What is a suprapubic catheter?
A suprapubic catheter (sometimes called an SPC) is a device that’s inserted into your bladder to drain urine if you can’t urinate on your own.
Normally, a catheter is inserted into your bladder through your urethra, the tube that you usually urinate out of. An SPC is inserted a couple of inches below your navel, or belly button, directly into your bladder, just above your pubic bone. This allows urine to be drained without having a tube going through your genital area.
SPCs are usually more comfortable than regular catheters because they aren’t inserted through your urethra, which is full of sensitive tissue. Your doctor may use an SPC if your urethra isn’t able to safely hold a catheter.
An SPC drains urine directly out of your bladder if you’re not able to urinate by yourself. Some conditions that may require you to use a catheter include:
- urinary retention (can’t urinate on your own)
- urinary incontinence (leakage)
- pelvic organ prolapse
- spinal injuries or trauma
- lower body paralysis
- multiple sclerosis (MS)
- Parkinson’s disease
- benign prostatic hyperplasia (BPH)
- bladder cancer
You may be given an SPC instead of a normal catheter for several reasons:
- You’re not as likely to get an infection.
- The tissue around your genitals isn’t as likely to get damaged.
- Your urethra may be too damaged or sensitive to hold a catheter.
- You’re healthy enough to stay sexually active even though you need a catheter.
- You’ve just had surgery on your bladder, urethra, uterus, penis, or other organ that’s near your urethra.
- You spend most or all your time in a wheelchair, in which case an SPC catheter is easier to take care of.
Your doctor will insert and change your catheter the first few times after you’re given one. Then, your doctor may permit you to take care of your catheter at home.
First, your doctor may take X-rays or perform an ultrasound on the area to check for any abnormalities around your bladder area.
Your doctor will likely use the Stamey procedure to insert your catheter if your bladder is distended. This means that it’s overfilled with urine. In this procedure, your doctor:
- Prepares the bladder area with iodine and cleaning solution.
- Locates your bladder by gently feeling around the area.
- Uses local anesthesia to numb the area.
- Inserts a catheter using a Stamey device. This helps guide the catheter in with a piece of metal called an obturator.
- Removes the obturator once the catheter is in your bladder.
- Inflates a balloon at the end of the catheter with water to keep it from falling out.
- Cleans the insertion area and stitches up the opening.
Your doctor may also give you a bag that’s attached to your leg for the urine to drain into. In some cases, the catheter itself may simply have a valve on it that allows you to drain the urine into a toilet whenever needed.
SPC insertion is a short, safe procedure that usually has few complications. Before the insertion, your doctor may recommend taking antibiotics if you’ve had a heart valve replacement or are taking any blood thinners.
Possible minor complications of an SPC insertion include:
- urine not draining properly
- urine leaking out of your catheter
- small amounts of blood in your urine
You may be required to stay in the clinic or hospital if your doctor notices any complications that need immediate treatment, such as:
- high fever
- abnormal abdominal pain
- discharge from the insertion area or urethra
- internal bleeding (hemorrhage)
- a hole in the bowel area (perforation)
- stones or pieces of tissue in your urine
See your doctor as soon as possible if your catheter falls out at home, as it needs to be reinserted so that the opening doesn’t close.
An SPC usually stays inserted for four to eight weeks before it needs to be changed or removed. It may be removed sooner if your doctor believes that you’re able to urinate on your own again.
To remove an SPC, your doctor:
- Covers the area around your bladder with underpads so that urine doesn’t get on you.
- Checks the insertion area for any swelling or irritation.
- Deflates the balloon at the end of the catheter.
- Pinches the catheter right where it enters the skin and slowly pulls it out.
- Cleans and sterilizes the insertion area.
- Stitches the opening shut.
- Drink 8 to 12 glasses of water every day.
- Empty your urine bag several times a day.
- Wash your hands whenever you handle your urine bag.
- Clean the insertion area with hot water twice a day.
- Turn your catheter when you clean it so that it doesn’t stick to your bladder.
- Keep any dressings on the area until the insertion area is healed.
- Tape the catheter tube to your body so it doesn’t slip or pull.
- Eat foods to help you avoid constipation, such as fiber, fruits, and vegetables.
- Continue any regular sexual activity.
- Don’t use any powders or creams around the insertion area.
- Don’t take baths or immerse your insertion area in water for a long time.
- Don’t shower without covering the area with a waterproof dressing.
- Don’t reinsert the catheter yourself if it falls out.
An SPC is a more comfortable alternative to a regular catheter and allows you to continue your normal daily activities without discomfort or pain. It’s also easy to cover with clothing or dressing if you want to keep it private.
An SPC may only be used temporarily after surgery or treatment of certain conditions, but it may need to remain in place permanently in some cases. Talk to your doctor about how to take care of and change your catheter if you need to keep it in for a long period of time.