This hollow and flexible tube can be used to drain fluids out of the bladder. The typical suprapublic catheter will be inserted through a small cut that has been made in the abdomen, just below the belly button. It is a permanent installation that is used for people who cannot empty their bladder on their own. There are some pros and cons of a suprapubic catheter that must be considered when deciding which type of catheter to use, so here is a look at some of the key points.
What Are the Pros of a Suprapubic Catheter?
1. It is often more comfortable than other forms of catheterization.
The suprapubic catheter generally slips into the opening that has been cut for it by a urological surgeon and then can be removed when necessary. This means the equipment required is portable and can be completed in most bathroom stalls in private if necessary. There is rarely any pain or discomfort with this process because the tube just slips in and out when needed.
2. It allows for continued sexual activity.
Traditional catheters make it difficult for those who are sexually active to remain that way. Some catheters that are traditionally installed are placed permanently, making intercourse virtually impossible. Because the suprapubic catheter is placed in the abdomen instead, there is no need to worry about any of the equipment involved.
3. There is usually a lower risk of infection involved.
Because there isn’t the pubic involvement with this catheter, there is a lower overall risk of infection for most people who need a long-term catheter solution. There is also less overall skin contact with the equipment required for emptying the bladder, which means most people are able to avoid the skin breakdowns and other medical side effects that typically come with a traditional catheter.
4. Accidents are more rare with a suprapubic catheter.
Not only are these catheters less likely to be pulled out accidentally, but they are also less likely to be sat on or damaged in some way. This means there are fewer urine leaks around the tube itself so that health complications may arise from the need to drain the bladder. Even if the catheter becomes blocked, most people can have their urine drain through the urethra so that an emergency trip to the doctor doesn’t need to happen.
5. The procedure is completely reversible.
If the need for a catheter is temporary, then the suprapubic site can be quickly reversed for a permanent removal. The site heals rather quickly and only a small scar beneath the belly button typically remains. Even though it can be temporary, it can also be a long-term and nearly permanent solution for those who have adequate use of their hands to manage the catheter.
6. Larger catheter tubes can be used.
Most traditional catheters can only go up to a size of 16ch. Many must be even smaller than this in order to be successfully placed. In comparison, the size of a suprapubic catheter can often be as large as 20ch over time. Most people are able to start with a tube that is larger than the largest urethra catheter that would be used, which means less time is required to drain the bladder.
7. You’ve got options.
A suprapubic catheter can either be installed so that it drains urine into a drainage bag or it may have a valve which can then empty the bladder directly into a toilet or receptacle with the bladder maintaining storage until then. Only a doctor can help decide what is right for you.
What Are the Cons of a Suprapubic Catheter?
1. It can create a lot of sensitivity.
The site of the suprapubic catheter is known to become hypersensitive in some patients after the site has been prepared. Some people have this feeling go away over time, but others do not have the feeling go away at all. Most people report that the bothersome feelings reduce over time, but there is a risk that the catheter site may be very uncomfortable and remain that way for as long as it is in place.
2. Some people are not good candidates for this procedure.
For people who are dramatically overweight, installing a suprapubic catheter can be rather difficult. There is a direct correlation to the level of obesity associated with an individual and an increase risk that the catheter will not be installed at all.
3. The suprapubic catheter site may produce some discharge.
As with the sensitivity issue, most people will see some discharge around the catheter site for the first few days that it has been installed. Sometimes this discharge can continue on for a few weeks before it decides to eventually dry up. For some people, however, the discharge at the catheter site may be permanent, lasting as long as the catheter is in place. This requires a dressing to be worn at all times over the site.
4. There’s still a risk for infections to occur.
Any time a catheter is used to drain the bladder there will be a higher risk of an infection occurring. This is especially true when it comes to urinary tract infections. People with a suprapubic catheter are also at a higher risk of developing bladder stones than the rest of the general public.
5. The site may actually begin to heal.
There are some people who have the site of their catheter begin to heal over time. This creates a smaller, tighter opening that can make it difficult to have the catheter tube installed. When this happens, a doctor may decide to either try a different type of catheter or move the suprapubic catheter site to a new location so that the old location may continue the healing process. Either way, this often means that routine catheter changes can become highly problematic.
6. Catheter blockages are known to occur over time.
Everyone who has a suprapubic catheter installed will likely suffer from blockages at some point in time. Catheter blockages occur frequently over time and this may require patients who have this catheter installed to have what is known as a cystoscopy. That’s a surgical procedure where an instrument is inserted into the bladder to determine the source of the bladder and to have it be washed out.
7. It may need to be changed every 4 weeks.
Although it may be up to 10 weeks before the first catheter is changed and it may only need to be changed once every 12 weeks afterward, some people need to have changes every 4 weeks. It’s not uncommon to see blood in the urine after this change occurs as well, which can become highly bothersome.
A Viable Alternative for Some
The pros and cons of a suprapubic catheter show it is a viable alternative for some patients. Because it can be temporary or long-term and it allows for sexual activity, many people will want to give this option some consideration with their medical provider.