What is a suprapubic catheter?
A suprapubic (soop-ruh-PEW-bick) catheter is a tube that goes into your child’s bladder through the belly. You might also hear it called an SP catheter. A doctor makes a small hole in the lower belly to put the catheter in. The hole is called a “stoma.”
An SP catheter carries urine (pee) from the bladder to a disposable bag. Your child might have this type of catheter for different reasons, including:
- Leaking urine
- Not being able to urinate
- Health problems
How do I care for the stoma?
You need to care for your child’s stoma and catheter every day. This prevents infections. You need to clean the catheter tube and the opening where it goes into the belly. Follow these steps to clean the stoma, or opening.
- Clean your hands with soap and water and dry well, or use an alcohol-based liquid or foam hand cleaner. (See Do You Know … Clean Hands.) You do not need to wear gloves.
- Take off the dressing (bandage) if there is one.
- Use soap and water to clean the catheter where it leaves the body. This can be done during your child’s daily sponge bath. Be careful not to pull on the catheter. Rinse the area with warm water and pat it dry.
- Clean any dried blood or mucus away with hydrogen peroxide blended with an equal amount of water. You can mix the hydrogen peroxide and water in a medicine cup. Water from your tap is fine. Use a cotton ball or cotton-tipped swab to gently wipe the skin around the catheter. Rinse with warm water on another cotton ball or cotton swab. Pat dry.
- Check your child’s skin daily. Some redness and clear fluid draining from the area is normal.
- Put on a new dressing (bandage) if the old one looks dirty or wet.
How do I care for the drainage (leg) bag?
- Keep your child’s catheter and leg bag in place to keep the tube from coming out.
- Keep the leg bag below the level of your child’s bladder so urine does not back up.
- Keep the leg bag off the floor.
1. Empty the bag
Empty the bag when it is 2/3 full, or at least every 8 hours even if it is not full.
- Wash your hands well with soap and water and dry well, or use an alcohol-based liquid or foam hand cleaner.
- Put an empty container under the drain spout, and open the spout to let urine drain out.
- Be careful not to touch the spout to the container or touch the spout with your hands. Clean it with an alcohol wipe if you do either of these things.
- Close the spout when the bag is empty.
2. Change the bag
Change the leg bag once a week. Change the bag right away if it gets dirty, cut, or torn, or if it starts leaking. Otherwise, germs could get in and cause an infection. If the urine bag falls off the catheter tubing, clean the end of the tube and put on a new bag. Follow these steps to change the bag.
- Clean your hands with soap and water and dry well, or use an alcohol-based liquid or foam hand cleaner.
- Gather the following supplies:
- A new leg bag
- A new stopcock, if your child’s bag uses one
- Red cap, if needed
- Alcohol pad or Site Scrub®
- Connect the new stopcock, if you have one, and the new bag before you take the old bag off.
- Bend the catheter over to keep urine from leaking if you do not have a stopcock.
- Take the old bag off. Take off the old stopcock if you have one.
- Clean the end of the catheter with a Site Scrub or alcohol pad.
- Connect the new bag, and attach it to your child’s clothing.
- Check the tubing for kinks. These can keep urine from draining into the bag.
How do I clean the tubing?
You might need to clean the tubing by rinsing it with saline or sterile water. This helps keep urine draining from the catheter more easily. It can help prevent stones, or crystals, from forming when all the urine does not drain from the bladder. If the urine looks cloudy or “milky,” your child might have a stone caused by a bladder infection.
You might need to rinse your child’s tubing every day if the catheter is draining less than usual or stops draining. You might also need to rinse it if your child’s urine looks cloudy or bloody, or has mucus in it.
Follow these steps to rinse the tubing
Clean your hands with soap and water and dry well, or use an alcohol-based liquid or foam hand cleaner. You may wear non-sterile gloves after cleaning your hands.
- Gather the following supplies:
- Sterile saline or sterile water
- 10 ml syringe
- Alcohol pad
- Red cap, if needed
- Sterile top for drainage bag or sterile gauze pad, if needed
Put 10 ml of saline or sterile water into the syringe. This liquid is called the flush.
If the bag has a stopcock
- Open the tap toward your child, so “OFF” points to the bag. Figure 1 shows you what this looks like.
- Remove the red cap and clean the flush port with an alcohol pad.
- Connect the syringe and slowly push the 10 ml flush into the bladder. Do not force the flush.
- Pull back slowly on the syringe until you see urine. Once you see urine, stop.
- Turn the tap toward the flushing port. This allows fluid to drain from your child’s body into the bag. Figure 2 shows you what this looks like.
- Take the syringe off the flush port. Scrub the flush port well by rubbing it firmly all over with an alcohol wipe. Put a new red cap on it.
If the bag does not have a stopcock
- Wipe the connection between the bag and the catheter with an alcohol pad. Then, take the leg bag off the catheter tubing.
- Put a sterile top or sterile gauze over the open end of the drainage bag. This keeps it clean until you put the catheter tubing back on it.
- Connect the syringe to the catheter tubing. Slowly push the 10 ml of flush into the bladder. Do not force the flush.
- Pull back slowly on the plunger of the syringe until you see urine. Once you see urine, stop.
- Take the syringe off the tubing and put the leg bag back in place.
You might need to rinse the catheter more than one (1) time a day if the urine is bloody, cloudy, or not draining. If urine is not flowing out after you try rinsing the catheter twice, call the hospital. If it is hard to push the saline or water flush into the catheter, do not force it. This could damage your child’s bladder.
When to call the hospital
Go to the hospital right away if your child’s catheter comes out or you pull it out by accident.
Call the hospital if you notice any of the following.
- You see a lot of fluid draining or leaking around the catheter (a small amount is normal).
- Your child has a fever, acts irritable, or has redness and pain around the catheter or in their back. The urine or the fluid draining around the catheter smells bad.
- The urine is cloudy and does not turn clear after you flush the catheter.
- You see blood in your child’s urine.
- The catheter stops draining 6 to 8 hours after you change it.
- The catheter is clogged and does not flush easily.
What else do I need to know?
Your child’s SP catheter might not drain all the urine from the bladder. This can cause crystals, or stones, to form in the bladder. Your child’s urine might look cloudy or milky if this happens. Help your child drink plenty of fluids. This helps the urine stay clear and flow easily.
Use the log sheet the nurse gives you to write down how much urine your child makes.
If you have questions about your child’s SP catheter, please ask their doctor or nurse.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).
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