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Care of your Suprapubic Urinary Catheter 

 

What is a suprapubic catheter? 

            A suprapubic catheter is a flexible rubber tube, called a Foley catheter that is inserted into your lower abdominal area and into the bladder to drain urine.  This catheter is required because of the problem you are having passing your urine.  Depending on the reason you can’t pass urine will determine how long the catheter needs to remain in place.  A tiny balloon is on the end of the catheter that is inside your bladder.  The balloon is filled with sterile water so the catheter does not fall out.               
            The catheter is connected to a drainage bag that can be worn on your leg under your clothing during the daytime and you will be given a larger bag (bedside bag) for during the night.  Whatever bag you are using, you need to keep it lower than the level of the bladder to promote drainage. 
           At the insertion site, there will be a suture placed to secure the catheter and to keep it from being pulled to tightly.  There will be an antibacterial ointment placed on the skin around the site and a small dressing will be applied.  There will be a small piece of tape that will be placed over the catheter to attach it to the skin.  Movement or tugging on the catheter will then pull on the tape and not the catheter.
            Your normal life does not need to change because of the catheter or the bag.   Normally there is no reason you cannot continue your activities of daily living and continue to do what you normally do.   In fact, it may even increase your independence.   
           The following paragraphs will give you instruction on (1) how to care for the skin at the sight of the insertion, (2) how to change the drainage bag, (3) how to empty the bag when it is full, (4) how to clean the drainage bag, (5) personal hygiene, and (6) how to obtain supplies.  (7) You will also be given instructions of when you should call the urology nurse or your doctor.

1.         How to care for the skin at the site of insertion.

Assemble needed supplies:

  • Clean wash cloth and clean hand towel
  • Liquid soap
  • Antibacterial ointment
  • 4x4 Gauze dressing
  • Tape

            How to clean and inspect the skin

  • Skin care and dressing change should be done once daily.
  • Wash your hands
  • Gently remove the dressing and discard into the wastebasket.
  • Inspect the skin.  A small amount of redness and clear drainage is a normal reaction of the skin around the catheter.  A large area of redness, blisters, or drainage that is not clear and has an odor should be reported to your doctor right away.  
  • Wet the wash cloth with warm water and apply a small amount of  the liquid soap
  • Wash around the catheter and the skin to remove any kind of drainage around the site or from the catheter.  
  • Rinse the area.
  • Pat the area gently with the clean towel to dry it.  Do not rub.
  • Apply a small amount of antibiotic ointment to the skin around the catheter site.
  • Using a clean scissors, make a single cut in the 4x4 to the center and place around the catheter so the catheter is in the center of the 4x4 gauze.   Secure the gauze with tape. 
  • Allow some slack on catheter tubing so as not to pull and put a piece of tape over the catheter and on the skin.  Make sure the tubing is not kinked and that the urine can flow easily through the tube.
  • Wash your hands

2.         Changing the leg drainage bag.

The nurse will help you set up the drainage bag, will show you how to measure the length of the tube that will work best for you, and will show you how to attach it to the catheter.  

    • The tube on the bag can be shortened to the desired length at any of the smooth sections of the tubing.  When cutting leave as much of the smooth section on the remaining tubing as possible.
  • Put the buttons of the straps through the buttonholes at the top and bottom of the bag with the buttons on the outside (away from the leg).  The soft side of the bag is considered the “in-side” of the bag.
  • The outlet at the bottom of the bag should be closed.  The closed position is with the snap toward the top of the bag. When closing, make sure it snaps into place
  • Position the bag with the soft backing next to your leg and adjust the straps for comfort.  You can cut off the excess of the leg strap.  If you wash the straps, they will shrink about 2%.    Do not have the straps too tight because you do not want to disturb the circulation in your leg.
  • Attach the tapered connector on the bag to the large hole at the tip of the catheter.  Be sure there are no kinks in the tubing to ensure drainage.  Be sure to keep the connector clean.

3.         Empty the drainage Bag

Empty the leg bag when it is one-half to two-thirds full.  Empty the full-size bedside bag every 8 hours or so. You do not have to disconnect the bag from the catheter to drain it. Do the following to empty the bag.

  • Aim the tube to direct the flow and then flip the clamp downwards.    You can empty this into the toilet, a large container, or into a urinal.  Care should be taken to keep the tip clean. 
  • After you have emptied the bag, flip the clamp upwards and be sure that it snaps into place.

 

 

4.         Cleaning the drainage bag on a daily basis.

Clean the reusable urine drainage bag daily.   After detaching the drainage bag from the catheter tubing, you can either plug it while you are cleaning the bag, or if you have a second bag, you can attach that to the end of the catheter.

  • Drain all urine from the drainage bag and rinse with warm water.
  • Fill the bag with one part white vinegar to three parts tap water.  You can let this sit for about 30 minutes or so. 
  • Empty and rinse.  If you are storing this bag, it can be kept in a plastic bag but be sure to let it air dry prior to closing the bag.  This will prevent bacterial growth.

5.         Personal Hygiene

  • You can take a showerBefore you get into the shower, disconnect the drainage bag; place the clean plug that you have been given into the tip of the catheter and be sure that it is secure. 
  • After you have finished your shower, reconnect the drainage bag to the catheter.  Be sure to clean the plug after each use so that it is clean for when you need to use it again.  It can easily be stored in a small plastic bag or other type of clean container.
  • Until you see the doctor for the first return visit, daily clean the skin around the catheter, site and apply antibiotic ointment.
  • If there is no drainage noted around the catheter, you will not need to have the site covered with a dressing.  However, you still need to gently wash the skin around the site daily with warm water.
  • Wash your hands before and after each time you empty your drainage bag, or any time you disconnect and re-connect the catheter to the bag.

 

6.         Obtaining Supplies:

You will be given a prescription for the supplies that are needed for you to care for your catheter and for the drainage bags.  This can be filled at most medical supply companies.  You should verify that the medical supply company will accept your particular insurance.

It is important to remember the following:

  • Be sure there is no kink in the tubing that leads to the drainage bag .
  • Be sure to keep the drainage bag below the level of your bladder so that it will drain properly.
  • Drink about six glasses of water daily to dilute possible bacteria within the bladder.

                                                  

7.         Reasons to call the Doctor:
                                                                                                  

  • You notice the incision has become red, swollen, blisters on the skin.
  • The area of the reddened skin is warmer than elsewhere.
  • There is pus draining from around the Foley insertion site.
  • There is a significant increase in bloody drainage and/or clots are noted in the urine that does not go away with increasing your fluid intake.  A light pink tinge is normal for the first several days.
  • You notice there is a significant decrease for urine that is draining or if the urine stops draining for more than an hour.  This could indicate a blockage in the tubing.
  • You have nausea or vomiting
  • You have chills or fever of 101 or more degrees
  • There is severe pain that is not relieved by pain medication
  • The Foley catheter becomes dislodged.

 

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During daytime hours, call the Urology Clinic at 936-734-7030 and a call center representative
will connect you with a urology nurse.

After hours and on weekends call 734-936-6267 and ask the operator for the Urology Resident
on call.

 

 

 

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References: 


Catheter Care. Retrieved   11/25/2009. www.med.umich.edu/1libr/urology/postcare/meatal.htm
Suprapubic urinary catheter care. Retrieved   12/2/2009. www.urologyassociatespc.com
Care of suprapubic catheter. Retrieved   12/2/2009. http://hp.medselfed.com/asp/prodPrint.asp?prodId=441 
How to care for your suprapubic catheter. Retrieved   11/25/2009. www.drugs.com/cg/how-to-care-for-your-suprapubic-catheter.html

 

 

 

Created:  January, 2010
C.Neer RN, H. Atiemo, MD