Suprapubic catheter care

Your catheter will make it easier for you to drain your bladder and avoid infections. You will need to make sure it is working properly. You may need to know how to change it. The catheter will need to be changed every 4 to 6 weeks.

You can learn how to change your catheter in a sterile (very clean) way. After some practice, it will get easier. Your health care provider will change it for you the first time.

Sometimes family members, a nurse, or others may be able to help you change your catheter.

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.

Follow these guidelines for good health and skin care:

• Check the catheter site a few times a day. Check for redness, pain, swelling, or pus.
• Wash the area around your catheter every day with mild soap and water. Gently pat it dry. Showers are fine. Ask your providers about bathtubs, swimming pools, and hot tubs.
• Do not use creams, powders, or sprays near the site.
• Apply bandages around the site the way your provider showed you.

You will need to check your catheter and bag throughout the day.

• Make sure your bag is always below your waist. This will keep urine from going back into your bladder.
• Try not to disconnect the catheter more than you need to. Keeping it connected will make it work better.
• Check for kinks, and move the tubing around if it is not draining.

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. Then:

• Make sure your new catheter is lubricated on the end you will insert into your belly.
• Clean around the site using a sterile solution.
• Deflate the balloon with one of the syringes.
• Take out the old catheter slowly.
• Take off the top pair of gloves.
• Insert the new catheter as far in as the other one was placed.
• Wait for urine to flow. It may take a few minutes.
• Inflate the balloon using 5 to 8 ml of sterile water.
• Attach your drainage bag.

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.

Contact your provider if:

• You are having trouble changing your catheter or emptying your bag.
• Your bag is filling up quickly, and you have an increase in urine.
• You are leaking urine.
• You notice blood in your urine a few days after you leave the hospital.
• You are bleeding at the insertion site after you change your catheter, and it does not stop within 24 hours.
• Your catheter seems blocked.
• You notice grit or stones in your urine.
• Your supplies do not seem to be working (balloon is not inflating or other problems).
• You notice a smell or change in color in your urine, or your urine is cloudy.
• You have signs of infection (a burning sensation when you urinate, fever, or chills).

SPT

Dauw CA, Wolf JS. Fundamentals of urinary tract drainage. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

Davis JE, Silverman MA. Urologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 55.

Updated by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.