Daniel Davidson, MD, MBA, DBA, PHD
Introduction:
For those who are unable to empty their bladders naturally through the urethral route, suprapubic tubes (SPTs) are essential passageways for urine drainage. Urinary diversion can now be reliably achieved with this minimally invasive surgical operation, which entails a small abdominal wall incision leading directly into the bladder to install a tube. A doctor’s bedside suprapubic tube change is a delicate process that demands accuracy, dexterity, and close attention to detail. We explore the nuances of suprapubic tubes, their purpose, and how to change them at the bedside in this article.
What is a Suprapubic Tube?
A medical device called a suprapubic tube (SPT) is used to drain urine when a person is unable to use the natural urethral pathway to empty their bladder. Through a tiny incision made in the lower abdomen, usually above the pubic bone, a hollow catheter is surgically inserted into the bladder. Using this other path, urine can constantly drain from the bladder and collect outside the body in a bag.
When urinary retention arises from a variety of medical disorders, including neurogenic bladder dysfunction, urinary blockage, pelvic trauma, or bladder dysfunction following surgery, suprapubic tubes are frequently employed. They are also used in situations where traditional urethral catheterization is risky or impractical, including in strictures or urethral injuries.
A qualified healthcare provider, such as a surgeon or urologist, will normally place a suprapubic tube in a clinical setting while under local or general anesthesia. During the surgery, a little incision in the lower abdomen wall is made, and the catheter is then advanced through it into the bladder. To keep the catheter from coming loose, it is usually fastened in place with sutures or a retention balloon.
Procedure for Changing a Suprapubic Tube:
In order to preserve urine drainage, changing a suprapubic tube is a delicate technique that requires replacing the old catheter with a new one. A medical professional or other qualified healthcare provider usually does this procedure at the patient’s bedside. A detailed tutorial explaining how to change a suprapubic tube can be found below:
Assemble Materials:
Sterile substitution suprapubic catheter (e.g., Foley catheter) of the proper size and kind
sterile gloves
antiseptic solution (such as povidone-iodine or chlorhexidine)
draperies that are sterile
Needles
lubricant gel
local anesthetic, if appropriate
Securing tool (such as a suture or retention balloon)
Get the patient ready:
Assume a comfortable supine or semi-recumbent position for the patient on the bed.
Make sure there is enough light, and reveal the patient’s abdomen.
To reduce nervousness, reassure the patient and go over the process with them.
Wash and sanitize:
Using mild circular motions, cleanse the area surrounding the current suprapubic tube insertion site with an antiseptic solution.
Before continuing, let the antiseptic solution entirely dry.
Anesthesia, if necessary:
To decrease discomfort during the treatment and to numb the insertion site, use local anesthetic.
Using a sterilized syringe and needle, inject a tiny quantity of lidocaine or another local anesthetic into the surrounding tissue.
Await the anesthesia’s onset before moving forward.
Removal of the tube:
Remove the suture or adhesive dressing that is holding the existing suprapubic tube in place with caution.
To extract the tube from the bladder, use mild traction and make sure to proceed slowly and deliberately to prevent damaging the surrounding tissue.
New Tube Insertion:
Apply a water-soluble lubricating lubricant to the tip of the sterile replacement suprapubic catheter using sterile technique.
Applying sustained, gentle pressure, insert the catheter into the bladder through the site of the existing incision.
Move the catheter slowly and cautiously, using tactile input and, if possible, fluoroscopic imaging as your guides.
Make sure the catheter tip is inside the bladder and that the balloon (if any) is inflated in accordance with the instructions provided by the manufacturer to keep it there.
Keeping the Tube Secure:
To stop displacement, connect the new suprapubic tube to the skin with a suitable anchoring tool, like a suture or retention balloon.
Make sure the tube is firmly in place and does not put too much strain on the tissue around it.
Evaluation and Record-Keeping:
Examine the suprapubic tube’s position and functionality to ensure that it is functioning properly and that enough pee is being drained from the bladder.
After the procedure, keep an eye out for any indications of bleeding, discomfort, or problems in the patient.
Keep track of all the procedure’s specifics, such as the kind and size of catheter used, any problems that arose, and the patient’s reaction.
Conclusion:
When it comes to facilitating urine drainage for people with different urological disorders, suprapubic tubes are essential. A suprapubic tube change at the patient’s bedside is a specialist treatment that needs strict adherence to sterile procedures and close attention to detail. Physicians can safely and successfully perform this treatment, guaranteeing the best possible patient outcomes and comfort, by according to established protocols and guidelines. Suprapubic tube management improves patient mobility, quality of life, and general well-being in addition to making urine drainage easier.
