Urethral and Suprapubic Catheterisation

09 January 2013

What is the difference?

The difference between the two routes is the part of the body into which the catheter is inserted (See figures 4, 5, 6 & 7).
Urethral Catheter Insertion
The catheter is inserted into the urethral opening (from where you would normally pass urine). This is the usual and most common route for catheter insertion (See figures 4 & 5). 
(Figure 4)
Uretheral Site of Entry - Male Side View 
(Figure 5)
Uretheral Site of Entry - Female Side View 
Supra-Pubic Catheter Insertion
The catheter is inserted directly into your bladder via the abdominal wall in order to drain urine. It can be inserted as a temporary or permanent measure.⁹⁺¹⁰ Hospitalisation is normally required to create the supra-pubic opening and to insert the initial catheter. This is positioned directly below the umbilicus (belly button) usually when the urethral route cannot be used (See figures 6 & 7 below). Standard length indwelling catheters  are routinely used supra-pubicly, usually size 14-16ch with a 10ml balloon .  A collection bag is attached to the supra-pubic catheter for continuous drainage.  This is then secured to your leg.
Your initial catheter usually remains in your bladder for approximately 4 weeks before being changed either in hospital or in your home. 
Occasionally, leakage may occur during the first few weeks after the procedure, in which case a dry dressing around the supra-pubic site may be applied.  Routine catheter changes can be undertaken at home by either your District Nurse or Continence Advisor.
(Figure 6)
Supra-pubic Site of Entry - Male Side View
(Figure 7)
Supra-pubic Site of Entry - Female Side View


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