It is important to use a sterile technique when changing supra pubic catheters. It is also a good idea to watch a doctor or nurse perform a supra pubic catheter change before you attempt to do your first one. Check that the old and new catheters are the same size. Look for matching numbers eg: 18fr and that the catheter port ring colors match. A supra pubic catheter change of different sizes should only be performed in a hospital by qualified medical staff.
Why and how often to change a supra pubic catheter depends on the user and catheter type. Catheters are durable but they do not last forever. The longer a catheter is left in the more chance of infection, blockage, sticking and other problems. Depending on the type of catheter, they have a shelf life of several years and use life of one to three months max. Silicone Foley and silver coated catheters may be changed every 3 months. Check the catheter packaging for details.
NOTE: I take no responsibility for how you use or misuse these guides or any problems that may result from that use. Many have asked me things about changing supra pubic catheters. This is only my personal experience (and explanations). In an emergency such as a blocked catheter call an emergency service! In the event that is not possible and the situation is life threatening, here is a quick emergency 3 step guide to changing supra pubic catheters. You can do this in a seated position or laying flat. Please only attempt this if you have already called emergency services and you are really, really desperate.
3 Step Emergency Supra Pubic Catheter Change
- Plug a 10cc syringe onto the old catheter port and deflate the catheter balloon.
- Remove the old catheter and insert the new one as far in as the old one was.
- Plug the 10cc syringe onto the new catheter port and inflate the balloon.
I have had to do this and survived. Sterility comes second in an emergency. Your first supra pubic catheter change should be done by a doctor or a nurse six weeks after install.
10 Step Easy Safe Supra Pubic Catheter Change
Catheter Change Equipment:
- Catheter change pack (often these include all below but the new catheter and drain bag).
- Lubricant (to lessen the pain and ease the new catheter in).
- New sterile catheter of appropriate size (to replace the old catheter).
- New drainage bag (don’t plug a dirty drain bag onto a sterile catheter).
- Pair of sterile gloves (to avoid infection).
- Sterile saline or water (to inflate the catheter balloon).
- Two 10cc syringes (one to deflate and one inflate the balloon).
Catheter Change Method:
Have the supra pubic catheter user take a big drink of water and lay face up. Thoroughly wash your hands and forearms, remove any dressing, and clean around the supra pubic catheter site. Prepare your workspace. Then take a deep breath and try to relax. We know it can be a daunting task. My mother has been changing supra pubic catheters for years. My beautiful Mum has done 100′s of catheter changes for me and still gets nervous every time I ask her too. I love you Mum.
Caution: When changing supra pubic catheters note how far the old one was inserted. This is where most people go wrong. I have bleed from the penis for days because a new catheter was pushed in to far. On two occasions at the hands of doctors who failed to make this vital observation. You can mark the old catheter with a pen or clip something onto it near the skins surface prior to removal if you wish.
- Using a sterile method open out your catheter change pack and check for or add; a new sterile catheter (open the packet dropping the catheter onto your sterile field), two 10cc syringes, sterile saline or water, a sterile lubricant and gloves.
- Wash your hands and forearms thoroughly and dry with a clean dry towel.
- Using a sterile technique put the gloves on.
- Open the lubricant and apply it liberally to the first two inches of the catheter tip (that is the pointy end where the eyelets are).
- Fill one 10cc syringe with 8cc of saline (or clean water) and plug it firmly onto the new catheter port (where the colored ring is, you may test inflate the balloon at this point if you wish, but don’t waste time).
- Plug the second empty 10cc syringe onto the old catheter port and draw back on it to deflate the balloon (it may have less than 8cc). Remove the catheter (you may feel some mild resistance. If you are sure the balloon is fully deflated, it’s alright to give it a little tug).
- As you withdraw the old catheter it is VERY important to note how far in it was. Also note, your hands are now no longer sterile.
- Pick up the pre-lubricated catheter and insert it. Only push it in as far as the previous catheter was (if you insert it too far it may go into a ureter or the urethra).
- A little bleeding is common after changing supra pubic catheters. If some urine starts to flow it usually means you have the catheter in the correct position. Keep holding the catheter in position and slowly inflate the balloon with 8cc of sterile water. Once the syringe is empty unplug it from the catheter port.
- Attach a new clean drainage bag.
Congratulations you are done.
Tips on Changing Supra Pubic Catheters
- A quick change is a good change.
- Using a topical numbing gel around the catheter site prior to change to help ease pain.
- Sterilize water by boiling and set aside until cool.
- Do not leave a person alone after changing supra pubic catheters. Watch for any bleeding or adverse reactions.
- A few blood clots in the tubing are common. If it lasts for more than a few hours something may be wrong.
- Some bleeding is common after changing supra pubic catheters. If it lasts for more than an hour something is likely to be wrong.
- Profuse bleeding at the site, in the tube, or from anywhere else is not common. If it lasts for more than five minutes something is terribly wrong. Call a doctor.
- Check, and if needed top up the amount of fluid in a catheter balloon every four weeks.
- Never leave a supra pubic catheter out for more than a few minutes.
- Never cut a catheter trying to release it.
Resources
- Living with Supra Pubic Catheters: Super Supra Pubic Catheters
- Queensland Spinal Cord Injuries Service: Changing Supra Pubic Catheters PDF
- UROlog: Bladder Catheterisation
This information is so useful. I am going for surgery this week to have a suprapubic cath installed. My urologist is sparse with the information and even my family dr was not overly familiar with spc’s.
I have a question my urologist kind of shrugged off. I was using a regular indwelling catheter for a few years but my bladder started rejecting them. Are there other catheters for supra pubic besides foley. Has anyone else had a spasming bladder?
Hi MissPies, Foley is the name of the original designer, surgeon Frederick Foley of Boston, Massachusetts, in1930. Catheters have since evolved into many brands made from modern materials. Silicone Foley catheters have lead the market for some time. More recently silver coated Foley catheters are proving popular for comfort which means less spasm, and less urinary tract infections. We cover these and anti-spasm medications in detail here: super supra pubic catheters
IDC, SPC, CIC… All bladder drainage catheters are essentially Foley, and have Dr. Foley to thank for his brilliant initial concept. A flexible tube passed into the bladder held in place by a balloon. The tube has two separate channels. One is open at both ends, to allow urine to drain into a collection device. The other has a port (with valve) on the external end to inflate the internal balloon holding it in place.
Hi Graham, thanks for your response. I was aware of all the different types and origin of the foley. My body doesn’t seem to tolerate the balloon – my bladder has become very tiny (I really do have TB haha). My family doc said he thought there were other kinds. I don’t want to go thro surgery to have this rejected. Any insight?
Hi Graham, I,m back. I read further and note that my bladder may be the size of a grape and the meds I could use to stop or control spasms. This site is amazing. The info is so accurate, at least according to my expanding awareness. I hope my bladder will give me another chance at catheters. Not having a cath is sentencing me to the house and daily laundry. Very dis-couraging. Thank you for such a great sight.
I have lived with my Supra pubic catheter for the past 11 months and like other contributors to this site I received virtually no in depth instruction from any of the medical people involved. I have since done my own research and with the experience of ‘using’ the catheter I now feel much more confident and manage it with ease. The biggest step forward for me was the discovery of the ‘belly bag’ which I cannot praise enough. It allows me to play golf and do other activities which were very difficult when using the ‘leg bag’. Points of interest: When using the belly bag out of the wrapper be aware that the ‘nozzle’ is slightly open and must be fully closed to avoid leakage and after emptying the bag ensure that the nozzle is fully closed.
My poor husband is currently suffering and has suffered for the last month because he is having pain in his penis and also some bleeding episodes at the head of his penis. He currently is urinating through his penis, at least some of the time, bypassing the catheter.
He is under Hospice and they change the catheter out once a month, primarily because there is so much sediment in my husband’s urine.
After reading your article, I suspect that they are putting the tube in too far.
Your website is so appreciated, I’m sure. Such helpful info!
Im going on 5yrs with sp tube, the last 3months ive been changing my catheter like every 10 days becauseit gets clogged up with white rocky stuff , and urine is fine but I also see like thick milky stuff floating in my leg bag. Does any one have idea how to take care of this? is my bladder filled with puss?
I use belly bag for years. how can bladder drain fully using belly bag since it’s located so close to bladder. shouldn’t catheter hang down so it can empty. i have had my share of UTI’S. every once in awhile my bladder lets loose expelling a LARGE amount of urine with no warning. i can’t find a pad that will absorb all of it. i’m afraid to leave the house. i change cath every other month with no problems. any help would be appreciated.
Jay it sounds like you have bladder stones. My client had them bad for months and her doctor perscribed her a medicine we irrigate with to inhibit the stones from forming. Weve finally got them under control but it took at least 6 months. Talk with your doctor to see if you should start doing that as well. Even irrigating with saline solution will help move the sediment around to keep the tube from blocking, though i will warn you, its not comfortable.
I current have a SPC for a month and I am having pain in my penis. It feels as if my bladder is contracting and let thr urine flow. This is very painful can someone help please
The last tip says “Never cut a catheter trying to release it”
Why ? What is the problem ? I am about to try it myself
Gary, the problem is it can disappear inside you.
my wife supper pubic blocks at least ever 1 to 2 weeks this is very upsetting for her help
I’m having my surgery the 13th. Any advice. Can anyone tell me where to get belly bags? I’m a hands on medically capable girl does this mean I could change the SP foley myself?? Thanks everyone! ALL input is needed and appreciated!!!
Jay, Do you use any medication for heartburn? Gaviscon is known to block catheters. If you use gaviscon it might be worth asking your GP to prescribe an alternative eg omeprazole.
hi for anyone having trouble with the ballon. iv had this problem where the ballon felt like it was cutting me, real painfull.after trying several cath sizes, and still having this problem, i tried a child pediatric cath, the baloon only inflates to a 5ml its great, i dont even no i have it in. im only a small framed female, so maybe that is why i could not tolerate the adult ones.