supra pubic catheter is a closed drainage system. Anytime you open it you are open to infection, but I’m not a Urologist. If you do bladder washouts just be as sterile as possible. Frequency will vary, as you are doing it to try and prevent infection I suggest every 2 or 3 days and see if it makes any improvement. I’m putting together a procedure kit I hope to make available through this website with footage of changing a catheter, flushing the bladder etc. Until then follow these steps. Gather a large (50cc) sterile syringe, a bottle (250ml) of sterile water (or at least cooled boiled water in a sterile container), an alcohol wipe, new clean drainage bag and sterile gloves (or use a hand sterilizing solution). Remove the cap from water bottle. Wipe around where the catheter and collection device (drainage bag in this example) plug together with alcohol wipe and loosen the connection. Pull on gloves or sterilize your hands. Draw water into the syringe until full, pointing it skyward squeeze any air out. Plug syringe onto catheter and slowly push the water into bladder. Slowly draw back on the syringe removing water bringing any sediment with it. Should it not completely fill the syringe again do not force it, it will be fine. Unplug syringe and empty of sedimentary water. Draw more sterile water up and repeat the procedure until you’ve used all 250ml. It’s a good idea to leave the last syringe full in the bladder and quickly plug a new clean drainage bag onto the catheter. You can then immediately see if the catheter is draining correctly. To reduce costs you can reuse these utensils by soaking in a sterilizing solution like Milton or Hibitane. Or even less costly simply bring to boil in a pot of water on the stove. Caff: Thank-you and I hope all goes well with your Father.

19. Hi, I don’t want to hog the space here, but I feel that I must enter the fray on motivation. I am a partial – C3-7, anterior and posterior laminectomies last year(2 different operations). At first they were surprised that I could use a manual chair, then when I could shift in the chair. They planned to kick me out of rehab using 2 quad canes. I objected strenuously and left using one single point each time. My physio and I have set a goal of walking without a cane – haven’t determined distance yet. I mention this only to support the idea of pushing oneself to the limit, and then setting higher goals. I know that it won’t work for some, but we all should push to our ultimate limit. None of us will know where that is until we reach it. I learned this lesson from a gimp who has a number of Olympic medals as a quad. Now for the reason for my note. I currently intermit catheter. At night I don’t wake when I naturally void in a bottle. Often the urine ends up over me and the bed an the bottle doesn’t leave the bed. Is is advisable to put in a SPC, shut it off during the day, except when traveling, and use the SPC and night bag for night? Thanks again – BobS

20. This site was so helpful. I’ve been in a relationship with someone for two years and finally, I know what the scar is, and why he’s so secretive about certain things. At first I thought he suffered from ED. Which I’m still not to sure about due to his smaller penis size(I can’t help but think, one thing has to do with the other). My friend just recently started spending the night at my house and he wet the bed. I got so mad cause I thought it was from him drinking too much the night before, but then he did it again the following night. We had an argument and I noticed he was very sensitive about the situation but still he didn’t spill the beans!! Last night I came across the catheter,(by the way I always would hear rustling of the garbage bag in the bathroom, or notice something tube-like in his pocket.)He was hiding it under a bin that sits on top on my toilet. I always knew he was hiding something but I never asked him, I felt, when he was ready he’ll tell me what’s going on with him. I didn’t say anything to him, cause really its no big deal I’m really here out of curiosity. I’m more worried about his health, and mental well being. **** Now my question. Should I approach him or just leave it alone? I want to make sure he’s taking care of himself and not doing harm just cause he’s trying to hide this from me. By the way I know I mentioned I thought he has ED but that’s because he can have an erection anytime(really ANYTIME) and he doesn’t ejaculate normally. But boy oh boy is the sex wonderful and I like the scar on his belly. :)

21. Hey Graham :) This is the comment you made that I was referring to “A quick look around this web site will show there is nothing quadriplegia or an SPC prevents me from doing in life” I think it would be pretty much impossible to get Bryan into a plane :/ Unless you were just speaking figuratively… He was married for 10 years and his wife left him a little over a year ago… and I am sure he feels he would never be able to have another adoring woman in his life. He has a young daughter who lives with her mother. He feels he pretty much has no control over his life or future. He is only 32. He has the same level of injury as Chris Reeve did… but we aren’t millionaires to get treatment and superb health care as he did. But what he does have is a very loving caring and dedicated family including 2 sisters(and their husbands) myself and his Dad. Ok.. sorry.. got off the topic:) Thank you for your input about the bladder flush… I forgot to ask the urologist today what his prescription was for the flush. Seems like there were 2 ingredients. When I find out… hopefully omorrow.. I will share it here. Thanks again:) Sandy :)

22. BobS: Nice to see you revisiting us. You have quite a story to tell, how would you like to be published? If you would like to write your experiences down at length and email to me for review I’ll make a page for you here. Anyone reading this is welcome to do the same. We’re always looking for interesting articles from people living with a disability and would love to hear all about you. I find setting goals a good practice, some call me a dreamer but I assure you all, dreams can come true. For someone as active as you Bob I'[d be hesitant to go for a supra pubic catheter, your level of sensation would be another factor to consider. Could you pass a catheter at night like when you intermit only inflate the balloon and leave in overnight? You could also try a urodome, it’s like a condom with a tube on the tip end, most use a skin glue with these and it can be a bit messy. I would explore all alternatives first, if unsuccessful and you still want to try an SPC I see no reason why you can’t. The Girlfriend: You answered your own question, he will tell you in time when he’s more comfortable in your relationship. It’s not usually something a guy will blurt out on the first date, Oh, and I pee through a straw.? All you need do is show an interest in his well being and assure him he can tell you anything. I encourage you both to build on an open and honest relationship. It sounds like you see the man not the chair, that is a very good sign, it’s what my girlfriend says to me and she is simply amazing. Many people think wheelchair bound people can’t get an erection or have the same emotions as everyone else. Fact is we do, the majority are quite capable lovers and will see beauty in you where no other can. I find scars attractive too, I think it’s because each one has a story behind it. Sandy: Welcome back, yes there is little in life that quadriplegia prevents me from doing, but that’s just me. Billy Crystal, Robin Williams and others donated millions to Christopher Reeve, still he died from a septic pressure area. We are very fortunate to have free public health in Australia and are quite a wheelchair friendly nation. Those on ventilators are strongly advised to stay in hospital until government funded equipment (from vent to cue tips) and carers are trained and put in place. A friend of mine, Perry Cross (perryx.com) is on a vent, he met with Christopher Reeve in 1997. Perry has just returned from India where after stem cell treatments he can breathe unassisted for hours at a time. He plans to seek further treatments. Tell Cody I said to look at it this way, his life isn’t over, a new way of life is just beginning. Set small goals, one of my earliest was to feel the sun on my face. By taking the positives and leaving negatives behind he will become a people magnet, and a great source of courage and strength to all who love him. If he can find himself and be ok with who he finds, a loving woman will in turn be able to find him. Re; bladder irrigation you may be thinking of saline (salt water)? I advise plain water as saline can cause the formation of small crystals in the bladder, which can become problematic. I know how terribly hard it is to see your boy go through this, hang in there Sandy.

23. Graham, Thank you for your advice. I must let you know that he is not wheelchair bound at all. He lives a ?Normal? life. The only thing he’s told me about the scar is that he was stabbed. I’m sorry if I mislead you in any way. It’s just nice to see regular people talking about it. I’ve searched on the internet quite a few times trying to figure out what is going on with him, and then the other day I found a visual. So back to the net I went!! I looked up urine tubes (Don’t Laugh), and found a picture of what I seen. I looked at so many articles but everyone knows medical journals are very confusing. I came across your site and it was the first that I could understand and had human touch to it. I’m sure there is more to his story and you’re right I have to wait for him to be comfortable enough to tell me. There could be a possibility that I’m wrong about the whole thing. But I’m pretty sure I’m right. My main concern is letting him know its okay, he sometimes has anger and trust issues and now I can understand more why he’s like that. Again thank you so much for your advice. I really appreciate it.

24. I use a big night bag when I go to sleep what’s the best position for sleeping with this bag? It seems I’m putting a strain on my catheter and it pinches me. Have u heard of this complaint before?

25. Josh: By “a big night bag” I take it you mean something like a 2000cc overnight drainage bag. I haven’t heard of pinching, some get red marks which can become blisters if say, the catheter is caught under your pants belt or very heavy blankets press it hard against your skin. In such a case the only long term position to avoid would be any that presses the catheter hard against your skin like laying face down. Whether sleeping on your back or side keep the catheter tubing and bag lower than the catheter site. Most drain bags come with a clip attached to the tubing, clip it onto your bed sheet to void the weight of the tubing pulling on the catheter. You could use a rubber band and bulldog clip to the same effect.

26. Graham, Have you read the article about the “The water catheter kit” ? If so what do you think ?

27. Hey Graham:) You sure know a lot about all this stuff!!:) Have you had any medical training.. or do you just research/read a lot? I finally have the info on the bladder flush from the urologist. He said to use 1 oz. of vinegar with 1 liter of sterile water. Actually, he just said “water” as in tap water or whatever. I think I would feel safer with sterile water or at the very least like you suggested boiled tap water. Our water is kind of hard here and we usually have to filter the water we drink to make it palatable. The doc said to do this flush like 3 times a day!! I was surprised. I thought more like 2-3 times a WEEK!. So.. I guess I’ll give it a try tonite when I go over there to be with him. Thanks again for you advice Graham! :) Have a great day/night! Sandy :)

28. Geoff: I think that is allot of messing around. Silicone Foley and most Bard catheters have tapered eyelet’s, no 90? sharp edges. Generally a little Lidocaine or similar numbing gel is all that’s required. Quote; “2 or 3 references that clean practice is satisfactory and sterile practice is not required” is not true, sterility is very important! Male or female we have spinctor muscles at either end of our urethra for good reason, to keep bacteria out. Introducing bacteria into the urethra will for most cause painful UTI infections and/or secondary bacteraemia (infection in the blood). Other than that it’s really a matter of experimenting to find what works best for you. My self-cath mates simply pre-lube the tip of a sterile catheter and carry in a sterile zip lock bag. Sandy: I’m no MD, just a keen learner. I dated a nurse for 10 years prior to my 14 years of living with quadriplegia and have been in and out of more hospitals than I care to remember. You get to know these things. Vinegar acts as a mild sterilizer which is fine as long as you don’t over do it. A ratio of 1 oz (which is 2 Tblsp or 30ml) per liter is right. Even at this weak strength some find the vinegar irritates the bladder. Vinegar or not I strongly suggest at least using cooled boiled tap water, hard water is ok, filtered may be better. Three washouts per day does sound excessive. Poor Bryan will never get any sleep, I would think daily sufficient. Keep in mind studies prove bladder washouts only effective in reducing bladder sediment not bladder nor urinary tract infections. Various antibiotic and antiseptic solutions have been used as washouts over the last few decade in aim of preventing and treating catheter-associated infection. There is concern that their use can damage the bladder mucosa and increase infection rates due to opening the closed system. Current UK National Health Service guidelines specify that antibiotic solutions are not effective in prevention nor treatment of catheter-associated UTI’s (NHS QIS 2004) and are therefore no longer advised.

29. Graham, Have only just discovered your excellent site and I wish to thank you for it and the efforts you put into it. Thanks again for your answer to my last question. My query now is about itchiness around my spc entrance into the bladder together with blood in the urine. Is this a common problem ?

30. Thank you Geoff: Itchiness is a sign of site infection, as is redness warmth or strong odor at the site. Your doctor can take a swab for testing. Keep the site clean, dry and with good airflow if possible. Bleeding is common in new Supra Pubic Catheter installs, the bleeding should subside within 3-4 weeks. Trauma (pulling on the catheter) can also cause bleeding so avoid it. If you have had blood clots or blood discolored urine in your tube for some time I suggest you go for an ultrasound to see if you have stones or some further problems.

31. Graham, Thanks for the advice, much appreciated. I understand what you mean about good air flow but it is rather difficult.

32. Hi Graham, What are your suggestions for giving the site good air flow? How often do you clean your catheter bag? What steps do you follow and what do you use to clean it with?

33. Bacteria thrive and multiply in a warm moist environment. I’m a slender build and still tend to fold near the catheter site. Meaning, you can’t see my catheter site when in a sitting position, it disappears into a crease. Yes it’s difficult to avoid that. Good air flow won’t always cure infections but will help prevent them. Sit in the sun and press on your tummy to expose the site sunlight, not something you might do at Bondi but sunlight kills some bacteria, dries and helps heal the site. On hot days take a clean towel drying any sweaty creases occasionally, using a fan and taping a dressing on may also help. Keep hair trimmed back as it promotes bacteria. Wipe around site morning and night with an alcohol wipe. Use a ‘breakfast in bed’ type tray under bed sheets to keep them off your site allowing air flow, this is often done for new supra pubic catheter users in hospital. Corn starch or baby powder, I’m not a fan but you can try them. I’m sure you could come up with many more ideas but there’s a couple. You can clean and reuse drainage bags or any equipment by soaking in a product like Sporicidin, Cidex, Metricide or Milton. Use two Milton tablets or 50 mL of Milton Solution per four liters of clean cold water. After squirting the solution through the bag tubing etc, completely immerse all items avoiding air bubbles. Use a china plate to keep submersed. Boiling drainage bags is not a good idea. Have a great day guys.

34. What a great site! I’ve has my SPC for two years plus. My neurogenic bladder is a legacy of colon cancer 8 years ago. I self-cathed for the first seven, then had a golf ball sized bladder stone removed and the SBC placed. I’m 58 and an active outdoors man. I have an ongoing problem with both plugged catheters and Urinary Tract Infections. My catheter has to get changed every month or it scales up and corks up tight. Of course this always happens in the middle of the night… Fortunately, I was trained to change my own catheters so it’s more of an inconvenience than an emergency. For those who are considering this as an option my advice is mixed. I like the convenience of it (like you said… I’ll bet anybody a beer that I can drink with you beer for beer until YOU have to go to the head..) but it increased the frequency of my UTIs. Because I am very active the stoma can become irritated and bleed both externally and internally. Riding in a truck on a bumpy road is not pleasant! The jarring against the seat belt smarts! I’ve also found that two leg straps are better than one when wearing a collection bag on the calf. Put one high on the thigh and one just above the knee. Keep the cinch loose on the knee band so that the tubing can slip. It keeps the tubing off the front of your knee so that when you bend, it stays connected. That really soft “POP” you heard when you pulled on your leg strap is the sound of impending disaster by the way! I’ve also ruined a couple pairs of favorite sneakers when I caught the drain valve on brush accidentally and filled up my shoe on that side. I picked up a couple of tidbits reading the comments above that I’ll try but my current inclination is to have it reversed and go back to self-cathing. I’m more worried about damage from the UTIs than the convenience is worth! Thanks!

35. Hi Graham, thanks for the information. This is a great site. Am I to understand that a stoma can be established from the bladder to the outside allowing a person to intermittently self catheter with lesser risk of infection than using a Supra Pubic Catheter? Thanks, Nick. Lorna, thank you for the quick info. I needed that.

36. Yes it’s possible to connect ureter’s (tube to bladder) or urethra (tube from bladder) to the outside. No it doesn’t provide less risk of infection and is not as easily reversible as an Supra Pubic Catheter. In general an SPC provides less risk of infection as it’s a closed drainage system where a self-cath type stoma has to be opened frequently and a foreign object (catheter) introduced creating opportunity for infection.

37. Graham, I am using a teaspoon of vinegar on a piece of paper towel to wipe around the site.

38. Pretty nice site, wants to see much more on it! :)

39. Thanks John, We’ll be publishing more articles soon I hope.

40. Graham, Thanks for your reply, I needed a little conformation on using vinegar. By the way this may be of some use to your readers. I attach my catheter using the flip lever of the tap to the bottom of my underpants which eliminates straps and sticky tape. The only drawback is the underpants need to be fairly long and body hugging. Kind of awkward as far as air flow goes but I am working on it. You close the tap lever over the edge of the underpants but you do need the sown ridge on the underpants leg otherwise the lever won’t hold. With the right type of underpants the catheter is held in place very well. Hope you understand all that !

41. Thankyou for your page which I have understood, even better than hospital describing. I am due for this procedure shortly and very unsure. I have been self catheterizing for 19 yrs now, now not successfully, I am 70 yrs old and told that this is my only option, but still very unsure, as I get so many infections. But I thankyou again for your info

42. Thank you so much for your page. It was the most informative thing I could find on the internet for my Ma. She’s had a catheter for ten years now and is looking into having an SPC. Her greatest fear is contracting an infection in the hospital during her procedure as she has gotten them there before, due to her low immune system from the MS. But my point is, thank you thank you thank you. I wish there were more people out there like yourself that such informative websites!!

43. Just wanted to say thank you for your candor and informative site.

44. My Husband became a paraplegic in April after a fall in rehab. He is a t10 incomplete. He currently has a foley catheter but his neurologist has recommended a SPC. He was given no info but an appt was made for a consult with a urologist. We cancelled it after home health nurses being negative. Also my daughter is an activity director in a nursing home and says she sees people every day that have had foleys for years and sees no need for a SPC. It would be great for my Husband to be able to have OP water therapy. Would this be possible with a SPC. What about sex? He is 69 and I’m 61 and all of a sudden he is in a hospital bed in the livingroom and suffering from severe pain from a bedsore. We are reeling from all this and a SPC decision seems overwelming at this point. Any SPC info or good sites that would help us get on with our lives would be helpful. I am taking the federal leave act to care for him but am still working 20 hours a week so he has to be left alone during those periods.

45. I am a 59 year young female who is a paraplegic. I am not able to transfer by myself so I have to wait until my husband gets home in the afternoon to go to the bathroom. I have never had to have a catheter of any kind — lucky me. As I get older I find that urination is getting harder to control — especially when I have water retention bouts. I only take a diruretic (?) when my husband is off and can help me go to the bathroom. I am considering a supra pubic catheter- just so I can go when I need to and don’t have to worry about leakage. I am trying to get as much information as possible. I would love to urinate whenever I need to and drink as much as I want. Should I be worried about this procedure or give it a shot.

46. Graham, The reason I clip the outlet valve to the hem of my underpants is to keep the valve from flopping around when I walk. This avoids using a holster or a strap, etc to keep the valve down. The underpants are the hugging type and have a turned up hem. (as explained in my previous comment). I still need to tape the catheter itself to my upper thigh. Hope this makes things clearer.

47. Thank-you all for the positive feedback, it’s much appreciated! Nancy: I suggest you re-book an appointment with a urologist, they will not perform the super pubic operation right there and then. If your husband can’t attend due to pressure areas take a tape recorder or cell phone. As a T-10 I expect he has little to no sensation below his naval, therefore the neurologist suggested an SPC. I have a saying, “Many opinions make a balanced choice.” Sex, you will have to experiment, be patient and try new things. To me sex is more than the act, it’s tantric foreplay on all five senses. Just as the blind develop a heightened sense of hearing, losing feeling/use of your legs heightens all your other senses. Jeannie Duncan: Try an IDC (Indwelling Catheter) first. It’s the same as a superpubic catheter only inserted through your urethra not stomach wall. Yours is a lifestyle choice so see if IDC and self emptying works for you. You leak now you will leak with an IDC but the point is a trial of lifestyle not appearance, sensation or stigma. If the method improves your lifestyle then sure, go for an SPC.

48. Great articles. Thanks so much. We have a son injured 1 year ago and are thinking of a new method rather then CIC.

49. Thanks for the suggestions. I hate to sound dumb but is a foley catheter the same as an IDC? If not, what is the difference? It seems so good to have someplace I can connect with others in this same situation, We have a support group that meets monthly but it’s an hour away and we have no way to get there at this time. Having this is like having a lifeline for me. Thanks.

50. Nancy, hi The simple answer to your question is yes the Foley catheter is the same as the IDC. The Foley is a name of catheters used to drain urine from the bladder held in place by an inflated balloon. They are usually latex but silicone are also available. The catheters can either be used as an IDC, inserted into the bladder through the urethra or as a SPC.

51. My urologist just prescribed UREX to help prevent infections.. What do you know about Urex? Thanks.. Eddy

52. My husband is disabled, paralyzed down the left side. How easy is it for him to manage cleaning etc. with only the right arm working?

53. Hi Paulette, after practice people often become very skilled using one hand to do things. There are also gadgets/aids available that can also make it easier eg to hold jars/bottles when trying to open, to help putting on socks. When dressing put clothing on the left side first and sit to put on lower garments. If buttons and zips are hard they can be replaced with velcro. Shoes today can be bought with velcro fastenings, laces can be replaced with elastic laces that remain fastened but stretch when putting on the shoe. Initially it will be difficult but with practice it will become easier. Your husband will get very frustrated at times, which is understandable because a once fast and easy activity now takes allot of time and effort. If you have access to an occupational therapist they help your husband ways be more independent. There are also sites on the internet that explain dressing techniques to make it simpler.

54. Eddy: Urex is the same as Hiprex. Paulette: Cleaning around the site, emptying collection device etc. should be easy enough with one arm. One thing that might be difficult for him but not impossible is changing the supra pubic catheter. Holding the catheter in place and syringe plugged in while inflating the balloon can be hard even with two hands.

55. Hi Graham, Thank you for your prompt reply and information. My husband is a stubborn man. He says he will consider it a little longer. If I am not at home to help with SPC I think he would need a nurse every day to help him? P.

56. Paulette, I have had a SPC for 24 years now. I think the only think I might add is this: If your husband has to cath one way or another, the SPC is the easiest way to go for everyone involved. The SPC has to be changed like them all but a max. of 2 times a month but usually much less than that, instead of cathing many times a day. The SPC can be plugged when not needed or connected directly to a day or night bag for continuous drainage. Sorry for butting in, I just though I may be able to help.

57. I encourage anyone to post helpful replies Eddy and thank you, Shaddow and all who do. I was thinking similar, hubby could use a flip flow valve (a small lever tap plugged into the catheter end) and empty a few times daily in bathroom or into a receptacle. As a quadriplegic I have no wrist or finger movement in either hand and my carers only come for a few hours each morning and night. I spend the entire day alone using a 2000cc drain bag hooked up under my wheelchair. No good pushing stubborn people, I should know ’cause I’m one, haha. Just remind him it’s always reversible. Have a great day guys, life’s to short.

58. Graham, As I told you I am now taking urex. I was initially taking it morning and night as prescribed. You stated once every 3 days is enough for you.. How would we know how much to take? I am experiencing a lot more bladder spasms since I started taking Urex. Could urex be causing these spasms or is it just coincidence? Since I think it is causing it I am going to cut back on the urex and see what the spasms do. Any thoughts?

59. Graham, Have you heard of anyone having urinary tract infection problems with wine or the preservative Sulphur Dioxide?

60. Eddy: Urex is not a necessity so it’s safe to cut back just don’t overuse. I’m unaware of Urex causing bladder spasms, find the balance between spasm and sediment levels that suits you best. Geoff: Sulphur Dioxide is safe for moderate consumption and is reduced by your liver to harmless sulfate excreted in urine. It prevents discoloration of white wine. Wine can lower urinary pH reducing some bacteria and therefore sediment. I recently added some beneficial to supra pubic catheter food/drink info to the article under “Lifestyle.”

61. Graham, Thanks for the info on sulphur dioxide and wine.

62. I’m having trouble with my leg bag. I have an spc and it seems when the bag gets half full it really pulls down on my catheter-any suggestions for this? I got it real tight around my leg. I’ve had my spc about a month. I use a leg drainage bag. If I were to use a plug how often would I have to drain it?

63. Hi Josh, I have had the SPC for 24 years now. In your first question you say the bag starts filling and pulls on your SPC. I am assuming you are not using an extension tube? I have the SPC in place, then I hook an extension tube cut to the right length in between the leg bag and the catheter.. Have you tried that? Your second question is determined by how much you are drinking. The bladder can only hold so much and then needs to be emptied. Everyone’s bladder holds a different amount. My bladder for example will not hold much at all so plugging it would not work for me, I have to have the constant drain or my bladder will void/leak on its own

64. A big HI to you, Graham! Sorry it’s been so long since I’ve posted, but you know how life can get @ times! Hope you’ve been keeping well. RE: Bill’s SPT. I can’t believe he’s had it in almost 2 years (I think) already. For many months, Mandelamine(Methanamine) MD 1 GM. q.d. worked pretty well, cutting my cath. changes way down to about q. 3-4 wks. HOWEVER, The good old U.S. of A. fairly recently stopped making it. I can only get Methanamine HIPP, which is similar, but for SOME dumb reason, his sediment has since been back full force; as are the q.wk.cath. changes. I have to irrigate, using about 30-40 cc’s q.d. of NS….I pretty much stick to sterile technique, but you must know how difficult it is to get sufficient equipment, RN or not. He can’t overdo the cranberry juice, so I’ve been mixing it with water and sweetener, any more and we have the diarrhea back, “catch 22”!! He takes as much water and other non-caffeinated fluids as tolerated. Do you have any more info’ about the difference between the Meth. MD, and HIPP that would account for this? MD/Pharmacist don’t know there are a few chemical property differences, but the MD/Pharmacist both state it shouldn’t make that much of a difference, but I know you’ll believe me when I say it does!!!! Any other medication similar to try? It would have to be an antibacterial like Meth., and NOT an antibiotic he can’t stay on. Again, I’m not offered by MD much more help so I thought I’d try my “Super Pubic Tube” expert again!!!! Any suggestions are always welcome by you! Sincerely, Anne

65. Hi Anne, I wouldn’t think there’s any difference between MD and HIPP, certainly not to the degree Bill is experiencing. The only things to try are other Methanamine brands – Hiprex, Ural, Urex and there may be some generics available. Diet could also be affecting urinary pH lessening the effect of Methanamine. Keep urinary pH down at 5.5 or lower to ensure the hydrolyzation to formaldehyde and ammonia occurs. I listed some pH lowering foods under “Lifestyle” in the article. Nice to hear from you Anne. All the best.

66. Graham, How much urine is left in the bladder after using the super pubic catheter? There must surely be some remaining.

67. I am a 58 year old c-5/6 quad from diving accident 39 years ago. I have been using an external condom catheter all this time and now I am experiencing urinary tract infection after urinary tract infection as my bladder seems to just be warn out. My urologist is suggesting a Super Pubic Catheter and I am hesitant. I’m of the old school I guess. I wear a back brace and a seat belt and am very active. Has anyone got an answer on how to get around this problem? I’m not happy about this change to begin with and I need to have these questions answered before I say yes or die from kidney failure. Thanks, Jimbo

68. Geoff: The volume your bladder can hold varies from person to person. I’ve held over 1000 ml before. For most the urge to void starts around 300 ml. Any catheter supra pubic, indwelling or intermittent should drain your bladder to it’s relaxed state leaving 20 to 30 ml. The ability to bear down would leave even less. Jimbo: If you have tried medications and all other avenues of Urinary Tract Infection prevention a Supra Pubic Catheter is a good option for you, as you say better than renal failure. Don’t forget it is reversible should it not work out. I think you will find an SPC has many advantages over condom type catheters.

69. Graham, Thank you again for a thoughtful and precise answer to a question. The reason I asked about the residual after using the super pubic catheter was about the chance of an infection beginning in the 20 to 30 ml left each time even after drinking three litres of fluid a day as you suggest. I am now drinking about the 3 litres a day including cider vinegar in some water and and lemon juice in other. Have you any advice re these attempts to prevent infection?

70. Geoff: An SPC works best as a closed system with a collection device attached so the bladder is constantly draining. The benefit is little chance of a Urinary Tract Infection developing or getting into the system. The best treatment for UTI is to stop them from ever starting. Diet can help avoid UTI though remember if you take a Hiprex or Urex type preventative you want to keep a 5.5 pH. Plain or filtered water lowers pH. If pH is not important apple cider vinegar, cranberry and lemon juice are good, avoid coffee tea and carbonated drinks. A healthy pH is 6.5-7.5 so give yourself a break periodically.

71. I am due to have a Super Pubic Catheter fitted in 2 weeks. I was told initially that it would be a day procedure, however when I saw the Consultant he said it is more complicated than they first thought & wants me to go in the day before & stay the night of the op too! I have coughed out two catheters when I had a bad virus & the district nurses are finding it more difficult to insert a change as my urethra has gone into my vagina. I don’t understand any of this really & why I need to stay overnight in hospital when I am more comfortable in my home. I am scared about having this done as I have some feeling in my tummy & don’t want to be in pain. I get blood in my bag often & have infections often. I also bypass a lot. I just don’t know whether to have it done or not?

72. Hi Suzan, nobody can force you to stay in hospital but it’s probably best to do as they suggest. Having sensation there you will have pain for a few weeks then it should settle down. Ask for a numbing gel like Lidocaine or Xylocaine and apply it to the site. Considering your current complications I think an Super Pubic Catheter would be beneficial to you. Some discomfort is surely better than bleeding, bypassing, infections etc. Should it not work out it is reversible.

73. Hi Graham, Thank you for your reply. The Consultant said he might have to remove part of my bladder & close off down below so I don’t have any leakage as he couldn’t guarantee that a Super Pubic Catheter would completely resolve my problems. Is this normal in a lot of cases as I am getting more scared by the day? Plus if he closes off down below & the SPC blocks how will the urine come out without bursting? I am so glad I found this site as it is very informative with both positives & the negatives.

74. My son has had a Supra Pubic Catheter for the past 4 years, however the nursing home he is in has removed this, the reason I have been told is because of constant urinary infection. Could he have this procedure done again and would he need a general? At the moment he has pads which I am not happy about. He suffered brain damage five years ago so he is disabled and cannot do anything himself

75. Suzan: I see, that must be a very intimidating thought. I am not an MD nor Urologist, if you’re unsure I can only recommend a second professional opinion. Given your further info I totally agree with staying in hospital. Two nights will pass quickly, we’re talking about lifestyle, plumbing, your womanhood. Closing of down there is usually achieved by stitching the neck of your urethra closed, that is the start of the draining tube from your bladder. Especially in females this is not usually reversible. I would inquire as to the chances it won’t be necessary, alternatives and even if, can’t it be done later if proves needed? When the only exit from your bladder is a Supra Pubic Catheter which blocks you will generally bypass urine around the catheter. I don’t know your case history but feel an SPC alone would have to be an improvement on your current status. Try to let go and not be scared, as we do you’ll look back and think what was I so worried about? Have a great day Suzan

76. Hi Graham and Susan. — Susan, My SPC has been in place for almost 24 years. I also have leaking through the penis when I over strain to lift something or maybe if I am pinching the tube off.. Like you have said, that is your emergency relief valve and once it is stitched closed it cannot be used as the relief valve.. I live in Denver Colorado and Craig Hospital is one of the leading Hospitals for spinal cord injury. My urologist at Craig uses Colegen/contigen (sp) to close off the the urethra passage where it connects to the bladder. What he does is insert the needle at the opening and inject the collagen in causing the opening to be obstructed or swollen which will not allow the urine to easily pass by.. He injects around the opening many times causing the obstruction. This collagen does wear off after a couple years on me as the body absorbs it. I then go back in when I start leaking again and have it done again, a 15 minute procedure.. This also allows a catheter to be used if need be, a little extra pressure is needed to insert the catheter past the collagen site.. This is reversible as the collagen wears off so it is not permanent. This could be an option for you.

77. I am so confused. My husband just got the super pubic tube with a leg bag. The doctor didn’t explain anything really and one question I didn’t think to ask is about bathing. He said to keep a bandage on and replace the bandage just like it is now and then every 4 weeks we go back to him to put another tube in. But after I got home, I was confused about bathing. Do I take the bandage off, leg bag, and just leave the tube hanging? Wow… I feel so dumb about this and not happy with the doctors neglect in explaining more. Any help would be greatly appreciated.

78. Wow Eddy that is fascinating. Could you please email me with your experiences at Craig Spinal Denver, that would be awesome. I’ve friends in Denver. I’ve heard of collagen in lips and butts but don’t know anyone first hand with it in their bladder neck, that’s very interesting. Lynda: Yes a Supra Pubic Catheter can be re-performed, usually about an inch away from the original site. Typically someone with an Acquired Brain Injury is given a general but it may not be necessary if he will stay calm. An Super Pubic Catheter is one of the best methods to avoid UTI so I would look into the sterile practices of who has been changing the catheter. Kitty: Drain the leg bag and leave it connected. Most people have two sets of leg straps replacing the wet ones after bathing. If you mean a site (catheter entry point) dressing/bandage leave it on during bathing then clean and replace afterwards with a new clean dry dressing/bandage. The dressing is usually only required for a couple of weeks, then leave uncovered and use an alcohol wipe or similar to clean around the site morning and night.

79. Hi, I had a supa pubic catheter fitted 10 weeks ago now. The procedure has worked really well, yes I did have a lot of pain from the site to begin with put the site is now really healing well and is draining perfectly. My problem is that 10 weeks on I am still experiencing terrible spasms daily that I am struggling to cope with due to the level of pain and I am also bypassing due to the spasms and continually have wet pads, which is why I had the procedure done in the first place to get away from wet pads. I have tried a number of different medications – oxybutynin, Lyrinelxl, and now had Usistas recommended to try. Up to know nothing seems to be making any difference, and my Urologist says after trying this she has no other answers only taking it out. I really really don’t want to have to take it out because in every other way its working perfect. Please have you any help or ideas, as the pain is pretty horrendous at present.
    Many thanks

80. Hi Kerry, I take it you are talking about bladder spasm known as an overactive bladder, for this Oxybutynin (Ditropan) is one of the best available treatments, were you taking the maximum dosage? For more general muscle spasm many take Baclofen. It sounds as if something is irritating your bladder, check your catheter balloon size is at the manufacturer’s recommendation, consider a catheter with smaller balloon. There must be a considerable amount in your bladder in order to bypass, be sure it’s draining well. While it’s good to use as small a gauge (diameter) catheter as possible a bigger gauge might prevent some of the bypassing. Have an ultrasound done to check for stones or some other irritant. You will want to get this sorted Kerry as they’ve found catheter irritation/rubbing increases the incidence of tumors. Other than these I’d put any action off for a few more weeks and rest to be sure it’s healed. That’s why you should rest especially in the early stages, to give the best chance at forming a tight seal around the catheter.

81. Hi Graham, I am so grateful for the information you have given me, this site is so helpful, so thank you for that.
    Firstly yes your are correct in thinking I meant bladder spasms, sorry I was not more specific, I have already tried Oxybutynin/ Ditropan 5mg tablets and Lyrinelxl which my doctor started at 5mg and then up’d the dosage gradually until I was on 20mg daily but sadly neither stopped the problem, I have now been prescribed Urispas 600mg daily to try. The points you have made have been a big help and I will certainly look into them all. I find the bladder spasms are so painful to cope with, I struggle to sit in my chair with them, so am spending alot of time lying down just to cope at the moment. My Urologist is wondering if my condition plays a part in the problem. I have a hemiplegic Paralysis, I have no movement or feeling down the whole of the right side of my body, so am wheelchair bound. Thank you for your help and encouragement, I will certainly preserver with it for a few more weeks as you advise. Many Thanks once again.

82. Kitty — I’m kind of new at this. I’ve had a Super Pubic Catheter for about 2 months. I always remove the bag before taking a shower — yes the tube simply hangs down. Before I get out of the shower stall I dry myself and put the leg bag bag on. It works for me just fine. I do this all in the shower stall in case there is any leakage. Hope this helps, Josh

83. What a great place to share a common problem… Thanks! I visited a rehab doctor yesterday at the request of my urologist. The rehab doc is a member of a group of Spinal Cord Injury docs in Phoenix. My problem is residual urine in the bladder causing frequent infections. The urologist has done a sphinctorotomy and a prostate resection trying to open up my urine pathway so I could continue using an external condom catheter. It darn near killed me because of the bleeding that I had as a result. My research told me this was a common thing and that’s why this procedure was nearly discontinued in the late 50’s. I was told with the use of a laser this would not happen. To make a long story short, the laser didn’t work so they went back to the old fashioned way while I was on the table and I nearly bled to death. Now the passage is open, but I still have residual.

84. A Supra Pubic Catheter is much easier to manage than an external condom catheter. As you have probably experienced even with skin glue they can come off and/or leak. I am quite active and the Super Pubic Catheter doesn’t stop me in anyway. If you wear a leg bag or drain periodically it will be the same, use a tap or plug the catheter onto wherever you tap/plug your condom catheter now. I know of the bladder electrode stimulus, most find it has limited success and isn’t really a good long term option. I can’t believe they did a prostate resection, especially without your consent. Frankly Jimbo I would go straight for the SPC. Do you take Hiprex, drink three litres/day, cranberry juice, etc for infection prevention? Try all the tips here and you may be able to continue with your current method.

85. Hi Graham, thanks for the feedback. The only questions I believe I have left is How do I deal with the back brace and seat belt issue? It seems like both of these will be in the way. I guess I’m wondering how to deal with this and not result in any kinking. Any ideas? Jimbo

86. Jimbo: The Super Pubic Catheter entry point (site) is usually below your pants line, that is in a sitting position about level with the top of your lap. An inch above the pubic hair area. As a C4 quadriplegic I also wear a seat belt type strap at lap height and cover with my shirt. I make a loop in the catheter in pants and run the 2000cc drain bag tubing out between pants top and strap. No one notices the strap or tubing. Many prefer to run the tubing down pants leg to leg bag, drain switch or drain bag. Those with a tap simply tuck it in their pants. So unless your back brace is of the kinky lace up crutch less corset variety it won’t be a problem. Just kidding, actually even if it was it would still be fine. I wear tight jeans and the only problem is the tube marking my skin. You can always tell the surgeon you want it as low as possible but stay out of the hairy areas as hair can promote bacteria and therefore infection.

87. Dear Graham, What a wonderful website this is for the world! I was looking for reasons my 61 year old brother keeps getting crystallization in the tubing of his Superpubic Catheter, also what causes the sediment. Hard to find anything relating to this. He has been wheelchair bound since 16 years old – just got SPC 4 months ago. Urologist has issued “idiot orders” for caregivers at group home. Most problems seem to stem from not enough fluid, cranberry juice as ordered. Trips to ER every couple of weeks with resulting UTI’s are very hard on Terry. Dark urine is usually followed by crystallization in tubing, then no output. Orders to flush 1 time a week by LPN issued – problem replacing leg tube & bag unless it’s leaking – sediment & cloudiness seem to always happen after we notice urine is very dark orange even if fluids are increased and urine turns lemonade yellow (our family term) Our next visit (if no more ER visits) to urologist for SPC change I am going to inquire about Hiprex. Thanks so much for that hint. Any other suggestions would be greatly appreciated.

88. Josh and Graham…. thanks so much for the help… I super appreciate it.

89. I spent new year at the beach with family. Hope you all had an excellent Xmas and this new year brings your dreams into reality. Stay positive guys!

90. Thanks Kitty and Tina: Tina, dark urine is indicative of UTI, it will help to drink steadily through-out the day maintaining lemonade yellow or even better clear. Everyone has bacteria in their urine which causes sediment to form. By drinking constantly the bacteria get flushed through before building up sediment. Alot use cranberry, many have posted other tips here from lemon juice to beer and certainly Hiprex or Urex type products are worth a try. Prevention is better than cure, stock him up with his favorite drink. It’s important to push constant fluids. More than 3 liters (6 pints) per day.

91. Hi Graham, I am afraid I am back with some more questions to do with my Supra Pubic Catheter catheter. A few days ago my tube got totally blocked with sediments (although I’m drinking the required amount), when my nurses came out to change the SPC they were here over an hour and they really struggled to get it out, eventually it came, and a new one was put in. However since all these problems my catheter keeps blocking for hours at a time and then just starts up again, there is no obvious reason for why its blocking at all but when it does I bypass large amounts, today my tummy has swollen right up and i feel like I can’t swallow, so I’ve been on to my GP who has told me I’m showing a klebsiella infection, which could be causing all the problems, she said its quite a bad infection. Do you think it could all be being caused by this infection, or have you heard about this infection?? I’m feeling very unwell and worried by the internal swelling and wonder if I’m to seek further advice or will this all rectify itself in time. Many thanks once again for your help.

92. Wow, I am glad I found this site. My husband is a quad and is going in the morning to have a super pubic started. I was quite questionable as to what to do afterwards. Just to give you some back ground on him… he is 38 years old having been a quad for 20 years now. He has had CHRONIC urinary track infections for about a year now. As soon as he gets off antibiotics he has another uti show about 2-4 days later. His neuro suggested the sphincterotomy but with his age, the new technology coming all the time, not to mention us still being somewhat newlyweds this didn’t sound like a great idea for us. We have since consulted with a urologist and he suggested this SPC as (like you said) if it doesn’t work or if he has any problems he can simply remove it. I feel much more confident in what to do once I get him home and it’s all for me to take care of. I do have one question still. My husband does suffer from extreme disreflexia at times (the sweats/shakes/etc you spoke of), which can be very life threatening. He suffers extreme peaks in his blood pressure while suffering the disreflexia. He has used the Foley catheter in the past while hospitalized and it seemed to cause disreflexia. Is this something we should expect from the SPC also? Our urologist seemed to think possibly the balloon was filled too much (when in the hospital) and that may have been what caused it. I haven’t read anywhere else that this would be something to watch for but with him having it so often I want to be sure if it does happen we’ll know what’s causing it. Oh… and what types of beer are naturally brewed? My husband used to drink a beer or two a day thinking this would help with the uti’s. We found that at times the uti’s were yeast so he stopped drinking the beer in fear it was making things worse. He drinks cranberry and also has cranberry pills… There is also another type of drink he gets from a company called Kordial it’s “On Tract” powder (D-mannose) this works well to prevent uti’s if there is anyone out there that may be looking for a natural alternative. Thanks again for your site and info… I am sure I will get back on after his procedure and keep up to date on the “in’s and out’s”… no pun intended. :D

93. My 92 year old mother voids >1,000 cc at night but very little during the day. For years she was getting up every hour or so to urinate. I requested the md order a foley catheter which has given her full nights of sleep but causes UTI’s, bladder spasms and leakage’s. If she were to get a Supra Pubic Catheter, could she void normally during the day (pinching off the tubing) and then attach a large bag at night?

94. Kerry: It’s common for a supra pubic catheter to stick, requiring a firm tug. First! it’s essential to ensure the balloon is totally deflated. Klebsiella is a nasty infection resistant to many antibiotics. No it won’t just go away. Typically contracted in hospitals by people with a pre-existing illness associated with low immune systems, it could be the cause of all your problems. If your Dr. advised no treatment I strongly encourage a second opinion especially as you have Hemiplegic Paralysis. Kill the Klebsiella infection asap. Megan: Amongst quadriplegics a Foley catheter through the penis (IDC) commonly causes irritation along the urethra and tract to bladder resulting in Autonomic Dysreflexia. A Supra Pubic Catheter may cause the same, or more severe at least for several weeks post-op then it should settle and be less irritating than the IDC method. Any incidence of UTI should also decrease. You should be prepared for blockages carrying a spare ‘quick change kit’ when away from home as you would with an IDC. Newly weds, how sweet :) Congratulations! I too would avoid a sphincteroctomy even if I were a monk. Consult your local alcohol outlet re: naturally brewed beer. Most yeast is killed in the gut, any residual should be flushed through quickly as beer like most alcohol is a diuretic, so follow up with water. Kordial sounds interesting, I haven’t tried it. I will reply to your quadriplegia post when I get a minute and look forward to hearing how hubby and yourself are doing. Margie: At your Mothers age if she has full sensation I would be hesitant to suggest an SPC. A larger gauge catheter/balloon may sting more to put in place as numbing gels like Lidocaine, Xylocaine can have adverse side effects for elderly folks, KY etc are fine. Pinching the tube off is better done with a tap inserted into the catheter end rather than leaving it open to infection. A tap and/or drain bag can be used with an IDC or SPC. Some taps allow a drainage bag to be plugged onto it, open the tap overnight, close and remove bag during the day. I understand the hindrance leaving an IDC in 24/7 can cause. My concern is the initial trauma and ongoing pain an Supra Pubic Catheter may cause your Mum.

95. Hi Graham, Well here I am a week later. Wow, where do I start!? The procedure went ok, as good as could be expected I suppose. After the three hour ride back home we could tell it wasn’t going to be a “good night”. Yep, here comes Mr. Dysreflexia. Thankfully we already have medication to help with that or we would have been in a real pickle. He was in quite a bit of pain and was passing a lot of blood and clots, of course when I mentioned dysreflexia I don’t have to go into all the shivers and shakes and crazy b/p readings or sleepless days and nights. We talked to the doctor every day and I really thought my hubby was going to want it OUT before he could give it a chance. Luckily or maybe finally. I think it was on Friday the doctor sent a Rx for bladder spasms. Woohoo!!!! He took one that night and it worked miracles. The bleeding has stopped and he hasn’t had any more clots either. It is definitely emptying as where we were emptying a normal leg bag maybe twice daily it has gone to at least five times daily, and being completely full! Same at night of course and thank goodness no more in/out catheterization! I know he will feel relieved once he gets used to things being different. We go back on Thursday to have it “upsized”. Keep Mark in your thoughts and prayers that this round will go much smoother, and at least this round we’re prepared with the meds he may need. Also, just a note to anyone who hasn’t been through this or is looking at having this done in the future and those spouses and caregivers out there. The most important thing for the person who is having this treatment done is to keep them positive. We (“normal people” as you may have it) cannot even begin to imagine the frustrations that come, the feeling of having something “strange” and unusual “plugged” into your belly, the discouragement of being down (again, for some). When you are going through the recovery process with them be sure and tell them how great they are doing, how much better they are going to feel in the long run, how quickly they are catching on, etc. Suffering from quadriplegia can be bad enough, then you have another drastic thing to go through and make you feel “different” they need our support!!! Best of luck to everyone and thanks Graham for the great info. I am sure we’ll keep you in touch as to how things go this round.

96. I am a 48 year old female with Multiple Sclerosis. My bladder has always been a very difficult thing in my life. I have been taking ditropan and detrol for a couple of years now and find them to be helpful. I was suppose to be in a study for botox for the bladder that I was quite excited about. It’s been a long time coming and is finally going to happen the beginning of Dec. But in the meantime I am having a very difficult time with getting on off the toilet, but reading some of your responses it seems to be necessary to still take the ditropan and detrol, which was what the botox was hopefully going to eliminate as well as pads. I have not been able to walk for almost 3 years not and the strength in my legs will no longer hold me up to lift up my pants. I have recently been told about the Supra Pubic Catheter and am quite intrigued, but a little scared. Where does the bag go? If it is on the leg can you wear jeans and how do you empty it if you have jeans on but can’t get them on or off to do so? and what about shorts in the summer time?

97. Hi, I am a 44 year. old mom who’s deaf and disabled with moderate Cerebral Palsy. Just had a Super Pubic Catheter done this past August. What an experience it has been. My question I have is pertaining to showering. Because of me now having a stoma, is it BEST to shower everyday to prevent possible infections? I feel embarrassed asking this question.

98. Cathy: There are many types of collection devices. Latex leg bags can hold around 750 ml in general and can be worn on the thigh or calf, in jeans the calf is better. The drain tube with tap is accessed at the bottom of jeans leg. In shorts a smaller thigh 500 ml bag is better, drained the same way. If you can empty frequently simply plug a tap straight onto the end of the catheter and keep it tucked inside your jeans/shorts/panties/etc. If unable to frequently drain, a 2000 ml drain bag is often used hung bedside bed/wheelchair drained morning and night. Trishie: Don’t be embarrassed hun you’re amongst friends here. No you can continue your regular shower routine. A shower does not remove all bacteria. If you’re worried frequent use of alcohol wipes or any sterilizing preps will help prevent cross infection. Use a different wipe around each area.

99. Graham, thank you for the advice… I have been using baby wipes, but maybe alcohol would be BEST??? As for showering, I was doing it every other day, seems like I should be doing it everyday instead to prevent Urinary Tract Infection’s from happening. I experience urethra pain, like stinging and burning sensations everyday, I see my Urologist next week, and will mention this to him. Any more advice, new friend?? :0) Have a GREAT day! Trishie :0)

100. As a working professional Quad I have managed for 36 years with intermittent cats 3x per day. My very amazing wife who married me 10 years ago has been by me through all the urinary tract infections, hospitals and good times as well. As I have a bit of a large belly over the years will this kink or pull the cat as I am forward in my chair at the keyboard most of the day and how much time off from work do you think I will need after the superpubic catheter is installed.