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Bladder Training After Suprapubic Catheter Use

A suprapubic urinary catheter is used for draining urine when the urethra or the bladder have been damaged or are convalescent. The catheter is inserted through a surgical incision done just above the pubic bone (hence the term supra which means above and pubic in reference to the pubic bone).

After surgery, prolonged use of a suprapubic catheter can deter bladder functions from going back to normal. This is where ‘bladder training’ comes in. It is a way of assisting the bladder resume its natural work.

Training the bladder:

It requires that you prevent the catheter from continuously draining by clamping it during the day. This is easily done by adjusting the ‘lock’ to ‘CLOSED’ position.

1.Leave it closed for about 2-3 hours. During that time some urine will have accumulated in the bladder. Attempt to empty the bladder naturally (on your own, without unclamping the catheter) into a measuring container and write down the amount of urine drained.

2.After passing urine naturally, release the ‘lock’ by turning it to the ‘ON’ position. Drain any residual urine from the bladder, gauge it and record it.

3.Clamp the catheter again and redo this process every 2-3 hours throughout the day. Once less urine residue starts flowing through the catheter, it will be a sign that your bladder training is making progress. The reverse also applies. Increasing amounts of urine passed naturally will indicate improvement.

4.Allow the catheter to drain freely at night by attaching a urine drain bag. Do this by un-capping the drain bag, connecting it to the catheter and setting the catheter ‘lock’ to the ‘ON’ position. Bladder training resumes as soon as you wake up in the morning.

5. The last part in home bladder training is to have the catheter clamped overnight. If urine residue measures less than 100ml in the morning, call your doctor for a scheduled catheter removal, usually within 24 hours unless it’s a weekend. If the amount of urine collected reaches about 100 ml during a 24 hour period, also schedule a catheter removal appointment. Meanwhile clamp the catheter. In the event you feel excessive bladder pressure, unclamp the catheter and restart bladder training. Always inform your doctor about this.

6.Continue emptying your bladder every 2-3 hours, until the suprapubic catheter has been removed. Adhere to prescribed antibiotics or other medications as instructed. Keep a daily report with your bladder training results.

Considerations when wearing a suprapubic catheter:

  • Shower only when the protective dressings are on.
  • Do not direct water to the catheter insertion site.
  • Do not use a bath tub with the catheter on.

Instances when you should contact your health professional:

  • Body temperature of 101ºF or higher (could be a sign of infection).
  • Redness and swelling around the catheter insertion point.
  • If the catheter falls out.
  • If the dressings come off.

Note:

Always observe hygiene before and after touching your suprapubic catheter. Wash your hands with soap and water for a minimum of 15 seconds. Alternatively, if there is no visible dirt on your hands, an alcohol hand sanitizer may suffice.