What is a Supra-Pubic Catheter?

Please note, this page is printable by selecting the normal print options on your computer.

This booklet has been produced to help you or your carer look after your Supra Pubic Catheter at home.

If you have any questions when you read this booklet please ask your Nurse before you are discharged from hospital. On discharge, a Ward Nurse will refer your care to the District Nurse based at your General Practitioners Surgery (GP). If you have any questions or concerns about your Supra Pubic Catheter, contact your District Nurse or GP once at home.

The urinary system
The kidneys produce urine, which is passed down the ureters into the bladder where it is stored. Urine is expelled from the bladder through the urethra (water pipe).

What Is A Supra-Pubic Catheter?
• A Supra Pubic Catheter is a urinary catheter that is inserted into the bladder from a small cut in your tummy, just above your pubic bone. You will not need to pass urine yourself from your urethra.
• The Supra Pubic Catheter is kept in place by a balloon that is filled with 10ml of sterile water to prevent it falling out. The catheter will drain urine from the bladder into a catheter bag. Alternatively, you may be offered a catheter valve that attaches to the end of your catheter but this will be discussed by your Nurse/Doctor because catheter valves are not suitable for all patients.

Why is a Supra Pubic catheter used?

A Supra Pubic Catheter is inserted if you:
• Have a problem with your urethra. If you have a blockage called a stricture and a urethral catheter cannot be passed.
• Have an enlarged prostate and a urethral catheter cannot be passed.
• Have suffered pelvic or urethral trauma.
• Require a catheter for long term use due to a congenital or progressive degenerative illness.
• Require a long term catheter and suffer from difficult urethral catheter insertions or long term urinary tract infections.
• A long term catheter has damaged the end of your penis and this will save further damage.
• Poorly functioning bladder which either fails to store or to expel urine adequately.

How is a Supra Pubic Catheter inserted?
• Normally a Supra Pubic Catheter is inserted via a hospital day case appointment (you will go home on the same day of admission).
• Insertion of a supra pubic catheter normally takes approximately 30 minutes. This will be performed by a doctor working on your Consultant’s Team.
• The procedure to put this catheter in place should not be too uncomfortable.
• If you already have a urethral catheter in place, your bladder will be artificially filled with sterile fluid before the Supra Pubic Catheter is inserted.
• A small injection of local anaesthetic will be given in your tummy to numb the area before a small cut is made.
• The catheter is put into your bladder through the small cut, and it stays in place by a small balloon which is inflated once the catheter is in your bladder. The catheter is then attached to a catheter
bag where the urine is then collected.
• In some circumstances a stitch is used to close the wound in your tummy and secure the catheter temporarily. The stitch needs to be removed after 10 days and this can be arranged with your District Nurse.

A dressing will be placed around the catheter site until the skin around the catheter has healed.

• Once you have had your Supra Pubic Catheter inserted this will stay in place for three months to allow the tract to settle and become patent before a catheter change is performed by your District
Nurse. There after, your supra pubic catheter is then changed approximately on three monthly basis by the District Nurse.

Catheter Hygiene
Follow these simple instructions to avoid the risk of infection:

  • Always wash and thoroughly dry your hands before and after touching your catheter and drainage bags.
  • You can have a bath or shower with the catheter in place, but first empty the catheter bag.
  • Once finished, dry the catheter and bag with a towel.
  • The skin around the catheter should be washed daily with unscented soap and water, rinsed and dried thoroughly with a clean wash cloth using downward strokes where the catheter tubing enters your body (or use a medicated cleaning cloth). This will prevent infection and the build up of encrustations around the catheter site. This should be done at least daily or twice daily.

Do not use cream or talc around the catheter site.

Emptying your catheter bag
You will be shown how to empty the leg drainage bag by opening the tap at the bottom of the bag. Empty it into the toilet if possible. Make sure that you close the outlet tap properly after emptying the bag. If you are unable to get to a toilet, drain the urine into a suitable container. Advice will be given to you by your nurse. The leg bag should be emptied when it is three quarters full as this will prevent it becoming heavy and causing discomfort. This is only a guide and you should use your judgement to ensure your comfort and well being.

What to do at night
At night a larger drainage bag (night bag) can be connected to the leg bag. Empty your leg bag before attaching the night bag. Once you have connected the night bag, open the drainage tap on the leg bag. This will ensure that your urine drains from the leg bag into the night bag. The night bag can be connected to a stand beside your bed. Each morning, close the drainage tap to the leg bag
and disconnect the night bag and empty it down the toilet. The leg bag can stay connected to the catheter for 5-7 days, leaving the leg bag connected in this way helps to reduce the risk of infection.
The night bag should be a non drainable night bag single use only disposed of daily.

Disposal of drainage bags
First empty the bag of urine into the toilet so it is empty. Put into a plastic bag and place in your dustbin.

Urine Infection signs
If you develop a fever, or have any burning, stinging or offensive, cloudy, smelling urine this may indicate an infection. Increase your fluid intake as this may help, but you will need to inform your Nurse/GP.

If urine leaks out around the catheter

This is not a serious problem. Check:

• There are no kinks in the catheter or the tubing
• There is no blockage
• You are not constipated; and drinking enough fluids orally
• If the problem continues contact your Nurse/GP for advice

If you see blood in your urine
This may be due to either catheter trauma where the tube may have been accidentally pulled, or a sign of a urine infection. Increase your fluid intake as this may help to clear the colour of your urine. If your symptoms persist contact your GP.

If no urine drains from your catheter check:
• Is the tubing kinked?
• Is the bag below bladder level?
• Are you constipated?
• Is the drainage bag connected the right way up?
• Have you been drinking enough?

Try walking or moving around as this may dislodge a blockage. If nothing drains and you are in pain, contact your Nurse or GP for advice.

If your catheter falls out
Immediately contact your Nurse or GP for advice. If this is out of your surgery’s working hours contact NHS Direct for advice. It is advisable to keep a spare catheter at home.

Socialising, Exercise, holidays and Work
Having a catheter should not prevent you carrying out your normal activities. If you are going on holiday and you have a permanent catheter bag speak to your nurse because a catheter valve, may be appropriate for a short term solution.

Sexual activity
A supra pubic catheter will not interfere with you resuming your normal sexual activity.

Women and Men should:
Empty the catheter bag and tape the catheter tube to your stomach (abdominal skin). This will prevent the catheter pulling and keep it secure.

What to eat and drink
Avoid caffeine drinks such as carbonated drinks, coffee or tea as these may irritate your bladder. Drink at least two litres of fluid a day. Keep a cup of water by your bed at night so that you can have a drink if you wake.

Further Contacts:
Your District Nurse works from 9am-5am 7 days a week
Twilight Nurses work from 8pm-1am contact phone numbers 01908 303048 or 07836336777
Your own GP
NHS 111
Urology Nurse Practitioner – 01908 996902 – Answer phone service available.