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Indwelling urinary catheters and drainage bags

03 June 2013
Q4  I need to have a catheter in for the indefinite future. Is it better to have a urethral catheter or suprapubic catheter?
 
A4. The answer to this may depend on the reason you require a catheter. There can be personal reasons for choosing either. You may find one more comfortable than the other or more discreet and it should be discussed with your Health Care professional/GP before you make a decision. However a urethral catheter may damage your urethra over a period of time and the balloon that holds it in place can damage the neck of your bladder, causing you to leak urine. If the catheter is forced through the external sphincter, the muscle that helps to control the flow of urine, it can cause damage resulting in urinary leakage.  
You are also less likely to sit on a suprapubic catheter and accidentally pull on it therefore fewer traumas caused. 
A suprapubic catheter gives an alternative entry point to your bladder, so if it becomes blocked, urine can drain through your urethra (although this may not be possible for everyone). This can act as a ‘safety net’ in that at least you are still able to empty your bladder until the catheter is replaced (this needs to be done as soon as possible and your Health Care professional/GP must be informed immediately.
A suprapubic catheter allows you to have normal sexual activity. It is also easier to keep the site of your suprapubic catheter clean. 
If you can use your hands adequately, you can be shown how to change your own suprapubic catheter, as it is easier to reach than a urethral one. 
You can use a larger size of catheter, making it less likely to become blocked.
There is a lower rate of infection in those with a suprapubic rather than urethral catheters.
There are some medical reasons for not being able to have a suprapubic catheter inserted.
You can have the procedure reversed and the site will heal quickly.
Hopefully the above information can help you decide which catheter is best for you!
 
Q5. What bags are available  to facilitate urine drainage?
 
A5. Many! There are leg bags, night drainage bags, a belly bag and some more specialised bags that may be more suitable for example if you use a wheelchair. The leg bags are available in 350ml, 500ml and 750ml capacity. The belly bag holds a litre and is worn as the name suggests around the belly! If you drain more than a litre at night CliniSupplies make a connector to attach it to a night drainage back enabling you to get a nights sleep without having to worry your bag will overfill.
Leg bags are available with and without a cloth backing. Drainage bags are also available as sterile bags and non-sterile bags. All these products are available on prescription and advice from your local continence adviser can be sought if you find your bag does not provide you with the discretion or the comfort you are looking for.
 
Q6. Do I have to use a night drainage bag?
 
A6. Yes (belly bag exempt if you do not pass more than a litre at night). The night drainage bag connects to the bottom of your leg bag. You then open the tap of the leg bag to allow the urine to flow into your night drainage bag. If you do not use a night drainage bag and you are in bed there is risk of your urine back flowing that could contribute to a urine infection. Apart from the Belly bag all other bags need to be below the level of the bladder to facilitate drainage. They should not be left to sit on the floor but supported on a stand. Some stands can either be hooked onto a bed, slotted under the mattress or stand on the floor. Some have the added bonus of an antibacterial coating on the stand to help ward off those pesky bugs! The night bags are available in singe use or drainable for use up to 5-7 days. If you share accommodation e.g. live in a residential care home you should always have the single use bag. These bags are still emptied prior to disposal of them and some are the tear type but the better one to have is the one with a drainage tap. (Once opened it cannot be used again)
 
Remember always wash your hands before and after any catheter procedure.
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