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Managing your bladder with a suprapubic catheter (Duke of Cornwall Spinal Treatment Centre)

Managing your bladder with a suprapubic catheter

A suprapubic catheter is inserted through your abdomen directly into your bladder. The procedure is usually carried out in Theatre by a surgeon. A general anaesthetic or a spinal anaesthetic will be used, depending on the level of your spinal cord lesion and any associated condition, such as autonomic dysreflexia. The procedure does not usually require an overnight stay.

The first change of catheter needs to be carried out at the Spinal Centre. Subsequent catheter changes can be carried out by yourself your District Nurse, carer or relative, if they have been taught how to do this.

Why is a Suprapubic Catheter better than a Urethral Catheter?

  • When a urethral catheter is used, the urethra may become damaged over a period of time, resulting in urinary leakage around the catheter. Additionally the balloon of a urethral catheter can cause damage to the bladder neck, leading to urinary leakage. A catheter that is forced through the external sphincter can cause damage.
  • The catheter is less likely to be sat on and accidentally ‘pulled’.
  • If a suprapubic catheter becomes blocked, urine can drain via the urethra (although this may not be possible for everyone). This can act as a ‘safety net’ if you suffer from autonomic dysreflexia when your catheter blocks. With a suprapubic catheter you have an alternative entry point to your bladder (via the urethra), if problems occur with a blocked suprapubic catheter or a catheter cannot be passed suprapubically.
  • A suprapubic catheter leaves your genitals free for sexual activity.
  • It is easier to maintain hygiene around the site of a suprapubic catheter.
  • If you have adequate hand function you can be taught to change your suprapubic catheter. The site of a suprapubic catheter is more accessible to you than the urethra.
  • The procedure is reversible. The suprapubic site will heal quickly on permanent removal of the catheter.
  • A larger size catheter can be used suprapubically, reducing the risk of blocked catheter. Urethral catheters should not exceed size 14Ch, whereas a suprapubic catheter can be gradually increased over a period of time from a size 16Ch up to a size 20Ch.

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