Suprapubic Catheter: Unciano Colleges Inc

Unciano Colleges Inc.
Circumferential Road, Brgy. San Roque, Antipolo City
Suprapubic Catheter
Submitted by:
Andrew James Quidez
Submitted to:
Ms. Lina Cinco, RN
 Word by Word…
 Suprapubic – means the area of the pubic bone, above the
level of the pubic hair.
 Catheter – means a hollow tube inserted to your bladder to

drain away the urine.
 Or simply saying…
 Suprapubic catheter – you have a urinary catheter inserted
into your bladder through the abdominal wall.
 It is INDICATED to…
 Urethral injuries
 Urethral obstruction
 Bladder neck masses
 Benign prostatic hypertrophy
 Prostate cancer
 And it is CONTRAINDICATED to…
 It is absolutely contraindicated in the absence of an easily

palpable or ultrasonographically localized distended urinary
bladder.
 Suprapubic catheterization is relatively contraindicated in

the following situations:
 Coagulopathy
 Prior lower abdominal or pelvic surgery
 Pelvic cancer with or without pelvic radiation
 What do we need…
 Sterile Gloves
 Antiseptic solution
 Gauze square, 4x4
 Needles, 18 and 25 gauge
 Percutaneous suprapubic catheter set (Pediatric: 8F, 10F;
Adult: 12F, 14F, 16F)
 Needle obturator
 Malecot catheter
 Connecting tube
 One-way stopcock
 Sterile drapes
 Anesthetic solution
 Syringe 10 ml and 60 ml
 Scalpel Blade No. 11
 Skin tape or nylon suture (3-0) with a needle drive
 Step by Step…
 Apply an antiseptic solution from the pubis to the umbilicus.
 Repeat the application of the antiseptic solution 2 more times
and allow the area to dry.
 Apply sterile drapes and verify the insertion site by palpating the
anatomic landmark.
 Fill the 10-mL syringe with a local anesthetic agent and use the
25-gauge needle to raise a skin wheal at the insertion site.
 Advance the needle through the skin, subcutaneous tissue,

rectus sheath, and retropubic space, while alternating injection
and aspiration, until urine enters the syringe Note the direction
and depth required to enter the bladder.
 Using the No. 11 blade, make a 4-mm stab incision at the

insertion site with the blade facing inferiorly.
 Insert the needle obturator into the Malecot catheter and lock it
into the port by twisting it so that the needle tip projects 2.5 mm
from the distal end of the catheter.
 Connect the 60-mL syringe to the port of the needle obturator .
 Place the tip of the catheter–obturator unit into the skin incision
and direct it caudally and at a 20- to 30-degree angle from true
vertical toward the patient’s legs.
o The practitioner’s nondominant hand should be placed on the
lower abdominal wall, and the unit should be stabilized between
the thumb and index fingers.
o The dominant hand should be used to advance the unit, while
aspirating, until urine enters the syringe.
o Once urine enters the syringe, advance the unit 3-4 additional
centimeters into the bladder.
 While securing the unit with the nondominant hand, unscrew the
obturator from the catheter .
 Advance the catheter approximately 5 additional centimeters

over the obturator and then completely withdraw the obturator
needle.
 Connect the extension tubing to the catheter and connect the
tubing to a urinometer or a leg bag.
 Gently withdraw the catheter to lodge the wings against the

bladder wall.
 Undrape the patient and apply skin preparatory solution (eg,
benzoin) to the skin.
 Apply drain dressings around the catheter at the insertion site.
 Tape the catheter to the skin (leaving a mesentery between the

skin and catheter) or stitch the catheter to the skin.
 Nursing Care …
 Caring for Your Skin near your Catheter
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 doctor or
nurse 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 doctor or nurse
showed you.
 Make Sure Your Catheter Is Working

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.
 Changing Your Catheter

You will need to change the catheter about every 4 to 6 weeks. Always
wash your hands with soap and water for at least 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 doctor right
away. Insert a catheter into your urethra through your urinary opening
in your labia (women) or 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 doctor or go to the local emergency room.
 When to Call the Doctor

Call your doctor or nurse 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 doesn’t 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).

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Unciano Colleges Inc.

Circumferential Road, Brgy. San Roque, Antipolo City

 Catheter – means a hollow tube inserted to your bladder to

 And it is CONTRAINDICATED to…

 It is absolutely contraindicated in the absence of an easily

 Suprapubic catheterization is relatively contraindicated in

 Advance the needle through the skin, subcutaneous tissue,

 Using the No. 11 blade, make a 4-mm stab incision at the

 Advance the catheter approximately 5 additional centimeters

 Gently withdraw the catheter to lodge the wings against the

 Tape the catheter to the skin (leaving a mesentery between the

 Make Sure Your Catheter Is Working

 Changing Your Catheter

 When to Call the Doctor

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