Supra Pubic Catheter Question

[jigi]

To all those urology nurses out there, just wanted to pick your brain.

-Client had a recent SPC change

- Acquired a UTI

- Presented to ED as had urethral leakage and retention, subsequently SPC was changed but a smaller size was inserted

-Client then went home and continued to have urethral leakage

So the question is, how likely is it for this client to go in to urinary retention?

Thanks in advance!

[Aniroc]

Well, patients who have chronic retention or other urological issues that prevent them from long term catheterization often receive SPCs as a way to manage urinary retention. Therefore if after the catheter has been changed and the patient is still leaking or having retention issues, something else must be happening.

First thing I'd look at is the stoma. What is its character. Does the peristomal skin look healthy or inflamed, is there tracking, fistulas or hyperplasia. Did they use a new type of catheter that the patient may be allergic to causing inflammation around the site leading to leakage? Some patients are sensitive to latex and need silicone catheters. You may need to check the balloon positioning of the catheter as it may not have been inserted fully into the bladder space preventing proper drainage. If you believe the catheter is in correct position can it be gently flushed with easy return? And lastly, if the patient does have a confirmed UTI what antibiotics are they being prescribed and are they taking them correctly.

Its hard to say wether or not this patient will have retention as it depends on numerous conditions. If all else fails, this patient needs to be reassessed by their urologist as chronic leakage and or retention worsens their quality of life.

Hope this helps.

[americanTrain]

Seems to me that the Urologist would have inserted a larger one, not smaller, which they usually do on intervals until the right size fits the stoma. Im not a Urology nurse, and if I'm wrong, I admit. I have seen this in our place too.