Suprapubic

Typically a suprapubic catheter placement is an outpatient case. Sometimes, this catheter is placed in the emergency setting after trauma to the pelvis. The procedure typically takes approximately 30 minutes. After the skin is cleaned with sterile prep, ultrasound imaging is used to marka a site for access into the bladder. A small injection of local anesthetic is administered in your belly to numb the site of access. The catheter is put in your bladder through a small cut in the belly and it is able to stay in place inside the bladder with the help of an inflated balloon. The catheter is then attached to a catheter bag where urine will be collected. A dressing will be placed around the catheter site until the skin around the catheter heals.

Leg bag care instructions

• Leg bag is to be worn during the day
• An extension tubing attached to the catheter may come in 2 lengths so that the drainage bag can be worn on your calf or thigh
• Leg bag can be emptied using the drainage tap at the bottom of the bag.
• Empty the bag every 3-4 hours or before it becomes over-full which will depend on how much fluids you drink.
• Always keep the leg bag at a level lower than the bladder to allow for optimal drainage.
• Change the leg bag for a new bag every two weeks or if damaged.

How do I change my leg bag?

1. Wash and dry hands well
2. Remove protective cap from new leg bag
3. Pinch off end of the suprapubic catheter and withdraw fluted end of old leg bag tubing from catheter outlet
4. Firmly insert fluted end of new leg bag into the catheter outlet.
5. Secure new bag to your leg using straps provided.
6. Empty urine from old leg bag into toilet.
7. Toss old leg bag.
8. Wash and dry hands.

How do I attach a larger capacity night bag?

At night, a larger capacity bag is typically needed to allow for free flowing drainage. This larger capacity night beg is typically attached to the outlet of the existing leg bag or to a catheter valve if one is benign used.

1. Wash and dry hands well
2. Remove colored cap from end of new night bag tubing
3. Connected fluted tip of night bag end tubing into the bottom outlet of the leg bag
4. Open the outlet tap on the leg bag ; urine will run freely into the night beg
5. Place night bag into a container such as a plastic container in case of possible leakage from the night bag.
6. Make sure night bag is lower than your bed to aid in gravity drainage.
7. When removing the night bag, close the leg bag outlet or catheter valve and remove the fluted end of the night bag tubing from the outlet of leg bag or catheter valve
8. Empty urine from night bag into toilet or suitable container using drainage tap
9. Wash night bag with warm soapy water and hang up to dry
10. Store night bag in clean sealed plastic bag once dry.

Dressing changes

1. Wash and dry hands thoroughly before and after changing dressing and catheter
2. Gently remove old dressing and throw away
3. Check catheter site for any swelling, bleeding, irritation, unusual or smelly drainage
4. Check for any sores next to the exit site
5. Wash gently around the tube shied with soap and water
6. Use povidone-iodine swab stick to clean under the shield
   1. Start at the catheter exit site and clean outward in a circular motion about 3-4 inches from the site
   2. Do not clean back toward the tube.
   3. Throw away the used swab stick and repeat cleaning with new swab
   4. Let skin dry completely
7. Place 4” x 4” sponge around the catheter and tape it in place

• I am experiencing worsening abdominal pain with smelly, cloudy urine.

  You may have an urinary infection. Contact your doctor who may ask you to take a urine sample for testing purposes and may prescribe a course of antibiotics. Make sure to increase your fluid intake.

• There is very little or no urine draining to the bag for several hours.

  Causes may include

  • Kinked or bent tubing
  • Leg bag is above the bladder level
  • Low fluid intake
  • Constipation
  • Blocked catheter due to debris

  Be sure to check the catheter tubing and drainage bag. Be sure to take note of any kinks or bend in the catheter and try to straighten it out. Be sure the leg bag is below the level of the bladder at all times. Try moving or walking around to see if a blockage can be dislodged. If 4 hours or longer pass and no urine passes, contact your doctor.

• There is blood in the urine or around the catheter site

  This could be due to irritation of the bladder or urethra caused by the catheter. Another reason for blood in the urine can be due to an infection.

  If bleeding persists or is heavy after 2 days contact your doctor who may ask you to take a urine sample and may prescribe you antibiotics. Be sure to increase your fluid intake.

• I am having bladder spasms and leakage around my catheter

  Irritation of the bladder can cause bladder spasms which can also cause pain and leakage around the catheter site.

  Contact your doctor if you are experiencing bladder spasms. Your doctor may prescribe you an anti-spasmodic to relax the bladder.

• I noticed my catheter is falling out or leaking.

  This can be due to a faulty balloon, damaged catheter , or due to bladder spasm

  Contact your provider immediately if you cannot pass urine, bladder becomes painful, or if the catheter is completely removed. If you are still passing urine into the bag without significant leaking around the catheter site, notify your doctor during office hours.

Call your doctor and seek immediate medical care if you notice the following signs and symptoms:

• Signs of infection
• Increase pain, swelling, warmth, redness around drain site
• Pus/urine draining from the insertion site
• Fever
• Sudden change in color and smell of your drainage
• Tube is coming loose out of your insertion site