Starship Child Health Nursing guidelines Nursing guideline. Date last published: 11 December This document is only valid for the day on which it is accessed. Please read our disclaimer. Nursing guidelines. Indications Suprapubic catheterisation may be required in the following circumstances: Attempts at urethral catheterisation have been unsuccessful Urethral trauma is suspected Urethral erosion and urethritis with urinary retention Post-operatively following surgery to the genitourinary system e.
Bladder augmentation or cloacal repair Urethral stricture As a method of bladder drainage in spinal cord damage Long-term catheterisation in some wheelchair-bound patients Long-term continence management. Complications Accidental trauma on suprapubic catheter insertion piercing the peritoneum or bowel Urinary tract infection Haemorrhage Swelling, infection, encrustation or granulation at the insertion site.
Types of Suprapubic Catheters Catheter Description Two-way Foley Catheter - Self Retaining Double lumen - one lumen drains urine and a smaller lumen enables water inflation and deflation of the balloon Inflation of the balloon secures the indwelling catheter in the urinary bladder Pigtail catheter with suture Malecot Traction removal device Suprapubic Catheters with Fixation Plate These are small gauge g silastic catheters held in position by sutures, an adhesive disc, adhesive tape, a fixation plate, or a combination of these Not commonly used in Starship.
Suprapubic Catheter Dressing Notes A suprapubic catheter dressing is no longer required once the site has healed and is clean and dry. Patients can shower. Clean the skin around the catheter thoroughly with warm water. If using soap rinse the area well to minimise irritation. Creams and ointments should not be applied to the insertion site unless prescribed by medical staff. When prescribed by senior medical staff. Maximum volume is not to exceed mLs unless ordered by Consultant.
If the catheter has been spigoted for voiding assessment, unspigot and drain residual urine. Some suprapubic catheters may have a plastic plate around the insertion site. This must be removed prior to removing the catheter. Open the valve on the spout. Let the urine flow out of the bag and into the toilet or a container. Do not let the tubing or drain spout touch anything. After you empty the bag, wipe off any liquid on the end of the drain spout.
Close the valve and put the drain spout back into its sleeve at the bottom of the collection bag. Wash your hands again with soap and water. How do you replace your catheter? Removing the catheter Wash your hands with soap and water, and put on gloves. Fill a syringe with the fluid provided in the catheter kit. If there is a dressing on the insertion site, remove it. Clean the area around the catheter with the supplies from the catheter kit. Use another syringe to take out the water from the catheter balloon.
Hold the catheter close to where it goes into your belly. Gently pull the catheter up and away from you until it comes out. Putting a new catheter in Don't wait to put in the new catheter. Wash your hands and put on a new pair of sterile gloves.
Lubricate the catheter tip and push it through the opening in your belly. Push it in as far as the other catheter was placed. When the catheter is in place, urine should begin to flow through it. This may take a few minutes. After surgery neobladders have 2 catheters thin tubes that drain urine and help your body heal.
The other catheter is a suprapubic tube that goes from your lower abdomen belly into your neobladder see Figure 1. Figure 1. Your urine will drain into bags attached to the catheters. During the day, your drainage bags can be attached to your legs so you can move around more easily. You will need to empty these bags every 2 to 3 hours. This will allow you to sleep through the night without having to empty your bags.
You should have urine draining into both bags or 1 bag. After some practice, it will get easier. Your health care provider will change it for you the first time. You will get a prescription to buy special catheters at a medical supply store. Other supplies you will need are sterile gloves, a catheter pack, syringes, sterile solution to clean with, gel such as K-Y Jelly or Surgilube do not use Vaseline , and a drainage bag.
You may also get medicine for your bladder. Drink 8 to 12 glasses of water every day for a few days after you change your catheter. Avoid physical activity for a week or two. It is best to keep the catheter taped to your belly. Once your catheter is in place, you will need to empty your urine bag only a few times a day.
You will need to change the catheter about every 4 to 6 weeks. Always wash your hands with soap and water before changing it. Once you have your sterile supplies ready, lie down on your back. Put on two pairs of sterile gloves, one over the other. If you are having trouble changing your catheter, call your provider right away. Insert a catheter into your urethra through your urinary opening between your labia women or in the penis men to pass urine. Do not remove the suprapubic catheter because the hole can close up quickly.
However, if you have removed the catheter already and cannot get it back in, call your provider or go to the local emergency room. Fundamentals of urinary tract drainage. Campbell-Walsh-Wein Urology. Philadelphia, PA: Elsevier; chap
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