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Some people with bladder problems will need a catheter. The bladder is a balloon-like organ that holds pee. Some people aren’t able to empty their bladder properly. There are a few reasons why this might be, including problems that they were born with, surgery, and voiding problems.
If the bladder does not empty properly, or a child has retention, this causes a risk of infection. Urine can also track back up to the kidneys, which will cause damage. This can also cause incontinence. A catheter may be put in to drain your child’s bladder more effectively, which helps to reduce these risks.
A catheter is a hollow tube made from a soft, flexible material. This allows pee to drain from the bladder. A suprapubic catheter goes in to the body through the skin of the tummy, below the belly button, and into the bladder. A balloon on the inside end of the tube is filled with water, to stop the tube from falling out.
Suprapubic comes from Latin, and it means ‘above the pubis’. The pubis is the area where your private parts are. So ‘suprapubic’ means above your privates, which is where the tube comes out.
The first time that a catheter is put in will be by a doctor at the hospital. This will be done under general anaesthetic, which is a medicine that makes someone go to sleep and stops them from feeling the procedure. It is a simple procedure, and it is usually done as a day case. This means that you can go home on the same day, as long as there are no problems.
Normally, a bag is put on the end of the catheter for the pee to drain into. The bag can be attached to your child’s leg with a Velcro strap. You will be given a bigger bag to use overnight, while your child is asleep.
Other children will have a valve on the end of their catheter. This can be used to control the flow of pee. The valve can be closed during the day, and then opened over the toilet to empty the bladder. This can give a child a sense of normality, as the bladder can fill and be emptied when able.
If your child gets a lot of infections, or has a large bladder, it might need to be continuously drained into a bag.
Your doctor or specialist nurse will be able to tell you what should be best for your child. Bags and valves, whatever kind they are, all need to be changed every 5 to 7 days.
It can stay in place for up to 3 months. The catheter will then need changing. It will be changed at hospital by a nurse.
If your child is very scared or worried about having their catheter changing, they may be able to have some Entonox gas. This will help them to relax while it is changed. Please be aware that this may only be offered for the first catheter change.
After some time, you or your child will be taught how to change the catheter at home by yourselves.
For the first few days after it is put in, the skin around the catheter should be cleaned every day. Boil a kettle of water and let it cool down to a comfortable temperature. Use this to gently clean the wound. Dry the skin, and then apply a light gauze dressing. After a few days, the site can be left clear with nothing on it.
The best way to keep the catheter clean is to have a bath or shower every day. Take extra care to make sure that the catheter site is dried properly, to stop it from becoming sore.
Gently turn the catheter every day. This helps to prevent it from sticking.
To stop the catheter from pulling, tape it securely to the leg or tummy. Make sure that there are no kinks in the tubes, so the pee can continuously drain.
Make sure that the catheter is taped below the bladder. This means that gravity can drain the bladder properly.
This may be because the skin was not dried properly after washing.
Make sure that the skin around the catheter is properly dried after baths and showers.
If the problem continues, get in touch with your specialist nurse.
This may be caused by:
Check that the catheter is not kinked or blocked.
Get in touch with your specialist nurse, as your child might need some medicine to help with the spasms.
Putting a catheter in is likely to cause some trauma. This means that there may be some small injuries, but these should settle after a few days. Accidental pulling and catching the catheter can also cause injuries.
This problem should settle by itself. If there is still blood in the pee after a few days, please get in touch with the specialist nurse.
This may be due to a urine infection.
Encourage your child to drink at least 1.5 to 2 litres of clear fluids, like water or dilute squash.
Get in touch with your GP to arrange for a urine sample to be sent.
Please remember that this sample has to come directly from the catheter, and not the drainage bag.
This could be over granulation. This is when the body tries extra hard to heal a wound. Here, the body is trying very hard to heal the skin around the hole.
This is not an infection, and it does not need any antibiotics. Ask your specialist nurse for some cream to rub into the skin. This will help to settle the skin down.
This could be because:
To fix this, you can try checking the position of the catheter. If needed, reposition it, and unkink the tube.
If there is not a problem with the tubing, encourage your child to drink more.
If this does not fix the problem, contact your specialist nurse. They will tell you how the flush the catheter.
The catheter may fall out if:
If this happens, replace the catheter straight away.
If the suprapubic catheter falls out, it needs to be replaced within around 20 minutes. After this time, the hole will begin to close.
Put the catheter back in as you were shown by your nurse. Instructions are also given in the next section. If you can’t replace the tube easily, get in touch with the specialist nurse, or attend the emergency department at your nearest hospital, so that a medical professional can help.
Always make sure that you have a spare catheter at home.
You will need:
Place down something to protect the floor, in case any pee drips.
If you have any problems with changing the catheter, please get in touch with your specialist nurse.
Having a suprapubic catheter should not stop your child from doing any of the things that they like to do at school or at home. This includes swimming and PE.
You should get in touch with your GP or specialist nurse if your child has:
You should take a sample of pee to the GP or hospital. Samples should be taken from the catheter, and not the drainage bag.
Urine samples should be taken before starting antibiotics.
Ask your child to drink more, at least 6 to 8 glasses. Water is best. This can help to start flushing out the bugs.
Bags, catheters, and valves are available to get on prescription from your GP.
Your specialist nurse will let you know about the home delivery service you can sign up for. It is then up to you to get in touch with your GP or the home delivery service when you need more supplies. They should also be able to supply you with new syringes when you need them. Get in touch with your specialist nurse if you cannot get these locally.
If you have any questions or concerns, contact the Urology Specialist Nurses on 0114 226 0502.
Please read our resource for more information about risks of anaesthetics.
Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.
Resource number: URO3
Resource Type: Article
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