Super Supra Pubic Catheters
I hear people say Super but it is Supra Pubic Catheter. I have had an SPC for 16 years now and it has mostly been super. There is not much first hand info on the net so I will share my personal experience. Supra pubic catheters are a method of bladder management. It is a fairly simple procedure usually performed under a general anesthetic.
An incision was made about three inches below the belly button and a small hole is poked in the bladder. At this point, a catheter is inserted. It is held inside the bladder by plugging a syringe onto the catheter port and inflating a 5 to 40cc balloon with sterile water. The syringe is unplugged and a drainage bag is connected to the catheter flange. Usually the site (incision point) is low enough to hide below your pants belt line. It took three weeks for my supra pubic catheters site to settle and stop bleeding. I no longer keep it covered with any type of dressing.
With supra pubic catheters you must always keep a catheter in place. Your bladder can heal very quickly. In as little as ten minutes without a catheter in, you may not be able to get one in. Your body treats a suprapubic catheter as a foreign object. Forming a tube from stomach wall to bladder. Always trying to expel the foreign object, the catheter site never totally heals. It will always require a little cleaning. We use an alcohol wipe each morning and night. I’d much rather my carer clean around the super pubic catheters site than the pointy end of business (I’ll call him Sarge). Especially when your primary carer is a family member.
Changing Supra Pubic Catheters
Silicone Foley supra pubic catheters like these above are good for three months. I change mine every two months. Even then it often requires a little tug to remove. Some rotate their supra pubic catheters frequently to keep them free from sticking. This can cause leakage so I don’t do it.
Sterilize all equipment and around the catheter site. Deflate the old catheter balloon by firmly plugging an empty 10 cc syringe onto the supra pubic catheters port and drawing back. Remove the catheter taking note of how far it was inserted. So then you will know how far to push the new one in. Lubricate and insert the new catheter, then inflate the balloon. It should slip back a little to rest against the bladder wall. Holding the syringe plunger depressed, remove it and plug a new clean drainage device onto catheter flange.
You might like to check our 10 step guide on changing supra pubic catheters.
We once pushed my catheter in to far, right through the bladder and half way out my urethra. When we inflated the balloon it ruptured my urethra. Sarge was wounded by friendly fire! I bled from the penis for three days. The same can happen if it’s not in far enough. A little bleeding is common after a change or trauma (yanking on the catheter) but any bleeding should stop quickly.
Plug a leg bag or whatever drainage receptacle you prefer. I use a 16fr gauge Silicone Foley catheter with a 4-Sure 2000 cc overnight drain bag in a cover slip hung up under my power wheelchair. The 4-Sure is emptied morning and night, changed weekly. The boys get jealous when we have a session at the pub. They run back and forth to the bathroom while I don’t need to go at all. Check and top up the amount of sterile water in the supra pubic catheters balloon monthly. Some osmosis can occur in time and you don’t want the catheter falling out when asleep.
Lifestyles Diet Flying Sex and Swimming
Drinking is essential with Supra Pubic Catheters. It’s recommended you drink at least 3 liters daily to keep sediment levels down and the catheter eyelets clear. A lower urinary pH can be of benefit in reducing sediment and bacteria causing UTI’s. Bacteria don’t like acidic urine. Some pH lowering drinks and those of general benefit to supra pubic catheters are; cranberry juice, coffee, naturally brewed beer, buttermilk, wine, green tea, colloidal silver, distilled and filtered water.
Diet is unrestricted. You can eat anything you like. Some foods that lower urinary pH and help to reduce urinary tract infection are; beef, berry juices, corn, corn silk, eggs, fermented milk products (yogurt), fish, fowl, goldenseal, grape seed extract, gravy, horsetail, marshmallow root, probiotics, sour cream and whole grains. Avoid processed foods and artificial sweeteners. Please keep in mind it is all about balance. A healthy pH range is between 6.5 and 8.0.
Flying is no problem though be aware silicone slightly expands at 20 000 ft. Some tell me they like to use a smaller gauge catheter on international flights. I have never tried this. I fear I would be soaked in pee before I even got on-board the plane. I have flown many times without making any changes to my daily use of SPC. I’ve been in gliders, stunt planes, across the country and on international flights. I’ve never had a problem. I do suggest reducing fluid intake. If you can’t, or the free booze is too tempting, ask the staff if you can pee in a bottle rather than trying to get to the bathroom.
Sex is the main reason I went for Super Pubic Catheters. How can I put this… Sarge is always battle ready, free to stand to attention at anytime. No having to fold an indwelling catheter back and cover with condom. No having to do a quick self catheter drain to prevent leaking pee during sex. I’m good to go anytime. Now I just need to find someone to have sex with! Haha. A friend tapes her supra pubic catheters down to her side during sex. It’s a good tip if you like it rough, your partner is worried about hurting you, or you or your partner are turned off by the sight of a suprapubic catheter. You can tape it down.
Swimming is not a problem. Disconnect your drainage device and press a stent (sterile cone shaped stopper, can use anything really) into the catheter and splash on in. Avoid drinking to much before and during swimming. If for some reason the urine cannot be drained via the suprapubic catheter you will usually bypass. The sphincter muscle which controls urination can only hold so much pressure before it will leak and you go the old fashioned way. That is a good thing! While it is inconvenient at times it acts as a safety valve. When urine can’t escape it backs up into your kidneys and will nearly always cause kidney infections (renal sepsis can be life threatening).
Sleeping puts your bladder into a dormant state, yes it sleeps too. Sleep on your back, side or front as long as it doesn’t kink the suprapubic catheter or tubing. Having a large drink just prior to sleeping will help your urine remain clear overnight. Keep your tubing and drainage device lower than your bladder. I clip the tubing full of urine onto my bottom sheet so it can’t pull on my catheter. A quick look around this web site will show you, quadriplegia and supra pubic catheters don’t prevent me from living a happy full and active life.
Sediment and Urinary Tract Infection Prevention
You will never completely stop Urinary Tract Infections (UTI). Anytime you have broken skin you’re vulnerable to bad bacteria, especially when you have a suprapubic catheter pointing the way in. Good hygiene is very important. I suffer less than one UTI/yr. The only indicators are that my urine has a stronger odor and is darker in color. Other quadriplegics shake, shiver, sweat, suffer headaches, blotchy skin or possibly display autonomic dysreflexia symptoms. Females seem to be more prone to adverse reactions to UTI.
The latest research suggests drinking large amounts of water to flush the infection through works as fast as antibiotics. UTI can grow from sediment so keeping sediment levels down is paramount. Cranberry products, corn silk, naturally brewed beer, and wine are also good UTI preventatives (see Diet above for more). I have a few beers near everyday and haven’t needed anti-sediment medicines for a number of years now.
Infections at one time were so frequent we had to change my Super Pubic Catheter every two weeks. Bacteria grows on sediment and can build up blocking the catheter’s draining eyelet’s. We would perform a bladder washout daily. Taking a large 50cc syringe and sterile bottled water (or cooled boiled water) we would push the fluid in and out to “flush” the catheter. I don’t recommend frequent bladder wash-outs. It’s much better to cure the sediment and UTI problem.
The catheter insertion point (site) itself is also at risk of infection. If the super pubic catheters site becomes red, warm to touch, crusty, tingles, smells bad and/or is pusy you probably have a site infection. A doctor can take a swab to confirm. Keep hair trimmed back away from the site as it promotes bacteria. Exposure to the sun, saltwater baths, cleaning with an alcohol wipe morning and night, keeping it dry and with good air flow, will all help avoid site infections.
Silver is a highly effective antibacterial substance which can be applied to various types of catheters. Multiple studies have suggested that silicone urethral catheters coated with hydrogel and silver salts reduce the risk of developing bacteriuria. Specifically, silver alloy catheters (coated on both internal and external surfaces) were shown to provide a greater than 3x reduction in the development of catheter-associated bacteriuria over silver oxide (coated on the external surface only), silicone Foley, and standard laytex catheters respectively. Silver alloy catheters cost around $5 more than standard laytex catheters but if you find you are prone to urinary tract infections they are worth trialing.
UTI Medications and Drugs of Benefit
Hiprex tablets (Mandelamine) Urex or Ural the anti-infection drink can help. Hiprex is a pro-drug absorbed from the gut passing into the urine where it’s hydrolysed to formaldehyde. Formaldehyde causes the breakdown of proteins/sediment essential to bacteria. However this only occurs if urinary pH is less than 5.5 acidic which is considered an unhealthy level. It’s a big pill to swallow and tastes like horse piss but they work. They recommended twice daily but one every three days was enough for me.
You may like to try D-Mannose or Ethical Nutrients Urinary Tract Support (in Aus) and Probiotic supplements (see Diet above for more). Everybody produces sediment it’s just that “regular” people don’t notice it. Tell them to pee into a jar and wait 6 hours, they’ll see sediment.
With supra pubic catheters the bladder is constantly drained. Over time the bladder may contract or shrink (like any muscle does) frequently spasming. The condition is called an overactive bladder. Ditropan, Vesicare, Enablex and Detrol LA are bladder specific muscle relaxants. These are prescribed to help reduce spasm and shrinking. You can imagine how hard it would be to get a replacement catheter located correctly when your bladder is the size of a grape. Of course, please consult your doctor before taking any new medications.
Ceasing Use of Supra Pubic Catheters
No need to worry if supra pubic catheters are going to be the right type of bladder management for you. If for any reason you are unhappy with your SPC it is fully reversible. Just leave it out and resume your old method. Of course you must consult your doctor first. The last thing you want is a raging infection left trapped inside your body.
Basically you restrict fluid intake, remove the catheter, and cover the old site with a dressing. It is that simple. For best results we suggest you cease all activity for a few days to allow the site to heal. Keep the dressing clean. Also avoid showering and over-distending the bladder. Generally your bladder will seal itself off within 10-60 minutes. The suprapubic catheter site takes a few days to weeks to fully heal and will leave a small scar. Like I said however, please consult your doctor before you go leaving it out.
Kind Regards
Graham Streets
MSC Founder
Further Resources
- Care Guide: How To Care For Your Supra Pubic Catheters
- Queensland Health: What is a Suprapubic Catheter? PDF
- Spinal Injury Center: Managing your bladder with a suprapubic catheter
- Wikipedia: Suprapubic cystostomy
- Library of Congress Cataloging-in-Publication Data. Spinal cord injury / editor, Thomas N. Bryce; associate editors, Naomi Betesh. Rehabilitation medicine quick reference.
- I. Spinal Cord Wounds and injuries handbooks, manuals, etc. Bryce, Thomas N.
- II. Series: Rehabilitation medicine quick reference. [DNLM]
- III. Spinal Cord Injuries, rehabilitation handbooks: [WL 39 S757 2010] RD594.3.S6683 2010.
- Maki DG, Tambyah PA. Engineering out the risk of infection with urinary catheters. Emerging Infectious Diseases. 2001; 7:342-347.
- Karchmer TB, Giannetta ET, Muto CA, Strain BA, Farr BM. A randomized crossover study of silver-coated urinary catheters in hospitalized patients. Archives of Internal Medicine. 2000;160:3294-3298.
- Saint S, Veenstra DL, Sullivan SD, Chenoweth C, Fendrick AM. The potential clinical and economic benefits of silver alloy urinary catheters in preventing urinary tract infection. Archives of Internal Medicine. 2000; 160:2670-2675.
- Riley DK, Classen DC, Stevens LE, Burke JP. A large randomized clinical trial of a silver-impregnated urinary catheter: lack of efficacy and staphylococcal superinfection. The American Journal of Medicine. 1995;98:349-356.
- Newton T, Still JM, Law E. A comparison of the effect of early insertion of standard latex and silver-impregnated latex Foley catheters on urinary tract infections in burn patients. Infection Control and Hospital Epidemiology. 2002;23:217-218.
- Thomas L, Valainis G, Johnson J. A multi-site, cohort-matched trial of an anti infective urinary catheter. presented at Society for Healthcare Epidemiology of America (SHEA), April 7-9, 2002.
- Leape LL, Berwick DM, Bates DW. What practices will most improve patient safety? Evidence-based medicine meets patient safety. JAMA. 2002;288:501-507.
- Ahearn DG, Grace DT, Jennings MJ, Borazjani RN, Boles KJ, Rose LJ, Simmons RB, Ahanotu EN. Effects of Hydrogel/Silver Coatings on In Vitro Adhesion to Catheters of Bacteria Associated with Urinary Tract Infections. Current Microbiology. 2000;41:120-125.
- Liedberg H. Catheter induced urethral inflammatory reaction and urinary tract infection. An experimental and clinical study. Scandinavian Journal of Urology and Nephrology. 1989;Suppl. 124. BARDEX System with Anti-Infective Foley Catheter ®I.C.® 49629_0304-25.qxd 12/28/06 2:13 PM Page 1
Thank you Graham. My name is Denise and I am from Australia. I found your site by pure luck, but it is exactly what I was looking for. I have a Super Pubic Catheter due to Multiple Sclerosis and it has been bypassing almost constantly for the past 2 months.
The nurses keep changing the catheter, but it makes no difference. They got in touch with my Urologist and he was going to resite it, then they discovered I had a Staph Infection, so it had to be postponed. When he was ready to do the operation I got pneumonia, so I’m still left with a bypassing SPC which is really burning my skin, as I can only lie on my back – I can only sit out of bed long enough to have a shower.
I had my SPC inserted 5 years ago and would you believe, the site has never stopped bleeding. Sometimes it can take uo to 30 minutes for the bleeding to stop and then I have to have a pressure dressing applied, incase it starts again.
The site it self is so sore, I could cry. I drink plenty of water and have cranberry juice every day but still end up with UTI’s. The spasms are also unbearable. I am sorry for rambling on, but do you have any suggestions, besides suicide, because that’s what I feel that’s my last option as nobody seems to be taking my problem seriously. Please HELP
Gillian: Given the complexity of your problem the best thing you can do is follow your urologists advice. An SPC should work for you and if not still be reversible. Agent: It sounds as though that is exactly what’s happening. An antispasmodic drug like Ditropan, Enablex or Vesicare may reduce the spasming and allow room for the catheter when empty. Also be sure to keep your drainage bag below the supra pubic catheter site.
Denise: A resite could ease the problems but not cure. A quick relief and preventitive from urine burns is a coating of PLAIN vasaline, use something like a stable table to keep your covers off your tummy. Follow up with all the advice in our article for best results. For most the SPC site never truly heals, keep the site clean, use sterile catheter changing techniques, limiting trauma etc should prove beneficial long term. Ask your doctor about Ditropan and Hiprex, these should also help reduce site and bladder trauma from spasaming and urinary tract infection conversely. Urine burns are painful, hang in there Denise.
hi, my son who is a quad just had a sp on july 2, we went on july 14 for a post op and the dr changed the tube and couldnt insert the new one and had to do anther cysto and my sond blood pressure went up to 198/117, i had to request the nurse check his blood pressure, which really ticked me off, but anyway she was really short on how to care for the site and i also told them about all the sediment that i had seen and i was told that he would have this.
i almost lost him back in may as he had a indwelling and the home health nurse inserted it wrong and her was bleeding big time and ended up with uro sepsis and was in ICU for 2 weeks. any info on the sp would be very helpful and ease my mind. thanx
Denise: There are two basic types, laytex catheters usually brown or grey are designed to be changed monthly, the other silicone or hydro-gel coated catheters often opaque green or blue can be used for upto three months. See the guidelines on the packaging for a max recommeded usage time. The frequency of changing any catheter should otherwise be determined on an individual needs basis. A person who produces high sediment levels may find the catheter blocks every 3 weeks so regardless of laytex or silicone it will need to be changed every 2-3 weeks.
Debbie: Your son could benefit by following all of the advice in our article especially use of a bladder antispasmodic drug like Ditropan. I recently increased my dosage of same after finding bladder shrinkage made it difficult to correctly position a new catheter. I too had alot of bleeding.
Hello Graham: I’m researching the net for info on SPC, as my urologist recommend as alternative to foley chathater method. I have been a quad for 39 years (1970), and have managed with Texas Cathater until a five years ago. I started the IC method, however I could not get home health service for cathing because HHC comapanies would not allow nurse to come to my home 3 times per day.
My wife became ill and could no long do my IC, so my urologist suggested foley which is changed normally every four weeks in his office. This has worked, but it is not a long-term solution. Urologist suggested a SPC and explained surgical process, recovery time, and SPC foley method. He has had on a coupe re-do’s, as individuals had SPC pulled out of port by atendant or caught on clothing, or something.
I’m from the old school before high tech methods and medications, as most people “crapped-out” with a broken neck (C5/6) in 1970. (By the way, if someone is offended by my use of “Old Gimp”, I earned the name. It is my Badge of Honor.) In 39 years, I have been through all the highs. However, I thank you for your info, as I’m less concerned about the Supra Pubic Catheter method, as it is reversable.
I have complete trust in my urologist and his ability to preform this surgery. Your site has provided a lot of info about SPC care and mantainance. My knowledge of quadriplegia is extensive, but not about SPC. My background is Rehab Technologist with GA VR, and now a state retiree as of July 1st. Any suggestions welcome as I need to make a decision and schedule this surgery, as my current method is not a long term solution. Thank You Graham.
Hi I’m 82 year old and have had a catheter in for a few months. I am booked in to have a super pubic catheter fitted soon, but I don’t know if I am doing the right thing. The catheter that I have now has been rubbing on my penis and making it sore. The reason that I have a catheter is because of urine retention and I don’t want to go through an operation to have a massive prostate gland removed. I do not have cancer thank God. I am very scared of all operations and don’t look forward to having the super pubic tube done.
Note to Carol: What is an AHF setting, and what is an RND? I am an RN who has experience in changing, as well as flushing the SPC. IMPORTANT FYI to other recent inquirys about functioning and care of a Supra Pubic Catheter, please see Graham’s notes above the comments, as well as read the comment archives. Your answers will probably be there! Sincerely, Anne
Hi Anne, Just read your post concerning the ongoing problems Bill is having with spasms. I have had very similar problems since having the SPC fitted, the spasms are unbearable and some days i cant even sit up in my wheelchair due to the level of pain, I to have been put on Oxybutinin which only helps a little but like you said the side effects of a dry mouth are awful and get on my nerves. You mention botox treatment being an option, I was given 300ml of botox into my bladder in January and although it left me painfree almost immediately after having the treatment it only lasted a matter of a couple of weeks before all the spasms were back to normal. I am now going back in on April 30th for my 2nd treatment and the urologist has told me they will put in a larger amount this time which should help for a longer period. He has advised that I will need it doing every 3mths thereafter. I am holding out on this time it being more of a success but since having the SPC last August I have been in so much pain that if it doesnt give me the relief i need this time, i am considering having the SPC removed. Hope this helps you a little Anne, as at least i have experience of having the botox treatment. I hope Bill gets the relief hes after very soon.
Good to have you back Graham, and thanks again for a great site !!
Hi there, thanks for the information and reading everyones comments been a help to me. I was looking for information before I had SPC and botox but only searched UK sites and didn’t feel there was the kind of info I wanted. I had my supra pubic catheter done last Tuesday, it still sore and very weepy around site, but it not infected which is a huge relief. I got a confession, I terrified when it comes to having my first cath change done, sure once it done I wonder why so scared about it but I am. silly really as gone through much worse things. As a wheelchair user I have the bag high on thigh but use G straps which I dont get on with, anyone know other methods of holding in place? Thanks Terrie
Hi Anne, I’m still working on a full site overhaul which will include a whole new comment script. Meanwhile make a copy of your post before submission and repost if it doesn’t show. I did have a great time with my girlfriend thanks Anne and Kerry, she is so beautiful and totally awesome, the center of my universe. For Bill I think it would be worth the trip to try botox at least once, then you can weigh up if it’s worth the trip. Kerry makes a good point about the volume of botox used, you will want to take that into consideration too. Until such time I would prefer a dry mouth over spasming and the worse possibility of a bladder the size of a grape. Chewing gum or lollies (candy) can aleviate a dry mouth. I take 5mg Oxybutynin twice daily, my skin can become really dry. Terrie: It’s not silly to be afraid of the unknown, but I can assure you changing the catheter is quite a simple procedure. Now, you could attach some kind of backpack or something like a small pillow case to your wheelchair and place your leg bag inside it. You’ll find pictures of what I’m talking about in our Forum. There are many different tpes of drainage bags and collection devices you can experiment with.
Suzan: I’m glad to hear the catheter change has lowered pain levels. Try turning it frequently to keep it free. Four male urologists gawd, shame your good leg didn’t connect with at least one of them lol, how invasive & inconsiderate. 28 days is interesting, not cost effective at approx $179/12. I currently use blue Foley’s with an orange banded port, 5cc balloon, good for 3 mths approx $120/12. I posted Pubovaginal Sling Procedure information in the forum for you.
Terrie, first of all I want to comment on your fear of the Supra Pubic Catheter change. I presently have an opinion, similar to Graham’s, that it doesn’t have to be a huge “thing”. Fear of the unknown is part of it, I’m sure…but a little, quick “tug” is all my “Super Trouper” (ABBA fan forever!) Bill now experiences, and only for a few seconds. It is simply not a big problem anymore; a point which I hope you can get to, as I’m sure you can. ENOUGH… when you have all the other stuff to deal with!!! R/T spasms, now that’s another story. The local Urologist is now suggesting we try the med.”Vesicare” for Bill’s urinary spasms. Anyone had experience with it? Graham, I am willing to try the Botox Rx. at a later time, but presently his Neurologist wants him to try a Baclofen pump for his general spasticity…so I guess we will work with the “Vesicare” med. for the urinary sx., for now. WHAT a disease MS is!!! Not that any of you, (sans MS) are suffering less, but Bill’s symptoms are never-ending in their constant, unpredictable changes, a challenge to anyone’s intellect and background! I guess that’s the “Name of the Game”. (another ABBA plug)! XXXX’s to all of you in your effort to make things better, which I know we can do together with this site!
Anne: Seems like everything comes full circle huh? Oxybutynin (Ditropan), Tolterodine (Detrol LA), Solifenacin (Vesicare), and Darifenacin (Enablex) are all much the same drug for treating an overactive bladder, all have the same side effects. Sure it won’t hurt to switch but most likely it won’t make any difference. The advantage of these over Baclofen is they target the bladder smooth muscle specifically, though I understand the need for Bill to take Baclofen for his general spasm. I know a woman who had a Baclofen pump installed, it had to be removed a month later due to a terrible infection. I’ve a mate who takes 4x25mg oraly daily to great effect.
Hi all, I recently had a Supra Pubic Catheter proceedure after wearing a condom catheter for almost 30 years. I’m a 50 yr. old C2 quad with disjointed feeling and not much movement. Since I’ve had the spc I’ve had several different problems, it’s been almost 4 months now, it’s still uncomfortable and I am leaking once or twice a week, probably 100 to 200cc per episode. Is my body adjusting, or should I expect this? I’m going through many other changes, can age and quadriplegia be a factor? When I’m up in my chair I don’t urinate very much, and it’s usually very rust colored, is that common? Thanks Randy from CA…
I?m a 30yr. old c1-c2 with a SPC(5yr). I have to change my SPC every 10 days due to sediment. I tested my ph level and it was 8.3. My bladder constantly has a burning sensation, which causes spasms. I drink plenty of water throughout the day plus irrigate my SPC once a day. I do take Ditropan everyday. Any suggestions would be appreciated.
Hi Jeff: Believe I can help you with this one. I initally suggest for you to do all of Grahams reading re: this topic. It can be found previously on this site…even go into the archives for more comments. Many are relevant an helpful! For now, I can tell you that your pH is rather high (alkaline), an environment the urine “beasties” find more/most favorable to grow in than acidic, which is under 7…(7 being neutral). Mandelamine/Urex/Methenamine MD,etc., 1 Gm. 4X/day per originally suggested has helped immensely. Also, watch your diet, and avoid alkaline foods…this dietary list can also be found on line. I’ve found that Cran.Jce., mixed with h2o and sweetening rally helps my MS Pt. He gets diarrhea with too much (any) juice. Water galore is always helpful. I am an RN caregiver of my MS pt. (Bill) who’s SPC also attracts mega sediment. I also HAVE to irrigate. Graham has been my savior in helping with these problems…more than the Urologist who sometimes brushes it off by stating, “Bill’s SPC problems are like nothing I’ve seen much. He has a very difficult to manage, and contracted bladder!” NO S—-T SHERLOCK! Has he given me helpful solutions, heck no…but his nurse and GRAHAM have. You should try them. Foley changes that frequent are not good, and are costly! Also, you might investigate the special Cath. types that cut down on sediment; silicone, teflon, for starters. It’s what your insurance wll cover in this country, anyways. I have spent mega hours on your problem, and hope my knowledge I’ve gained will be helpful to you. Sincerely, Anne
Hi, I am a carer have several clients with supra pubic catheters and wanted to find out more so used your website, which has answered alot of my questions. Thank you.
hey all, i am new here . I have had a super pubic for about four months now, no luck. many uti’s. doc say’s bacteria interduce throu s.p. I keep it clean shower in morning, use hydrogen peroxide in morn and at night i drink alot of water and cranberry juice, vit. C. have a good diet. do any one have infromation on swimmimg, or surfing in the ocean with a super pub???? help. Danny
Danny: Vitamin C increases sediment levels in most people and sediment promotes bacteria/infections. Ask your Dr about trying Hiprex or Urex. As stated in the article and comments swimming is no problem. Avoid drinking an hour prior, empty your bladder and bung a spiggot or tap into the catheter. Saltwater is actually good for your super pubic catheter site.
Graham, is it ok to use an ointment on a sore spc site ?
Hi my name is Dennis i,m a c6 quad, I have had a spc for 2 months now and i,m wonder when it will stop bleding sometimes and having puss most of the time. Don,t get me wrong it is better than having it in the end of my thing and it dose not hurt so some puss and blood I can keep it clean. Thanks to you all for helping me out.
My dad recently had to have a SPC after many years of trouble urinating and a failed urethral reconstructive surgery. He doesn’t have a follow up appt. with the doctor for another month….any ideas of how to clean the tubing to get all of the sticky tape and lint off! Your help would be greatly appreciated!!
Graham, another question. My spc site gets very sore as the day goes on. The site shows no sign of infection, just a little itching that I have had before the soreness. I did have an inguinal hernia op recently and the soreness seems to have started about that time. I am pretty sure i do not have a uti. Overnight is is ok, just starts after I get up and gets progressively worse as the day goes on. I notice that the edge of the hernia incision is close to the site. Is it possible that the nerves have been upset by the hernia op? (They say if you want to know something, ask an expert)
Geoff: Hard to say what’s causing it, you could test your theory by taking ibprofen (Neurofen) which targets nerve pain. If you get relief you’re probably right, unfortunatly there would be no fix.
I found your site just googling around trying to see what my spc will look like. I have the procedure scheduled for this Friday. I am hoping I will sleep at night. I use timed voiding during the day, I am bed bound but can pivot to a bedside commode. In my wheelchair I can’t transfer myself, I have an adaptive chair that is cumbersome in a bathroom. I am looking forward to going out of the house again. Thank you for the real life advice and feedback. I learned more about my procedure from reading the posts than from all my pre-op visits.
I had the SPC since March 20, 2009. Recently noticed little blood near the openning. Should I be concerned?
Thanks Laurie. Robert: No a little bleeding now and then is common. It should stop quickly, If it’s a continual on going bleed you should try to find the cause, usually trauma like pulling on the catheter.
Hi just been reading all comments on SPC at the moment feel frighten. Could be having one shortly as i had a failed matroffanof (not sure on spelling). That was the most frightening thing i have ever had. Unfortunately the used my appendix and once the catheter was out my appendix collapsed and i was unable to use it. Now it has left me in a worse condition than before and the pain is unbareable at times. The UTI’S and pain in the kidneys leave me quite disablerling. My head all over the place would most of you say SPC way forward. Thanks
Anyone with a SP using a flipflow valve ? Do you have any problems when you switch it to free drainage? At the moment i’m having to constantly keep the valve off then when my bladder fills release it until its nearly empty then quickly clip off again. If I leave it to fully drain the spasams will kick in hard. I suppose its as if when draining my bladder is contracting and the cathater is touching the wall causing problems. Previous to this I had a regular catheter with a flip flow valve and had none of these issues.
Thanks Graham. As a former ICU Nurse, I make sure a sterile technique is used every time the catheter is changed. How often should the catheter be changed?
Debbie: I am thankfully on the right “trail” now, after a long time of problems. I would read everything here, including the archives. I totally agree with Graham. As a full-time RN caregiver for a Pt. with awful urinary problems,1 I am very thankful for this site ( a one of a kinder)!!!!!!!!
Hello Graham, I am a paraplegic and have gone to an internal catheter due to so many times of the external coming off at the wrong times. However, no I have found I just don’t ever sleep well and think it is due to some stress caused by the catheter. Also my body below my injury level seems to stay in a constant sweat. I am thinking of having an SPC done and would like your thoughts on the matter. New to the site, Charles
Hi Charles: Sweating is pretty common for new IDC (In-Dwelling Catheter) usaers as they irritate the urinary tract, urethra and bladder. It may settle after 3-6 months. An SPC (Supra Pubic Catheter) probably wouldn’t make much difference as they also irritate the bladder. Consult your doctor or a urologist about medications to reduce the sensitivity you experience. Also use anaesthetic gels like Lignocaine when changing the catheter. Exhaust all the less invasive options before considering an SPC.
My son is 19 and recently had a suprapubic catheter (2 months ago). Sometimes it will drain and sometimes it will not. I can flush easily but can’t get anything on return. He recently had it replaced and this catheter is doing the same thing. The doctor did say something about it being on his bladder wall, but really didn’t give any advice how to get it back going again. Any ideas how I can reposition it?
Hi Lynn: I’ve never understood the “against the bladder wall” reasoning. A catheter has two eyelets, if one is against the wall the other is still free to drain. If the bladder has constricted pushing the cather tip down the urethra then sure both eyelets are covered. An ultrasound will help determine what’s going on. Then solutions may include medications to relax the constricted (overactive) bladder, a different type of catheter, use of an indwelling catheter until things settle.
An example of “against the bladder wall” would be when one eyelet is blocked, and the other is, in fact against the bladder wall,ie, interfering with flow.
I have an spc—I use a night drainage bag at bedtime–my question is—-Is there any type of leg bag that is available large enough to replace the bulky night bag?
I appologize for my lack of response to recent questions. I hope the people who frequent here will cover my ass. We are working on a more reliable commenting system and whole new look to our website. With over 6000 valued comments to preserve it is quite a task.
In Southwest Washington, are there any nurses(RND) out there that have delegated flushing a SPC in AFH setting?
I have had a SPC since June, after a tube pull I had several infections. Sipro worked, but now I feel pressure to void and have to transfer to my bedside commode. After very painful contractions I manage to go about a teaspoon. It relieves the pressure for about about 20-40 min. then the cycle repeats.
I take detrol LA. Have my tube changed every 4 weeks. Lots of site discharge, dark mucus. My bag drains well, no fever. Doc is not very concerned. I am, the whole point of my SPC was to avoid risky transfers. Now I have to wait another 4 weeks to be told, things will probably resolve. I have been reading the posts since January when I decided to go with the SPC. I know someone has gone something like me, please share I am worried. Thanks
My husband has multiple sclerosis and wants a super pubic as well. The other one is causing him lots of uti’s. Does this one get this uti’s? Thanks, Juliann
Laurie: June and it’s strill weeping heavily doesn’t sound good. Ask your doctor to take a swab and test for a site infection, you may need antibiotics. I know it can be difficult but keeping the site clean sterile and dry will aid the healing process. Draining well and still getting the sensation to void indicates Detrol LA isn’t working for you. While at the doctors ask about increasing the dosage or switching to Ditropan, Vesicare or another similar alternative.
Juliann: Yes, anytime you have a foreign object inserted into your body there is a pathway for bacteria to get in. I assume your hubby has an IDC Indwelling Catheter. The incidence of urinary tract infections between IDC and the SPC Supra Pubic Catheter method are about the same.
Thanks Graham, I will have a site swab next visit and ask about a med change. I have found a few things that may help to keep my infections down. I go to to VA SCI clinic every 4 weeks for a tube change. In the past I was changing from my leg bag to my night bag daily.
I go to school for one class a day and did not want part of my tube showing. I got a cloth stethoscope cover. It slides over the part of my tube that comes out of my night drainage bag and I use cloth tape to secure both ends. The tube that comes out of the bottom of my pants is now covered. I am not trying to hide the fact I have tubes, I just don’t like my urine flow out there for all to see.
I am mindful I do have an open pathway for bacteria. Now when I go out my privacy is intact and I am minimizing the number of times I open the pathway. My leg bag would also reach capacity and it had no back-flow chamber like my night bag.
Accidental tube tugs during bag changes are down. I use a statlock at the y and a Bard wide leg bag strap above my knee to secure my tube. Let me know your ideas, thanks.
hiya all just been reading all your words of encouragment , i go in hospital on 13th oct for super pubic catheter im bialateral amputte with spina bifida , from all i have spoken to everyone says its the best thing they ever had done , so hopefuly il be saying the same next week x
hi newbie ti site here, i am dissabled, spinal nerve compression, wheelchair user, i’m having an SPC op on monday 19 th oct, as i am incontient with a retentive bladder, and feel releived to have found your site and this post to put me at ease. i also have type 2 diabetes and am on 216 units of insulin a day, stomach ulcer, high blood pressure etc, etc, so thanks for this great post, as i am getting feed up with none stop, water infections, yours truly papa12, uk
wow!!! im very shocked at all these comments and so many people that have spc. I have a four year old daughter soon to be five and she has a spc, due to bladder problems and spinabiffider. she still gets uti’s. the next step for her is a mitrofanof, witch she is not looking forward to.. she is very open about her spc at school, but doesnt understand why she has it! im asked questions from her eveyday about her condition and i can only be as honest as i can. she is an amazing child and is pleased with this web that i have found, as she now see that she is not the only one with it.
Hi Carly, most people only research these things when having problems or are considering a supra pubic catheter so we don’t see many “everythings fine” comments here. Just as we don’t drop by a mechanic to tell them my car is running great! I’m not a doctor nor Spina Bifida expert but if your daughter ~waves hello~ is of reasonable health and her spc works well, why go for a Mitrofanoff?
I wouldn’t be looking forward to it either. A surgical procedure where the appendix is used to create a conduit between the bladder and skin surface creating a stoma usually at the belly button where a catheter is then inserted several times a day to drain the bladder. I don’t see a medical reason as passing catheters can cause uti’s. Is it more a lifestyle choice?
hi all, had SPC op yesterday, home by afternoon, a bit sore, feeling bruised today but am feeling good, just got my leg bag fitted up, yours truly papa12
Great Site! I’m a colon cancer survivor that has a neurogenic bladder as a result of my surgeries. I’ve had a SPC for about four years and like most of the posts here, it’s a “love/hate” kind of deal! I like the convenience but I dislike the smells when I get a UTI and the occasional plugged pipe.
It took me over a year to convince my Urologist that I was a big enough boy to change my own catheters. I changed Urologists and the new guy got me set up with a refillable standing prescription for Cypro so my UTIs can be treated when they are dicovered instead of having to go into the doctor and do a culture.
A word of warning.. If you are as active as I am, it’s possible for the catheter to pop out without you knowing it. The balloons on all the foleys I’ve used do deflate over time. I check mine weekly by deflating it into a syringe then reinflating it. Since I started doing this, changes have been easier as well because it dislodges the balloon from the bladder wall.
Mine popped out sometime in the middle of the day at our lake cabin this summer. I discovered it when I went to take a shower. Panic ensued! We rushed to the local ER and found the folks there as ignorant about SPCs as I first was. I talked them out of a smaller, 16fr cath (I was wearing a 22) with a harder tip and reinserted the catheter myself while they stood by wringing their hands and waiting for my Urologist to call them.
I just kept a firm steady pressure on it, pressing just hard enough that it didn’t hurt too badly. After about 60 seconds it slowly went in! I had just gotten dressed when the Urologist called in and, you guessed it, gave them the exact same instructions! Ahhhh common sense and an empty bladder! I’m fairly certain that it had been out about two hours before I put the new one in.
OK, so an SPC may not be a particularly perfect or elegant solution but I could never wear shorts anyway (ugly legs…). But it’s better that self cathing four to six times a day. There are times when I wonder if I should go back to a self cath set up but after weighing the convenience factor, I’m sticking with an SPC! Thanks for all the great info here everyone!
Since I fell and broke my hip I’ve had bladder spasms that the doctor cannot control. I’m 88 years old. The hip healed just fine but they have not removed the cath, it’s been in since the operation 3 months ago. I am in horrible pain from the spasms. I want the cath out. It feels like I’m sitting on a thorn bush. My doctor wants to do a SPC which I’m okay with. Will it stop these spasms. If it won’t what will it be like with the SPC. When I have the spams, which are many everyday, I leak all over my bed. Please help me. Thank you. Evie
Hi Evie, the Supra Pubic Catheter method is a shorter path, that is less catheter in your body = less potential for irritation. Obviously you would no longer be sitting on the catheter so hopefully the thorn bush sensation will ease if not stop. I would think, whether you do or don’t go for an SPC, drugs like Ditropan, Enablex, Detrol LA or Vesicare will help reduce bladder spasm. Please ask your doctor as the risks involved with taking these medicines greatly increases with a persons age.
Another possible spasm cause is urinary tract infection, again your doctor can test for that. My one small concern as you have full sensation would be the pain at the SPC site (catheter entry point usually just below belly button). As I said, considering your current pain and discomfort levels it’s of little concern really and there’s always numbing gels etc.
Graham, I’m a registered nurse clinical educator and I have been searching for legitimate medical journals to teach our RN’s about protocol and standards for changing suprapubic catheters, and would you believe the info is very hard to find. Your posting has been my best resource so far. Unfortunately, I have to refer to medical/nursing journals/literature in my teaching. You don’t know of any do you? I appreciate the information you have provided. I’m sure it’s helping many people. Thank you, Tara
Hi Tara, I also found it hard to find so started making my own kit. Most are taught the technique of changing a supra pubic catheter by demonstration from someone who has done it before. I have written a 10 step procedure and plan to offer it for purchase through this web site. It will include a sealed sterile catheter change pack and an instructional DVD performing the steps, with follow up additional common questions and answers. Meanwhile I can only suggest you try a library, a spinal unit, and paraplegic, quadriplegic and spinal cord injury type of associations and support organisations.
hi just reading your comments, my father who is 87 had a pubic catheter fitted yesterday 3/11/09, he was addmitted into hospital last night as he was losing blood by the time he was admitted he had lost approx 2 n half litres i called the hospital this morning to ask of his condition they told me he was still losing blood, i just wondered was this normal
No Angela that is not normal and hospital is the best place to be. 2.5 L is a lot of blood to lose. At 87 I expect a transfusion would be be necessary. If it only started once home perhaps the catheter was accidently pulled on to hard.. no use speculating. I’m sure they will identify possibly with an ultrasound and help correct the problem asap.
I am interested in having a superpubic . I have a spinal cord injury for about 35 years. I was wondering if I did this procedure it could reduce my UTI ? thanks, Matt
Hi Matthew, reduce from what? What is your current method of bladder management? An Indwelling Catheter and Supra Pubic Catheter have about the same incidence rate of Urinary Tract Infection. Most UTI are caused by non-sterile proceedures. You’ll find this has been discussed a lot in the older comments here.
You?ve assisted my understanding on what is usually a hard to tackle subject. Thank you!
seriously considering spc. having read all the letters on this page am more convinced its the right way to go. the only thing that concerns me is, I’m immobile and worry as to how they would manage me to have the small op. your comments would be much appreciated.
I’ve had my SPC for 5 weeks now and I’m perfectly fie and active apart from a blocked ureathra. I use a flip flow without any problems and connect this to a night bag for convienience. In the 1st couple of weeks I had 2 kidney infections, now I drink lots of water and this helps keep them at bay aswell as stopping me feeling like I need to go to the loo when I don’t. My only concern is the SPC site is painful and always weeps a sticky goo & bleeds ocasionally.
I alternate between wearing a wound dressing and not. This is just to experiment really. I can’t seem to find a level of comfort and this is starting to wear me down, along with the smell when I am not wearing a dressing. I am active daily and my catheter moves in and out and rotates freely, however this seems to draw more gunk out. Any advice will be greatly recieved TIA Dave.
Graham: I first want to say that this site is an absolute godsend! For 25 years I have been managing through condom drainage with relatively infrequent bladder infections (C5/6 Quad). However, the last 3-4 years I have been experiencing frequent UTIs. So far, I have not been able to avoid this through the normal channels (cranberry juice, lots of water etc.).
Over the years I have had several sphincterotomy procedures, which was the preferred method of my urologist. Lately I have been considering a SPC, but only have two friends who have done it. One of them swears by the procedure and the other is not happy. Both of these gentlemen have been dealing with spinal cord injury for over 40 years. After reading through your site, I am still not 100% clear if having a SPC will likely reduce the amount of infections that I’m having.
I wish that I’d known about SPC earlier for the convenience, but I’m not sure if that is enough reason for me to try it now. I’m also wondering if any folks having a SPC have had to deal with autonomic dysreflexia/hyperreflexia in a severe form?
I did read where a few people had sweating for several months, but I’m afraid of the headaches, high blood pressure, profuse sweating etc. This is not a problem that I have had for several years, but it always reappears when I face any type of new trauma, such as surgery, bad infections etc.
Lastly, I’m trying to clarify if the Mandelamine would be helpful even while I am on condom drainage? If possible, I would like to try any noninvasive strategy that could help reduce or eliminate these infections. Recently I have been experimenting with D-Mannose. Has anyone tried this, and if so what dosage and how often. I will definitely pass the site information along to my other friends here in Canada. Thanks again. Roger
babs: Immobility is not a problem. Most people have a supra pubic catheter due to their lack of mobility and often are unable to self cath.
Dave H: To reduce pain apply a babies teething gel around the site. If it provides some relief you might want to use a more powerful topical local anesthetic like Lidocaine or Zylocaine. The weeping goo should lessen over the next month or two, it’s just your body trying to expel the catheter. Activity causes rubbing which causes pain but of more concern continuous rubbing has also been attributed to causing tumors.
Roger: Thanks mate. I would try an InDwelling Catheter IDC. They can be left in. The incidence rate of UTI between an IDC and SPC are around the same. I’m not a big fan of sphincterotomy. If you have tried the IDC method unsuccessfully SPC would be next. It’s always reversible.
I’m about to publish an article here on Autonomic Dysreflexia. While I don’t suffer from it greatly anymore when I did I found IDC and SPC incited the condition equally. As you know the causes and severity will vary between individuals but should not be overly severe in either case. It’s best to stop UTI at the cause though often hard to pinpoint.
Mandelamine should reduce UTI in any case as it’s converted to formaldehyde in the bladder. Many fully functioning people benefit from the drug. Can’t hurt to try D-Mannose. General dosage is one teaspoon daily. For acute urinary tract infections one teaspoon every 3-4 hours for 24-48 hours.
Thanks Graham for the teething gel tip I will try that. Do you suggest any form of dressing or just leaving it to breathe? To anyone worried about a supra pubic catheter on the grounds of insertion surgery, I’ll share my experience. I had mine inserted in A&E thats ER if your in the US. This was due to me having a full bladder one litre with no other way to expel it. There was no time for operating theatres. After a quick local anesthetic and a tiny incision the catheter was pushed through the bladder wall, it all took about two minutes and was painless.
Depends how much gel you need Dave, generally it’s little enough to not need covering. 5 weeks post op just keep activity to a minimum for a few weeks yet to reduce the small bleeds and allow a good heal. Thanks for sharing your experience with us.
Hello Graham, your website info is fantastic. I have a blocked uretha caused by calcified Prostate and the doc put in a Supra Pubic Tube. I use a leg bag during day and a foley bag at night. My problem is the tube gets blocked up frequently. I do flush twice a day with water but cant take much more than 2 ounces. I am also leaking thru the penis when the tube is blocked. I was passing stones and sand thru my penis but it looks like that stopped. I have had the tube replaced by doc 3 times since my operation Sept 25th.
I will try the beer… sounds good… I will also drink lots of filtered water and keep checking the tube. I try to keep everything clean. Penis burns which indicates UTI is present… was taking AZO but got to be careful with that stuff becasue it stains…. Question: am I doing things right???? How can I cut down on UTI?? RayT
Ray: Thank-you. 2 ounces (60 ml) is a reasonable amount for a bladder to hold and while bypassing thru the penis is inconvenient it’s a good safety valve for a blocked catheter. Sounds like you’re doing all the right things. Taking Mandelamine (Hiprex, Ural, Urex) or D-Mannose should further reduce sediment which in turn reduces blockages and UTI that build from sediment. It would be good to get to a point where you no longer need bladder washouts as they open you to infection. Checking your pH and the other tips in the article may also help.
Graham, thanks for the tips. I just returned from the urologist, who suggests that I might try a low dose of Macrobid (1 per day) for a month or two! He is not keen on SPC (or any other procedures for that matter, except for the sphincterotomies). I asked him about some of the uti prevention ideas which you have suggested, and although he believes that they could be effective, he did not seem convinced. Since I am not a big fan of antibiotics (unless really necessary), I would rather try an aggressive prevention strategy.
Three questions: 1. Should I be taking BOTH Mandelamine and D-Mannose? 2. I am finishing a seven-day run of Macrobid today and am assuming that I am mostly infection free. If my current infection is not fully eliminated, do you think that the preventative measures that you have outlined will KILL any remaining infection, or is it normally only useful for preventative? 3. Is there a good online source of the alkaline versus acidic foods, or so I just google and put together my own list? – Thanks Roger
I’m not a doctor Roger and don’t know your full case history but you said you’ve had several sphincterotomies and still have problems so why go through all that again. If it were me, I’d seek a second professional opinion. 1. One or the other is best. 2. Kill and prevent, some bacteria can only be killed with specific antibiotics. 3. Our article names most common types but there’s definately more.
Graham, you are fantastic… I tried the beer and it is working great. My urlogist also said to try pure real lemon juice and water w/sugar substitute to taste… both are keeping me UTI free and urine is nice and clean.. dont see much heavy sediment coming out. No more stones and no sand/grit coming from penis.
I am still flushing but now I am using bottled water 2oz and a touch of distilled white vineger(per doc). He also advised me to block off the tube for about 1 hour each day and start voiding from the tube. So far so good. Looking forward to spending Thanksgiving w/family (1st time out since I had Supra Pubic Tube) put in.
I do walk to mailbox but it feels like my whole lower part of me wants to come out thru my penis… after a while it calms down. It is just great to talk to someone other than the doc… thank you Graham have a great day tmw… RayT
I have been wearing a foley for the past 2 years due to a shrunken bladder caused by external beem radation and later cyro surgery[bladder freeze]. these procedures were done several years ago. I have very few infections but have leakage and spams sometimes when I’m standing or get out of a car. when I am in a recliner or sleeping at night I have no leakage and no spasm. my bladder only hold 4 oz. now the dr. has suggested a s p t procedure be done if first I pass a video urodymanics test. after reading all the comments i think I might be better off as is. appreciate your thoughts. thanks so much
Hi Charles, I’d be inclined to agree with you. It will come down to a personal choice only you can make after weighing up the advantages and disadvantages of a supra pubic tube. If your current leakages are annoying you could try an SPT. If it’s of no significant improvement it’s always reversible.
I have a sci for almost 13 years. I used the intermitten catheter for the first few years, then the catheter with leg bag. I started to leak and the uroligist found a tumor in my urethra, and it also was way too large (urethra). A biopsy showed that it was not cancer TG. 4 weeks ago I had a supra-pubic done. For the first 2 weeks I wasn’t leaking from, the urethra, but then I did again, but not alot.
Today a home nurse came to change the catheter. There was some redness around the area, and she had some problem pulling the catheter out. A lot of blood followed, but then stopped. It seemed to be alright and the urine went into the bag.
After she left, about 4 PM, I took a nap and when I woke up, I had a little urine in the bag and the rest on the waterproof pad I was laying on. It was soaking wet. It looks like there is no urine coming out of the catheter, it just straight comes out from the urethra.
Now it’s night time and I don’t know what I should do. It hurts some, but I don’t have all the sensation in that area. Is this all normal? Shouldn’t it be healed more by now? This is all new to me, and I am kinnda scared now. Should I go to the emergency when something like that happens or can it wait til morning and I call my urology?
Hi Oddy, Shifting your position sitting/lying and twisting the catheter may help. A blood clot has probably blocked your catheter or the eyelets are presssing against the bladder wall preventing flow. Grab a sterile syringe 20 or 50 ml works best and fill it with boiled cooled water, ensure it’s cooled! Disconnect your bag plug the syringe into the catheter and slowly push all the water in then gently withdraw. Repeat a few times. Pushing the water in should clear the clot/blockage if you can’t, replace the catheter. If you can’t withdraw the water the eyelets are probably against the bladder wall. Shift position and twist catheter. If that doesn’t help leave the supra pubic catheter in and put an indwelling one in as well until you can get to the emergency room. It’s still pretty fresh at 4 weeks, a little pain is normal. Please let us know how you go.
Thank you Graham. You never guess what happened. After I got off the computer, I called the nurse, she didn’t know what to do, and said, she’ll be here in the morning. I layed down, and wanted to change the dressing, and I see the catheter inflated (the balloon) sticking out from the urethra at the bottom. I thought I was seeing things. So I let the water out with the syringe and pulled the catheter ’til I had a back-flow, and filled the ballon up again. Now, I am having no more problems. I called the nurse back, and told her. She said , that never happened before. When she was here, she had student nurse with her, who done the procedure, and she pushed the catheter in way too far. I kept telling them, that the catheter wasn’t long enough. Thank you for your advise, it could’ve been a blocked catheter, that’s what the nurse thought also. I will keep your advise printed, in case I get a blocked one.
Wow your nurses might need retraining, they could have done serious damage. We once inflated my supra pubic catheter inside my urethra, I bled for days (as in article). To push it right through and out the other end.. wow. My carers grab the catheter right at the site, ensure the balloon is fully deflated and withdraw so they can see how far it was pushed in. Insert the new catheter an inch further than the old and inflate the balloon. It should slip back a little until the balloon rests against the bladder wall. A big drink before a catheter change helps give some room in the bladder to position the catheter correctly. I’m glad you got it sorted out Oddy.
Hello. We just got home from the Urologist and my husband has to have a SPC put in. This is one of MANY setbacks after an accident which resulted in cord damage. He is obviosly not happy. Any words of advice? Overall, is anyone experienced success with this and becoming active again? Any insight would be great! We’re new to this. :(
Hello Jessie, if you read the article and comments here on Supra Pubic Catheters you’ll find many live full active lifestyles with an SPC.
Hi, Have had the SPC for one year now. Yet, site is never really dryed up, excreting small spots of blood etc. Is this normal?
I had lots of pain after a few months of having a SPC. The problem I believed was a shrinking bladder, and the catheter rubbing on the shirking bladder wall. I installed a valve (taken off an old foley bag) and installed just below the catheter. Presto, the pain ceased. I turn the valve off, then leave it turned off until I feel I have to urinate. I then turn the valve on and drain the bladder into the urinary bag. I don’t do this all the time, maybe one or two times a day, or just before I go to bed with the night bag attached.
The valve is easy to open and close even with my pants on. I just reach down and turn the valve off and on through my pants (the fabric). Its easy to do, and even in public I have had no problem with calling attention to myself. The valve also is very handy while changing bags, because I can turn off the foley tube urine while I am changing the leg or night bags. I have had trouble with tubes coming apart at the most embarrassing times. I solved it by installing small radiator clamps.
One problem I have not solved fully, is keeping the leg strap up on my leg without pulling down on the catheter. I have tried a half dozen methods, the latest is using a strap around my chest, with another strap that goes down to the leg strap. It seems to work out OK, but does anyone have a better idea?
Improka: yes it’s normal. The body correctly thinks the catheter is a foreign object and constantly tries to expell it, so it rarely fully heals. prb: thanks for the tips. I’ve seen the garter belt method before, it was a small band above the knee and garter belts each side to leg bag. Apart from a pressure stocking with leg bag staps sewn to it my only other thought is fish hooks, have you seen those guys who hang their whole body from big fish hook? Ouch.
PRB, Hi just to let you know there is a product called a statlock that you stick to on your skin and it holds your catheter in place so you are less likely to pull it. I use one because the straps dig into my legs, It is very secure and can only be removed with adhesive remover.
Also you can get a product known as a flip flow valve which will save you making your own.
I have had an ureathel catheter since May 2009 however on Tues 9th Feb this week I had a SPC fitted, I’m having alot of spasms and leakage today but I know its early days and things need to settle down.
hi everyone. had a spc fitted two day ago, would like to know if should keep covered in shower and any other tips you may have. thanks again babs
Shelly: Thankyou! babs: I found it got so wet I’d need to change the dressing anyway so took it off during shower. After shower pat dry well and sterilize the area as best you can then apply a new dressing. After 4-6 weeks you shouldn’t require any type of dressing. Heaps of great tips in the article and comments here.
Shelly, thanks for the advise. I have come to rely on these valves, and its not too hard to remove them from the catheter bags, but probably not too clean. What would really be a good thing, are three way valves, which would really be handy in flushing the tubes and catheters without having to remove any tubes. Sometimes for cleaning, I use clorox, mouth wash (which has a lot of alcohol in it), hydrogen peroxide, or just plain water. Yet the other day I was told (from a test i took) I have a staff infection, but I didn’t have the slightest felling I had it, except the smell, which I have had a long time. I take so many drugs I always thought that it was just the drugs making the smell. I was told that some people who had problems with bladder infections take a low dose of sulfameth/trimethoprim every day.
The statlock you mentioned makes me wonder of fungus would build up under neath them. This happens with me if paper tape is left on too long. I had my SPC a year ago, and had very little trouble, until after two months, and I had lots of spasms, but they stopped when I started using a valve to shut off the flow from my bladder. This helped because the bladder got smaller from not having to store urine. The valve caused urine to build up and the bladder got larger. I know you must be very careful to not go too far and let urine backup into the kidneys. I just do it while I am awake, two or three times a day. I turn the valve off and on through my pants leg, and even though I am in public nobody knows I am doing it. Will look into the flip flow valves you were talking about. Thank you very much, God Bless
Graham, thanks for your feedback. One more thing. Since, I had the SPC operation 1 year ago, I always had a dressing. Since it leaks. Should I remove or keep the dressing? Would it help dry it out?
prb: Vinegar will kill %80-90 of bacteria at a ratio of 1 part vinegar 3 parts water if that works out cheaper. I don’t know of any 3 way flip flow type valves but will double check some continence aids catalogs I have here.
babs: You said 2 days ago? If 1 year ago unless you’re bypassing a lot of urine I would leave it uncovered for awhile and see how it goes. Dressings can get expensive. Hopefully it will dry out within 3-4 weeks and only require a sterile wipe around the site morning and night. Remember, the supra pubic catheter site rarely if ever truly heals over.
hi again everybody. spc doing just fine, now almost 4 weeks since i had it fitted dont want to speak too early but so far the best thing . you might be getting me mixed up with another babs as some of the comments dont tie in with mine. thankyou again. babs
Hi, Newbie here. When do the stitches come out of my SPC? Great info here. Look forward to talking with everyone. Mike
Hi Mike, it’s not common to have stitches after a super pubic catheter operation. Typical time frames would apply, cat-gut staples or nylon 4-6 weeks, self dissolving 6-8 weeks.
Graham, thanks for your reply. I had one stitch holding the Foley in place. My night time drain bag caused slight rotation/pulling which pulled on the stitch. Yesterday I removed the stitch and noticed the cath sliding out. A quick check and the balloon was still inflated. OK, I found the cath was inserted half way and held in place by one stitch. I’m assuming the whole idea is to keep the balloon off the inside bladder wound until it heals. I am now doing this using catheter stabilization stick on pads. I suppose the doctor felt he did not need to discuss this since I have been dealing with incontinence since 2002 when I fell off a ladder. Since 2002 I have used every kind of catheter. Graham, I’m grateful for your site and help. Mike in Tampa, FL. USA
Thanks Mike, in all my experience I have never heard of supra pubic catheters being stitched, but I am not an MD. In my opinion correct initial positioning is vital to stop the bladder healing over and getting a tube from stomach wall to bladder to form correctly. If it were me, I’d deflate the catheter balloon, gently push the cath all the way into bladder and inflate the balloon. You should then feel the cath slip back a little and rest against the bladder wall. Avoid that overnight pulling. I agree with your conclusion, I think the initial incision was made to big.
Hello Grahem, i have just been searching the internet for any help and advice i can get about my husband and i come across you site which i have just spent an hour going through :-) My husband has self cathertarised for 7 years now as he had strictures. he was on cefalaxin antibiotics 1 a day for 7 years tuesday just gone i had to rush him to hospital having to find he had cepsis. due to a untreated uti which he went to the doctors 6 weeks ago saying that he could self cathertarize properly it felt tight but then would jet out abit of wee then just suddenly stop. the dr told him to stop taking the tabs and to do a urine sample.
so he did that 3 days later rang for results it had come back rejected due to insufficiant information on the bottle this happend 4 times so then that was 5 weeks down the line and still no results no anti biotics and he couldnt get enough wee out.
we rang the docs last monday and they said that everything was satisfactury no futhur action.in the last week he has gone through 50 catherters trying to go to the toilet. then the next day his being rushed into hospital with this awful thing due to the neglagence of the doctor.which rang me on wednesday just gone and told me that the 1st lot of samples that he did (that were supposidly rejected) came back abnormal.
he has got to go and see a urologist next week to discuss a longterm thing for him, i suppose what im asking would you think would be best the spc??? he has a catherter in now and he said he has never got rid of so much urine in a long time. hope to hear from you soon – Kind Regards, Gemma
Hi Gemma, as hubby has full sensation he may suffer considerable discomfort from a Supra Pubic Catheter (SPC). If he requires a permanent catheter I suggest an indwelling catheter (IDC) as it’s non-invasive and the UTI incidence rate between SPC and IDC are equal. If that is unsatisfactory then sure, he could try an SPC, it’s always reversible. You may also want to look into a stoma. No antibiotic is meant to be taken for 7 years, sepsis can be life threatening, get clear and knock off the antibiotics, meanwhile I’d use the IDC method.
hi graham, thank you for your reply. i just told hubby what your reply was. he doesnt have any sensations the only way he knows when to go to the toilet is by his belly if it becomes large and firm. now im starting to think should he have been self catherterizing? would you be able to explain an idc and stoma he is quite worried about what is going to happen even though he dont say it i can see it, i keep trying to reassure him but i think with the help of this site he may feel a little better in himself. thank you again for the reply, regards, gemma
hi my name is adrian in uk just being fiited with ain dwelling catheter and their i was qietalot my difficuty insurting it. i had to go to have a catheter inserted in hospital and stay over night. The next day the head doctor consultant came round and said he was not happy with a indwelling catheter then suggested a spc.I suffered a head injury at the age off 7yrs and i had to relearn every aspect of day to day living over again and persional hygien walking and talking. But as i am a nurse at the hospial and look pritty normal the dr expect me to under stand every aspect on my own and i don’t. I don’t like asking for help this is the last thing i need i need help pleae help and addvise me i have aready tried isc,that don’t work for me just increasing usage of them.i have also tried conveines these don’t work for me either. how offten do spc need changing? what about sex? utis? at the moment i have a long tearm catheter in i am in quiet a lot of pain espicily at the tip. help, thank adrian
Gemma: 1. An indwelling catheter IDC is simply one left in place to drain the bladder. Much like your hubby does self cath only the catheter balloon is inflated to keep the catheter in place. A drain bag or similar is then plugged onto the catheter to collect urine. It involves no surgery and is something he can begin immediately and continue as long as he likes. 2. A supra pubic catheter SPC is similar only it does require a simple surgery to enable the catheter be passed via stomach wall rather than through penis. 3. There are several types of urostomies, a surgical procedure to divert urine away from a diseased or defective bladder. The ileal or cecal conduit procedures are the most common urostomies. Either a section at the end of the small bowel (ileum) or at the beginning of the large intestine (cecum) is surgically removed and relocated as a passageway (conduit) for urine to pass from the kidneys to the outside of the body through a stoma, a self sealing opening near belly button.
Adrian: Depending on catheter type it can be left in for one to three months. I covered sex and lifestyle with an SPC in the article at top of this page and in my “Sex After Spinal Cord Injury” article, in general there are no special requirements. The incidence rate of UTI for IDC and SPC are virtually the same. Good hygiene and sterile changes should be practiced for any catheter method. Diet and medications can also reduce UTI frequency.
hi graham, thanks for the last reapliy, As i have already told u i have just had a idc fitted 3days post after quiet a painful time it took the nurses 3 goes to insurt the catheter i am still in very much pain around the tip is this useual ,and i am getting a discharge from the tip as well ? why? yet again is this usal and will it go away. thanks .adrian
hey graham, i too am a quadraplegic, i was in a horrible car accident in 2003 when i was 16 and have been self cathing for 6 1/2 years so theres a catheter going in and out of me a couple times a day. we take all sterile precautions and i take cranberry and vitamin c tablets and i drink 8-10 glasses of water daily…sometimes more. yet i still get UTIs sometimes bad ones. ive been contemplating getting an SPC because a couple doctors have told me it will help reduce UTIs and it seems like you have really benefitted from SPC as well. so would you say that an SPC is better for me or do you have a better suggetstion?
Adrian: Tip of what? If you mean catheter site (the insertion point on your tummy) use a numbing gel. You’ve only had it 3-4 days so some pain is expected for upto 4-6 weeks then it should settle down. The discharge is your body trying to expel the catheter, it should also settle down after 4-6 weeks. This is all covered in the article Adrian.
Hi Richard: Bacteria often forms on sediment so reducing sediment helps reduce UTI. Doctor’s suggest +1000 mg of vitamin C and +3 litres (6.5 pints) of water/day to be of any benefit. I listed a bunch of other things to reduce bladder sediment/infection in the article including naturally brewed beer, Hiprex etc.
Before you go for a Supra Pubic Catheter try an IDC. It’s the same technique as self cath but you inflate the balloon, leave the catheter in place, and connect a drain bag or other urine collection device to create a closed system. IDC and SPC have about the same infection rates. So I don’t think UTI or sediment alone are reason enough to warrant an SPC. If there’s further reason, free to engauge in sex, esthetics, IDC is painful or such, then sure an SPC can be advantageous.
hi grahem, just an update had to rush hubby in again monday just gone nightmare. he self cathertarises they were going to put a stem in today which we have no idea what that is wondered if you knew? but they decided against it they are now saying that his cathertarising to much in a day when he is only doing it 2 to 3 times a day. they have told him not to cathertarise till the night time once a day surely if he is having problems with self cathertarising thats going to make no difference if anything make him bloated but i suppose they are the doctors.
they have said the reason he has problems self cathertarising it that his bladder is collapsing around the catherter and stopping the urine coming out. me personally thinks that they cant be bothered with him. i dont mean to sound harsh to my hubby but this is getting on top me now worrying all the time ill stick by him but just wish they would do something to give him a better quality of life, hope to hear from you soon.