Patient education: Suprapubic catheter placement (The Basics)

What is a suprapubic catheter? — A suprapubic catheter is a thin tube that is used to drain urine. It is placed through the skin of the lower belly, directly into the bladder (figure 1).

Normally, urine drains from the kidneys through the ureters, into the bladder, then out of the body through the urethra (figure 2). A suprapubic catheter lets the urine drain from the bladder into a collection bag instead. You might have a suprapubic catheter for a few days to a few months, depending on why you need it.

The surgery to place a suprapubic catheter is called a "suprapubic cystostomy." In this procedure, a doctor makes a small opening just below the belly button. This opening is called a "stoma." The catheter is placed through the stoma and into the bladder.

In some cases, your doctor will place a suprapubic catheter in an operating room. It might also be placed in the emergency department, or at the same time as another procedure.

Why might I need a suprapubic catheter? — Some diseases can block the normal flow of urine through the ureters. This causes urine to back up, which can damage the kidneys and cause infection.

You might need a suprapubic catheter:

●If there is a blockage in your bladder or urethra

●After prostate, bladder, or gynecologic surgery

●When other kinds of catheters do not work

●If you need a catheter for a long time

●If you have urinary retention (when your bladder does not empty completely) for a long time

How do I prepare for suprapubic catheter placement? — The doctor or nurse will tell you if you need to do anything special to prepare. Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Lab tests

●X-rays

●MRI or CT scan

●Ultrasound

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding or clotting problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●Lowering the risk of infection – In some cases, you might need to trim (not shave) your body hair before your procedure. You might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during suprapubic catheter placement? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia that might be used for placing a suprapubic catheter include:

•Local – This type of anesthesia uses medicine to numb a small part of your body so you don't feel pain.

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will give you a shot in the skin of your belly to numb the area. Then, they will use an ultrasound or special X-rays to see your bladder.

●The doctor will make a small cut over your bladder. They will insert the catheter through the cut.

●The doctor will place stitches around the catheter to hold it in place. Then, they will connect the catheter to a drainage bag. They will cover the area around the catheter with clean bandages.

●The procedure takes about an hour.

What happens after suprapubic catheter placement? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

Some people can go home after a short time, and others need to stay in the hospital. Before you go home, you will learn how to take care of the catheter.

What are the risks of having a suprapubic catheter? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding or blood in your urine

●Infection

●Injury to other organs

●Problems with kidney function

●Bladder spasms

●The catheter getting pulled out

●The catheter getting blocked or kinked

●Urine leaking around the catheter

What follow-up care do I need? — The doctor will want to see you again after the suprapubic catheter is placed. Go to these appointments.

What else should I know?

●You might have a small amount of clear to light yellow drainage around the catheter for a few days. This is normal. It is also normal to see some blood in the drainage bag for a few days.

●You can take a shower after 48 hours or when your doctor tells you to. Keep your wound dry when you shower. Wrap the catheter and drainage bag with plastic before you shower. Do this each time you shower until the wound fully heals. Once it has healed, you can wash the area with mild soap and water during showers.

●Do not soak in a tub or hot tub or swim while the catheter is in place.

Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: How to care for a suprapubic catheter (The Basics)
Patient education: Benign prostatic hyperplasia (enlarged prostate) (The Basics)
Patient education: Neurogenic bladder in adults (The Basics)
Patient education: Urinary retention (The Basics)

Patient education: Benign prostatic hyperplasia (BPH) (Beyond the Basics)