Student cath question

[bethem]

Hi everyone,

I have a question that is bugging me: Is a suprapubic catheter the same as a Foley catheter? If not, what is the difference, and is a suprapubic catheter harder to insert?

I want to do midwifery after I have finished my nursing degree and I am supposed to have knowledge and skills with suprapubic catheters, IV drugs and care and wound care.

Thanks!

[jmgrn65, RN]

suprapubic is inserted directly into the bladder similar to a g-tube except it is in the bladder usually done by a urologist. Nurses don't insert except possibly if one has fallen out then maybe depending on your states scope of practice a nurse can re-insert.

[bethem]

Thanks, that's helpful!:)

[Larry77, RN]

In our state we often replace them once they are established. Usually for the first few times the urologist replaces the suprapubics increasing in size each time until the stoma is established. Changing these once established is quite simple...actually easier than a Foley. It is my understanding that "Foley" (named after a an American urologist) actually refers to a catheter inserted through the urethra with an inflatable balloon at the end of it to prevent accidental removal.

In my experience it is always stated "suprapubic" when the catheter is not a standard "foley" and is inserted throught the lower abdomen directly into the bladder.

[Daytonite, BSN, RN]

A suprapubic catheter is a catheter (often a plain old foley) that goes directly into the urinary bladder through an artificially created stoma (cystostomy) in the suprapubic area. GYNs insert them during some surgical procedures. They are also placed in men with prostate and bladder cancers through a surgical created suprapubic cystostomy for long term bladder drainage. When we had men with these in the nursing home, we changed them on a regular basis just like any foley catheter, using sterile technique. You can't miss the hole on these like you can doing female caths! :chuckle The ones I saw used in female patients on surgical units were very small lumen, clear tubes, not foleys. As I recall, if they happened to come out, we had to call the surgeon. Those temporary post-op, small lumen, clear suprapubics are left in place until swelling has gone down sufficiently and the patient is able to pass urine through their urethra adaquately.

http://www.nlm.nih.gov/medlineplus/ency/article/003981.htm - here is a link to information on catheters. About 2/3 of the way down is a short section on suprapubic catheters.

http://www.steinergraphics.com/surgical/003_09.1.html - a medical source on catheterization. 1/3 of way down page is where the information on suprapubic puncture and catherization starts - has illustrations

http://www.nationalmssociety.org/pdf/forpros/SurgMgmtBladder.pdf - here is an article with pictures illustrating cystostomies.

http://www.stanthonyshospital.org/surgery/surgeries/cystostomy.htm - this is a patient information bulletin on cystostomy