Foley AND supra-pubic catheters?

Hi, ladies

Got a question or two - I'm having an MMK with my SAH on May 21 - I was doing some reading about the procedure for the MMK - it was mentioned that a Foley and a supra-pubic catheter would be used. Ok, I know where a Foley catheter is inserted, but where does the supra-pubic catheter go? Anyone know the chances of going home with a catheter?

Thanks for your help!

Hi Jodi,

I'm not sure what an MMK is, but I'll be having bladder suspension surgery and hyst. June 5.

From what I've read on the internet, I believe a suprapubic catheter is just a different kind of catheter than the foley catheter. Search for suprapubic catheter or bladder suspension and you should find something that explains the difference. It goes in the same place.

According to the paperwork my dr. just sent me "approximately 80% of patients go home with a suprapubic catheter and continue the voiding tirals."

Hope this helps.

Good luck!

BarbH

Okay, I think I've got it now.

Foley catheter allows urine to continuously flow into a bag. The suprapubic catheter has an on/off switch so to speak. This is so you can void normally with with switch closed and measure the amount of urine voided. Then you open the switch and allow the catheter bag to fill and measure the residual urine (urine left in the bladder after voiding).

Hope that's more help.

BarbH

A Foley Cath goes directly into the urethra. Supra-pubic (supra - above) so just about where your pubic hair line is. Lots of ladies go home with the supra-pubic cath and then go through a "training period" so to speak, getting that bladder working again before the cath comes out. Hope this helps.....now what's an MMK?

Thanks, Donah! That makes sense now. I'm not looking forward to this at all.

BarbH

Thanks, ladies,

BarbH, thanks for the info on how it's used - I haven't been able to find any good information on it - where did you find it? And thanks for the info on the chances of coming home with a cath - not encouraging!

Donah, that's what I was afraid of! I knew it couldn't be the same as a Foley, since I read that both would be used. Do they make a separate incision or use the same incision that was made for the hyst?

An MMK is Marshall-Marchetti-Krantz procedure - bladder lift for urinary incontinence.

I am not familiar with your type of bladder surgery, however, I had a bladder suspension procedure 5 years ago and I only had a Foley--now I did have it in for 7 days which I wasn't too happy about, but there was only one catheter which went in the usual place. Perhaps you can ask your doctor about the possibility of just staying with the one basic type. You will feel like you have to go to the bathroom all the time, but you won't be in pain because of the catheter. So just relax as best you can and try to ignore it. I started my period while mine was in a full 2 weeks early - I guess it was all the stress. Take or ask for your pain meds when you need them and remember to rest---maybe this can be done in your case but ask your doc. and get his advice. Best of luck to you and remember, at least you will be dry from here on out !

Hi- I had a LAVH with a Burch (BLADDER suspension) surgery on April 2, 2001. A Foley catheter is usually incerted into the urethra during surgery. It has a little balloon on the end that keeps it in your bladder until it is ready to be collapsed and taken out. Usually with bladder repair surgery, a supra- pubic cath is inserted . My supra - pubic was not ready to be taken out after I was kicked out of the castle a day and a half after surgery. While on a catheter, the nurses measure your out urine outputs before you can have it removed. It is often necessary to have a supra- pubic in place for a few days or weeks ,depending on what was done. To answer your question (which I tried to find out about for 2 weeks prior to surgery) the supra- pubic catheter is inserted thru a small hole in the skin ABOVE your pubic bone, NOT thru your natural urethral opening. Sounds gross, but actually tickled to have it removed, and the hole closes up almost overnight! It sure gives your bladder a rest when it it weak & sore, and they make sure that you CAN void on your own before it is removed.

I had the Burch procedure too, and yes, it exits out of the bladder right through your pubic area. Since I had an abdominal hyst procedure, the Burch procedure was done through the same incision. So I had the "bikini-line" incision with the hole for the SP catheter poking out about an inch underneath it. The most uncomfortable thing in my experience, was the stitch they took through the skin right next to the SP cath to keep the cath in place. That suture got sore! I discovered that if I moved the position of the bag from the left to the right, it would relieve some of the pressure. This was easier to do with the leg bag which they give you during the day than with that big honking bag they have you switch to at night. During the day I just moved it from the right leg to the left one. During the night, since one side of my bed is against the wall, and the cath had to come off the same side of the bed, I had to lay the other way around i.e put my feet where my head had been to vary the position of the cath. My only other problem was keeping kinks from forming in the cath. My nurse showed me how to coil it up to prevent twisting, but occasionally it slipped and kinked. The urine would back up into my bladder and the "back pressure" would wake me up by causing bladder spasms. As soon as the kink was taken out, I could actually feel the pressure disappear as the urine ran freely. I went through the bladder retraining too (I still have my "hat"--the urine measuring device I used for a week--as a memento. So was it worth the trouble? Yes, it was. My stress incontinence problem is gone! Permanently!! So now I can sneeze or cough in safety, I don't have to buy sanitary products ever again and I will never have to spend money on Depends!
Good luck.
Linda

I had a radical TAH BSO and my DD had told me that I would have a supra-pubic cath and it would be there anywhere from a "few days to a few weeks". I was starved trying to find information, so I can understand how you feel.

The cath goes in a tiny hole just above the pubic bone (on me, this was about 1-1/2 inches below my bikini incision from surgery) and was held in place with two tiny stitches. Mine was in for 18 days before it was removed in the DD's office. I think that S-P caths are less prone to causing UTI's and I believe that they are more comfortable when needing to be in place for more than just a couple of days.

One plus is that there is a clamp, so you can do bladder training. In my case, it was clamp the tube, void in the "hat" to measure when I had the urge, then open clamp and measure residual urine that comes into bag. My DD wanted residual urine to be less than 50cc's. I tried at 9 days post, but bladder wasn't ready. Waited another week and all was good. Had to keep the cath one extra day just because my DD doesn't have office hrs on Mondays.

You'll also have a large bag and a much smaller leg bag, so you can go out if you need to. I personally preferred the large bag when at home as the plastic from the leg bag made my leg sweat....but that's just me. And as far as the tubing kinking, you do need to be careful. I found that using some hypo-allergenic tape holding the tubing to my leg kept that problem at bay.

When the cath was removed, it automatically closed up on it's own. The only thing I had to do was put some triple antibiotic cream on it for a couple of days per DD's instructions.

Oh, and one other thing..I could clamp the tubing and remove the bag altogether while taking showers which I really appreciated.

I found that, just like the surgery, the anticipation of having the cath was much worse than actually having it. Sorry if this was long, but I had trouble finding information about S-P caths pre-op and wished that someone had been able to tell me of their experience. So, I hope this helps you a little!