This information explains what a suprapubic catheter is and how to care for it. A suprapubic catheter is also called a suprapubic tube (SPT).
What is a suprapubic catheter?
A suprapubic (SOO-pruh-PYOO-bick) catheter is a thin, flexible rubber or plastic tube (see Figure 1). It’s used to drain urine (pee) from your bladder when you cannot pee on your own.
Figure 1. Suprapubic cathether
Most catheters go through your urethra, into the bladder. Your urethra is the tube that carries urine from your bladder to out of your body.
A suprapubic catheter is used if a regular catheter cannot be inserted through your urethra. It’s inserted into the lower part of your abdomen (belly), right into your bladder.
Some people may need a suprapubic catheter when they have an injury to their urethra. Others may need it if they have a condition that makes it hard to urinate (pee). Examples are:
- Scar tissue that makes your urethra narrow. This is called a urethral stricture.
- Trouble controlling when you pee. This is called urinary incontinence.
- An enlarged (bigger) prostate.
- A tumor or cancer blocking your urethra.
During your procedure, your healthcare provider will make an incision (small cut) in the lower part of your abdomen.
This procedure has a low risk of complications (problems).
How to wear your suprapubic catheter and leg bag comfortably
Your urine goes from your bladder and through a drainage tube into a drainage collection bag. The drainage bag stays on your leg with a special tape called Cath-Secure®.
You will have 2 types of drainage bags:
- A leg bag. This is the bag you wear during the day. It holds half a liter (about 2 cups) of urine (see Figure 2).
- A night bag. This is the bag you will put on at night before you go to bed. It holds 2 liters (about 8 cups) of urine.
The tubing from your leg bag should fit down to your calf with your leg bent a little. If you have extra tubing, you may need to cut it. Your healthcare provider will show you how.
Figure 2. Leg collection bag
Place the leg bag on your calf or thigh using the Velcro® straps your healthcare provider gave you. Use a Cath-Secure® to secure the tubing to your thigh.
If the straps leave a mark on your leg, they’re too tight. Loosen them. Leaving the straps too tight can slow your blood flow and cause blood clots.
At nighttime, you will change the leg bag to a night bag. You’ll put it on before you go to bed. It holds 2 liters of urine.
How to shower with your suprapubic catheter
Once your healthcare provider says it’s OK, you can shower while you have your catheter in place. If you’re using a dressing, take it off before showering.
Let the soapy water run over the tube and tube insertion site. Rinse with clean water. Do not rub or push hard on the area around the tube insertion site.
Make sure the area around your tube insertion is dry. Put on a clean dressing after showering.
Do not take a bath or swim with your catheter until your healthcare provider says it’s safe to do so. Placing your catheter underwater can put you at risk for infection.
Do not shower with your leg bag. Your leg bag has cloth on the side and will not dry as fast. Shower with your night bag or with the plug in instead.
You may find it easier to shower in the morning before you change your night bag to your leg bag.
How to flush your suprapubic catheter
You may need to flush your catheter to clear it out.
Your healthcare provider will teach you how to do this. Follow their instructions.
How to change your suprapubic catheter dressing
You must change your dressing (bandage) every day (see Figure 3). Do this for 5 to 7 days after your procedure. You may need to do it for longer. Follow your healthcare provider’s instructions.
Here are the steps:
- Wash your hands well with soap and water or use an alcohol-based hand sanitizer.
- If you’re washing your hands with soap and water, wet your hands with warm water and apply soap. Rub your hands together for 20 seconds, then rinse. Dry your hands with a paper towel. Use that same towel to turn off the faucet.
- If you’re using an alcohol-based hand sanitizer, be sure to cover all parts of your hands with it. Rub your hands together until they’re dry.
- Take off your dressing to check for any signs of infection, such as:
- Pain.
- Swelling.
- Change in color or redness at the insertion site (where the catheter enters your body).
- Pus (thick yellow or white drainage).
Call your healthcare provider if you have any of these signs.
- Gently wash the area around your catheter with a clean washcloth or clean gauze, soap, and water.
- When you’re done, gently pat the area dry with a clean towel.
- Wash your hands well again, with soap and water or use an alcohol-based hand sanitizer.
- Place a new clean dressing around the tube. You may need to cut a slit in it so you can wrap it around the tube.
Figure 3. Dressing
How to clean your suprapubic catheter
Follow these instructions to clean your suprapubic catheter. Many people find it easiest to clean their catheter once a day, while they’re in the shower.
- Gather your supplies. You’ll need:
- Mild soap for sensitive skin, such as Dove®
- 1 Cath-Secure®
- Clean washcloth or clean gauze
- Wash your hands well. Follow step 2 in the “How to change your suprapubic catheter dressing” section for instructions on how to do so.
- Clean the area around the catheter using a clean washcloth or clean gauze, mild soap, and water. Start cleaning the catheter at the insertion site and then move down, away from your body. Make sure to hold the catheter with your other hand at the insertion site while you clean it. This will keep you from pulling or putting tension on the catheter.
- Rinse the area well and dry it gently.
- If you took off your old Cath-Secure®, attach the catheter to your leg with a new Cath-Secure®. This will keep the catheter from moving.
- Wash your hands well again, with soap and water or use an alcohol-based hand sanitizer.
How to take care of your suprapubic catheter drainage bags
- Change your drainage bag 2 times a day.
- Wash your drainage bags every day. See the “Cleaning your drainage bags” section for more instructions.
- Replace your drainage bags with new bags once a week. You should also replace your drainage bag if it gets clogged or blocked.
- Drink 1 to 2 glasses of liquids every 2 hours while you’re awake to stay hydrated. Staying hydrated can help the drainage work better.
If urine is draining into your drainage bag, you may see some blood or urine around the insertion site. This is normal. If urine is not draining into your drainage bag, call your healthcare provider.
Caring for your leg drainage bag
Empty the leg bag into the toilet every 2 to 4 hours, as needed. You can do this through the spout at the bottom of the bag. Do not let the bag get completely full.
Do not lie down for longer than 2 hours while you’re wearing the leg bag. This can keep your urine from draining the way it should.
Caring for your night drainage bag
Always keep the night bag (see Figure 4) below the level of your bladder.
When you go to sleep, hang your night bag off the bed. You can do this by using a small trash can. Place a clean plastic bag inside the trash can, then hang your night bag inside of the trash can.
Figure 4. Night bag
Cleaning your drainage bags
Clean your leg bag and night bag every day. Follow these instructions.
- Gather your supplies. You’ll need:
- White vinegar
- Cool water
- Clean your hands with soap and water or an alcohol-based hand sanitizer.
- If you’re washing your hands with soap and water, wet your hands and apply soap. Rub your hands together well for at least 20 seconds, then rinse. Dry your hands with a paper towel. Use that same towel to turn off the faucet.
- If you’re using an alcohol-based hand sanitizer, cover your hands with it. Rub them together until they’re dry.
- Rinse the bag with cool water. Do not use hot water because it can harm the plastic.
- Clean the bag to help get rid of the smell. Fill the bag halfway with a mixture of 1/4 cup white vinegar and 3/4 cup water. Shake the bag and let it sit for 15 minutes.
- It may be hard to get the mixture into the bag. If so, try putting the vinegar and water into a measuring cup that has a pour spout. Then use the spout to help pour the mixture into the bag.
- Rinse the bag with cool water. Hang it up to dry.
When to change your drainage bags
Change your drainage bag 2 times a day:
- In the morning after you shower, change the night bag to the leg bag.
- At night before you go to bed, change the leg bag to the night bag.
Replace your drainage bags with new bags once a week. You should also change your drainage bag if it gets clogged or blocked.
- Gather your supplies. You’ll need:
- A clean washcloth (not one you’re using for bathing) or a 4 x 4 piece of gauze.
- Your night or leg bag (whichever one you’re switching to).
- 2 alcohol pads.
- Clean your hands with soap and water or an alcohol-based hand sanitizer.
- If you’re washing your hands with soap and water, wet your hands and apply soap. Rub your hands together well for at least 20 seconds, then rinse. Dry your hands with a paper towel. Use that same towel to turn off the faucet.
- If you’re using an alcohol-based hand sanitizer, cover your hands with it. Rub them together until they’re dry.
- Empty the urine from the drainage bag into the toilet. Make sure the spout of the drainage bag never touches the side of the toilet or any emptying container. If it does, wipe it with an alcohol pad for 15 seconds.
- Place the clean washcloth or gauze under the connector to catch any leakage.
- Pinch the catheter with your fingers and disconnect the used bag.
- Wipe the end of the catheter with an alcohol pad.
- Wipe the connector on the new bag with the second alcohol pad.
- Connect the clean bag to the catheter and let go. Make sure the catheter is tightly connected to the bag to keep it from opening or leaking.
Check all connections. Straighten any kinks or twists in the tubing.
How long can I wear my suprapubic catheter before it needs to be exchanged?
You need to have your suprapubic catheter exchanged every 4 to 6 weeks. This can be done at your healthcare provider’s office. A visiting nurse can also change your catheter at home. Talk with your healthcare provider to learn more.
How to use a catheter plug with your suprapubic catheter
Once you’re comfortable using the leg bag, your healthcare provider may suggest using a catheter plug during the day (see Figure 5).
To use the catheter plug:
- Disconnect the catheter from your leg bag. Place the leg bag in the sink.
- Place the catheter plug into the end of your suprapubic catheter.
- Secure the capped suprapubic catheter to your abdomen with tape.
When you’re ready to pee, uncap the plug. Let the pee drain into toilet.
Figure 5. Catheter plug
Driving
You can drive with a catheter unless your healthcare provider gives you other instructions.
Exercise
Talk with your healthcare provider about whether you can exercise while your catheter is in place.
Swimming
Do not swim for the first 6 weeks after your catheter is placed. Talk with your healthcare provider about swimming after 6 weeks.
Travel
It’s safe to fly on an airplane with a catheter. Let the Transportation Security Agent (TSA) know that you have one.
When to call your healthcare provider
Call your healthcare provider right away if:
- Your catheter comes out. Do not try to put it back in yourself.
- You have a fever of 101°F (38.3 °C) or higher.
- Your catheter is clogged with mucus, blood, or blood clots.
- You’re making less urine than usual.
- You do not have urine draining into your drainage bag.
- Your urine smells bad.
- You have bright red blood or large blood clots in your urine.
- You have abdominal (belly) pain and no urine in your catheter bag.
- You have any signs of infection, such as pain, swelling, change in color or redness at the insertion site, and pus.