Learn about what to expect when a suprapubic catheter (SPC) is inserted and what it is used for
A suprapubic catheter (SPC) is used to drain urine from your bladder if you cannot urinate on your own. An SPC is inserted into your bladder through a small hole in the lower part of your abdomen instead of through your urethra.
Because of this, SPCs are more comfortable and less likely to cause an infection than regular urethral catheters. Learn about what to expect during insertion and what SPCs are used for.
What to expect during suprapubic catheter insertion
Before the procedure
- The patient is asked to lie down on a gurney with their legs spread apart.
- The lower abdominal wall is cleaned, and the suprapubic area is shaved.
During the procedure
- The patient receives parenteral analgesia with or without sedation.
- The distended bladder is palpated to mark the insertion site at the midline and two fingers (4-5 cm) above the pubic area.
- Ultrasonography is used to verify the bladder location and ensure that no loops of bowel are present between the abdominal wall and the bladder.
- An antiseptic solution is applied from the pubis to umbilicus. This is repeated twice before allowing the area to dry.
- Sterile drapes are applied, and the insertion site is verified by palpating the anatomic landmark.
- An SPC is inserted a couple of inches below the navel, or belly button, directly into the bladder just above the pubic bone.
- Insertion is done through a Stamey device, which helps guide the catheter in with a piece of metal called an obturator.
- The obturator is removed once the catheter is in the bladder.
- A small balloon at the tip of the catheter is inflated to prevent it from falling out.
- The insertion area is cleaned, and the opening is stitched.
After the procedure
- A bag is attached to the leg for urine drainage.
- Two options for drainage include:
- Free drainage: Urine is stored in a drainage bag.
- Catheter valve: A valve at the end of the catheter helps drain the urine straight into the toilet.
- Dressings are used to cover the wound.
- The patient may be recommended to:
- Avoid physical activity for 1-2 weeks.
- Maintain adequate daily fluid intake.
- Avoid bladder-irritating drinks such as tea, coffee, and fizzy beverages.
- Prevent constipation by eating fiber.
- Avoid using creams, powders, or sprays near the site.
- Some pain and discomfort around the site of the catheter is normal. However, if pain or bleeding persists for more than 72 hours, the urologist should be contacted.
- The catheter can be changed every 4-6 weeks depending on the type of catheter and patient’s needs.
What is a suprapubic catheter used for?
SPCs are used for the following reasons:
- Urethral trauma or injuries
- Urethral obstruction
- Post-gynecological operations (surgery for prolapsed uterus or bladder or stress incontinence)
- Spinal injuries
- Lower body paralysis
- Multiple sclerosis
- Parkinson’s disease
- Long-term catheterization needed for incontinence
- Benign prostatic hypertrophy
- Prostate cancer
- Bladder cancer
Suprapubic catheterization is contraindicated in the following situations:
- Coagulopathy (tendency to bleed uncontrollably)
- History of lower abdominal or pelvic surgery
- Pelvic cancer with or without pelvic radiation
What are complications of suprapubic catheterization?
Some problems to watch for include:
- Urine flow that stops draining out of the catheter
- Redness, pain, swelling, or pus in the area around the catheter
- Pain, fever, and abdominal discomfort
- Urine is leaking around the catheter (normal around a new catheter site)
- Smell or change in urine color (cloudy urine)
- Signs of infection (burning sensation when urinating, fever, or chills)
- Bleeding
Complications of suprapubic catheterization include:
- Hematuria
- Post-obstruction diuresis
- Cellulitis
- Abscess formation
- Bowel perforation
- Intra-abdominal visceral injuries
