Medical Technology

Suprapubic Catheter Catheterization

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A suprapubic catheter is a special type of catheter which inserts directly into the bladder through the abdominal wall.  This explanation begs the question: what is a catheter.  A urinary catheter is a device which inserts into the bladder to drain urine from the bladder.  Catheters can be necessary because of disabilities that do not allow the person to urinate normally.  They can also be a tool used diagnostically, especially if urine is needed when normal micturation could be contaminated, such as when a woman is menstruating. 

Usually, a catheter inserts via the urethra and into the bladder.  However, in some situations, a suprapubic catheter is needed.  Instead of the normal route, a suprapubic catheter is inserted into the abdominal wall, just above the pubic bone, directly into the bladder. The insertion is a minor surgical procedure, which can be done under two forms of anesthesia. The first is a local anesthetic before inserting the catheter.  The other option is done under full anesthesia.  Usually, the catheter is inserted under general anesthesia only when it is part of a larger, pelvic surgery procedure.

Other than in situations of pelvic surgery, the other common use of a suprapubic catheter is where the urethra is obstructed, disfigured or malformed.  In these situations, it becomes necessary to bypass the urethra in order to drain the bladder.  This can be used in daily life or in diagnostics.  Diagnostically, a suprapubic catheter is commonly used after severe physical trauma to the pubic area to collect urine samples.  Since severe physical trauma commonly occurs comorbidly with kidney damage, urinalysis is usually indicated in these situations.  Suprapubic catheterization can also be indicated in situations of prostatic hypertrophy, as this can obstruct the urethra.

Finally, suprapubic catheterization can be a healthier, safer and more versatile version of a standard Foley catheter for those who use catheters on a daily basis.  Because increased risk of urinary tract infections with a catheter as well as some issues of leakage, suprapubic catheters can be a good alternative.  It is however important to note that, as with all indwelling, permanent catheters, suprapubic catheters can increase risk for bladder cancer.  Therefore, those who routinely use a suprapubic catheter are encouraged to have annual bladder exams. Generally, however, the decreased incidence of urinary tract infections outweigh this risk. 

Suprapubic catheterization can seem frightening and miserable at first, but can be a very liberating and safe alternative as well as offering practical use in several diagnostic situations. 

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