Suprapubic and Clean Intermittent Self-Catheterisation

Table of Contents

1. Introduction
2. Indications for suprapubic and intermittent catheterisation
   1. Suprapubic catheters
   2. Intermittent Catheterisation
3. Risks and complications of suprapubic catheters
4. Care and management of suprapubic catheters
   1. Managing the abdominal wound
5. Changing a suprapubic catheter
   1. Managing bypassing and suprapubic catheter blockage
6. Teaching patients to self-catheterise
   1. Frequency of catheterisation
7. Product choice
   1. Other information needs
8. Summary
9. References

Risks and complications of suprapubic catheters

Suprapubic catheters are not inserted without risk and the National Patient Safety Agency issued a rapid response report in 2009 (NPSA, 2009b) following three deaths related to the insertion of a suprapubic catheter. The purpose of this report was to alert staff to the potentially life threatening risks that might occur following catheter insertion.

Task 6

1

Select the two most serious complications of suprapubic catheter insertion from the list below and then select Check answer. a) Catheter acquired urinary tract infection b) Bowel perforation or intestinal injury c) Urethral erosion d) Haemorrhage from perforation of vascular structures within the pelvis (Intra-abdominal bleeding) e) Altered body image The correct options are numbered b) and d). b. Bowel perforation or intestinal injury d. Haemorrhage from perforation of vascular structures within the pelvis (Intra-abdominal bleeding)

Task 7

2	What might indicate a bowel perforation had occurred? Enter your answer in the box below and then select Check answer. - Abdominal pain (persistent lower abdominal pain, spreading away from insertion site) - Pyrexia - Signs of localised peritonitis

Other serious complications include peritoneal perforation without bowel perforation, infection and haematuria. If any of these serious complications are suspected medical attention should be sought immediately.

More minor complications, such as suprapubic catheter blockage, pain, urinary tract infection, or wound infection are common occurrences. Informed consent must be obtained from patients prior to suprapubic catheterisation, as with any other procedure. This requires the patient to understand the nature of the procedure as well as the risks and benefits of suprapubic catheterization (Harrison et al, 2010). It is advisable to provide the patient with written information in a format that they can understand before undergoing the procedure. Patients should also be provided with information regarding the signs of serious complications, e.g. bowel perforation and peritonitis, if they are discharged within a short time of the procedure, including who to contact if these symptoms occur.