Looking after your child's suprapubic catheter

This page explains about looking after your child's suprapubic catheter and what to expect when your child comes to Great Ormond Street Hospital (GOSH).

A suprapubic catheter is used to drain urine from the bladder.

The urinary system consists of the kidneys, the bladder, the ureters and the urethra.

The kidneys filter the blood to remove waste products and form urine. The urine flows from the kidneys, down through the ureters to the bladder. From here it passes through another tube called the urethra to the outside when urinating (weeing).

A catheter is inserted through a small incision (cut) in your child’s abdomen (tummy) into the bladder. The catheter is held in place by a small balloon on the inside or a stitch to the skin. It is often used after operations to the urinary system as it allows it to rest while it is healing.

Generally, the catheter will be inserted during the operation. In most cases, the suprapubic catheter is only needed on a temporary basis until the urinary system has recovered from the operation.

Sometimes, the catheter can cause bladder cramps or spasms, but we will give you medication to deal with this before you go home.

Bladder spasms can show up as tummy pain or discomfort in the penis or bottom area. Constipation can make the spasms worse, so make sure that your child is eating a balanced diet and drinking plenty of fluids when you are back home. If you are at all concerned about bladder spasms, please telephone the ward.

The drainage system consists of the catheter (thin, plastic tube) and a collection bag. You will also need some tape and new collection bags. We will supply you with everything you need before you go home.

• The catheter will remain in place until your child comes back to the ward to have it removed.
• Keep the catheter taped securely to your child’s stomach (tummy) so it does not get tangled in clothing. Replace the tape if it becomes loose or dirty.
• Keep the catheter as straight as possible – if it kinks, this will stop the urine flowing properly into the collecting bag.
• Keep the collection bag below waist level but off the floor in case it gets trodden on. We can supply you with a shoulder bag to help keep it out of the way.
• Your child should avoid rough and tumble play which may cause damage to the catheter or the operation site.
• Encourage your child to drink plenty of fluids – this will keep the urine flowing, reduce any discomfort and reduce the risk of an infection developing.

You will need to empty the collection bag at least four times a day:

1. Wash your hands
2. Stand or sit your child near the toilet
3. Open the valve at the bottom of the bag
4. Empty the bag into the toilet
5. Close the valve.

You should do this once a week, or if the bag becomes disconnected.
You will need: A new collecting bag

1. Wash your hands
2. Bend the catheter over to stop urine leaking
3. Remove the bag from the catheter. There is a special valve at the top of the bag so it should not leak urine when you do this
4. Attach a new collecting bag
5. Straighten the catheter.

You should call your family doctor GP or the ward if:

• Your child's urine becomes infected – signs of infection include darker than usual, smelly or cloudy urine. Encourage your child to drink more fluids and call the hospital.
• Your child has a sudden bout of pain – this is usually a bladder spasm – encourage your child to drink several large drinks at once.
• Urine is not draining into the bag.
• Urine is leaking into your child's pants or nappy rather than the collection bag.
• The catheter falls out.