Suprapubic Catheter

What is a suprapubic catheter?

A suprapubic catheter (SPC) is a thin, flexible rubber or plastic tube that healthcare providers use to drain urine (pee) from your urinary bladder when you can’t pee on your own. Many people think you can only use a catheter by inserting it into your urethra and guiding it up to your bladder (urethral catheter). But a suprapubic catheter accesses the bladder from a small cut (incision) in the lower part of your abdomen.

Suprapubic catheters are generally safe and have a low risk of complications. Many people use them because they’re more comfortable than urethral catheters. You may also need a suprapubic catheter because an injury to your urethra makes catheters that enter through your urethra difficult or impossible to use.

Why would someone have a suprapubic catheter?

Healthcare providers use suprapubic catheters to drain pee from your bladder when you can’t pee on your own. The following conditions may cause problems peeing:

• Urinary incontinence.
• Pelvic organ prolapse.
• Prostate cancer.
• Prostate enlargement (benign prostatic hyperplasia).
• Surgery on your prostate or genitals.
• Spinal cord injury.
• Lower body paralysis (paraplegia).
• Multiple sclerosis (MS).
• An epidural, which can cause you to temporarily lose control of your bladder.
• Parkinson’s disease.
• Urethral stricture.
• Inability to pull back your foreskin (phimosis).
• Buried penis.
• Scarring.

Are suprapubic catheters common?

Healthcare providers don’t use suprapubic catheters as often as urethral catheters. However, they may recommend a suprapubic catheter if you must use it long-term or if you’re having urethral surgery.

What happens during suprapubic catheter placement?

A healthcare provider may first take imaging tests (X-rays or ultrasound) around your bladder and the surrounding areas to make sure it’s safe to place the suprapubic catheter — sometimes loops of your small intestine (small bowel) rest between your bladder and your abdominal wall.

Then, they’ll clean the skin of your lower abdomen where they’ll make the incision with an antiseptic, like iodine or alcohol, to help prevent infection. They’ll then apply a local anesthetic to numb the area so you won’t feel much pain. In some cases, they may give you general anesthesia so you aren’t awake.

Once you’re numb, they’ll make a small cut on your skin and place the suprapubic catheter. Once it enters the bladder, pee will drain out of the catheter and into a collection bag. They’ll use about one stitch to help keep the catheter in place. They’ll put a bandage around your incision to help prevent an infection. The tip of the suprapubic catheter also contains a small balloon. They’ll also inflate the balloon with sterile water to keep the catheter in place in your bladder.

If you need to use a suprapubic catheter for a long time, the provider will teach you or a close friend or family member how to safely change it.

How long does it take to place a suprapubic catheter?

Suprapubic catheter placement is quick — it usually takes less than 20 minutes.

How do I care for my suprapubic catheter?

It’s important to keep the area around your suprapubic catheter clean. Thoroughly wash your hands with soap and water before you change or otherwise handle the catheter. This helps prevent the spread of germs that can cause an infection.

Remove the bandage and check for symptoms of an infection around the area where your suprapubic catheter goes in, including:

• Pain.
• Swelling.
• Discoloration.
• Pus.

Call a healthcare provider if you have any of these symptoms.

You should also gently wash the area around your catheter at least once a day with soap and water. Gently pat the area dry with a clean towel.

How do you change a catheter bag?

To change a catheter bag, you should:

• Wash your hands with soap and water.
• Remove the stopper or open the clamp that keeps your collection bag shut.
• Empty the collection bag into a toilet.
• Pinch the catheter tubing shut with your fingers and disconnect the collection bag.
• Clean the end of the catheter (drainage port) with soap and water or an antiseptic wipe.
• Clean the tip of the new catheter bag with soap and water or an antiseptic wipe and connect it to the catheter.
• Make sure the catheter tube isn’t twisting or pinching shut.
• Wash your hands again.

It’s a good idea to wash your collection bag if you’re going to use a suprapubic catheter for longer than a week or if it smells. Wash the inside of the bag with soap and cool water and thoroughly rinse it with clean water. You can also rinse the bag with a solution of 1 ^¼ cups white vinegar in 2 quarts of water to help reduce odors and prevent infection.

How long does a suprapubic catheter stay in?

It depends. You may only need to use a suprapubic catheter while you’re healing from a treatment or condition. Once you recover, you no longer need to use it.

If you need to use a suprapubic catheter long-term, you should change it at least every four weeks.

How often do you have to flush a suprapubic catheter?

It’s important to rinse (flush) a suprapubic catheter with sterile water to help prevent blood clots from blocking the device and otherwise keep the catheter clean and working properly. You should flush your suprapubic catheter at least once a day.

What are the benefits of suprapubic catheters?

A suprapubic catheter allows you to drain your bladder continuously. Not emptying your bladder can cause:

• Severe pain.
• Swelling (distended bladder).
• Urinary tract infection (UTI).
• Permanent damage to your bladder or kidneys.
• Death.

Some people think a suprapubic catheter is more comfortable and easier to use than a urethral catheter. It’s also possible to have sexual intercourse while using a suprapubic catheter, which is something you can’t do with a urethral catheter.

What is the downside of a suprapubic catheter?

All catheters include risks, including suprapubic catheters. Possible complications may include:

• The catheter falls out.
• Blockage prevents the catheter from draining.
• UTIs.
• A burning or cramping pain in the area around your bladder (bladder spasm).
• Pee leakage around the catheter.
• Bleeding.
• Bladder stones.
• Bowel injury during placement.

Can you still pee normally with a suprapubic catheter?

No. Your pee doesn’t leave your body through your urethra when you use a suprapubic catheter because your bladder is always nearly empty.

What is the recovery time?

Any pain, swelling and bruising around your incision should go away after a few weeks.

Is there anything I can do to make it easier to use a suprapubic catheter?

The following tips can help reduce discomfort or pain when you use a suprapubic catheter:

• Increase your fluid intake. You should drink at least eight glasses of fluids every day. Water is best.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain. Don’t take NSAIDs on an empty stomach. You must also drink a lot of fluids when taking NSAIDs. Not everyone can take NSAIDs, so it’s a good idea to check with a healthcare provider first.
• Strengthen your pelvic floor muscles. Kegel exercises (pelvic floor exercises) can help relieve bladder spasms.

When should I call a healthcare provider?

Reach out to a healthcare provider right away if you have any problems or questions regarding your suprapubic catheter.

Call a healthcare provider right away if:

• You have a fever over 100.5 degrees Fahrenheit (38 degrees Celsius).
• Pee is leaking around your suprapubic catheter.
• You have pain or a feeling of fullness in your abdomen.
• You notice blood clots or blood in your urine (hematuria).
• You have little or no pee flow into the collection bag.
• Your suprapubic catheter comes out.

What is the difference between a Foley catheter and a suprapubic catheter?

A Foley catheter goes through your urethra into your bladder. A suprapubic catheter goes through a small incision in your abdomen.

A note from Cleveland Clinic

If you can’t pee, you may need a suprapubic catheter to empty your bladder. It can feel strange carrying your pee in a bag outside your body and it’s hard not to be conscious of it. You may fear that it could leak, which may prevent you from doing your everyday activities. These feelings are normal. A healthcare provider can teach you how to use a suprapubic catheter, answer any of your questions and help you feel better.