What Is a Suprapubic Catheter?

A suprapubic catheter (SPC) is a hollow, flexible silicone tube placed directly into the bladder through a small opening in the lower abdomen, a few inches below the navel. A small balloon at the tip of the catheter is inflated inside the bladder to hold the catheter in place. Urine drains continuously into a bag, or into the toilet via a catheter valve.

The first suprapubic catheter is placed by a urologist in the operating room or procedure suite under local anesthesia with sedation, or under a brief general anesthetic. After it has been in place for several weeks and the tract is well established, the catheter can be changed at home or in clinic on a regular schedule.

Why Would Someone Need One?

A suprapubic catheter is considered any time long-term bladder drainage is required and a urethral (Foley) catheter is not the best option. Common reasons include:

Common Indications

  • Chronic urinary retention — bladder will not empty on its own
  • Urethral injury or stricture — when a tube cannot be passed through the urethra
  • After pelvic surgery (e.g., prolapse repair, anti-incontinence surgery)
  • Patients who need long-term catheter drainage but are sexually active
  • Wheelchair users or patients with limited mobility who cannot easily perform self-catheterization
  • Severe skin breakdown from incontinence when other options have failed

Why It's Often Preferred Over a Foley

  • Lower infection rate — the entry site is on the abdomen, not in the urinary tract
  • More comfortable for long-term use
  • No urethral irritation or pressure injury
  • Easier intimacy — nothing in the urethra
  • Easier to manage for caregivers

How the Urine Drains

You have two main options for managing urine flow:

Free Drainage

Urine drains continuously from the catheter into a bag worn on the leg during the day and a larger bag attached at night.

  • Leg bag — held with straps under your clothes
  • Night bag — larger, holds overnight drainage
  • Belly bag — worn around the waist; an alternative to a leg bag for some patients

Catheter Valve

A valve replaces the bag. Urine collects in the bladder and you open the valve every few hours to drain into the toilet — similar to normal voiding.

  • Discreet — no bag visible
  • Keeps the bladder exercising
  • Not recommended if you have small bladder capacity or bladder spasms

How to Care for Your Suprapubic Catheter

Daily Care

Cleaning the Insertion Site

  • Always wash your hands before and after touching the catheter or bag
  • Clean around the insertion site with warm soap and water once or twice a day, then pat dry
  • Sterile saline can also be used to clean the site
  • Do NOT apply creams, ointments, or talc near the site unless your urologist tells you to
  • You may keep a small dressing over the site; many patients prefer to leave it open to air once healed
  • It can help to gently rotate the catheter a quarter-turn during cleaning to prevent the tip from sticking to the bladder wall

Securing the Catheter

  • Use a fixation device or tape to anchor the catheter to your abdomen
  • Securing it prevents painful tugging and reduces the risk of the catheter being pulled out

Fluids and Diet

  • Drink about 1.5 to 2 liters (~6–8 cups) of fluid per day unless your doctor has told you to limit fluids
  • Water is best. A mix of water, juice, and squash is fine
  • Limit caffeine, alcohol, and carbonated drinks — they can irritate the bladder
  • Avoid constipation: eat fruit, vegetables, and whole grains

Bathing

  • Showers are preferred over baths, especially in the first few weeks
  • For the first few days after placement, keep a waterproof dressing over the site
  • After the site is fully healed, normal showering is fine
  • Avoid scented soaps or bath products near the site

How Often Is the Catheter Changed?

The first change is usually done in the urology office about 4–6 weeks after the original placement, once the tract through the abdomen has matured. After that:

  • Most suprapubic catheters are changed every 4 to 12 weeks
  • The exact interval depends on the catheter material and your situation
  • Some patients (or their family members) are trained to do the change at home
  • If the catheter ever falls out unexpectedly, it must be replaced quickly — the tract can begin to close within a few hours. Call our office immediately. If after hours, go to the Emergency Department.

Never try to remove or change your own catheter without specific training from your urology team.

What Problems to Watch For

Most patients do well with a suprapubic catheter long-term, but you should know what to look for. Contact our office if you notice any of the following:

Call the Office

  • Urine has slowed or stopped draining
  • Leakage of urine around the catheter (some leakage at a new site can be normal)
  • Insertion site is red, swollen, sore, or has pus
  • Mild blood in the urine — common after a catheter change; usually settles within 24 hours
  • Small bumps of tissue (granulation) at the site that bleed easily

Seek Urgent Care

  • Fever, chills, or feeling generally unwell
  • Severe abdominal or back pain
  • Catheter has fallen out — needs replacement within hours
  • Heavy or persistent bleeding from the urine or the site
  • Foul-smelling, cloudy urine with pain or fever (possible UTI)

Frequently Asked Questions

Will I still feel the urge to urinate?

Some patients do. A small amount of urine may still pass through the urethra at times, especially early on, or when the catheter becomes blocked. If this becomes uncomfortable or frequent, let us know — there are several options to help.

Is sexual activity possible with a suprapubic catheter?

Yes. One of the main reasons to choose a suprapubic catheter over a urethral catheter is that it leaves the urethra free. The catheter can be taped to the side or temporarily clamped during intercourse.

Will I always have a urinary tract infection?

No. Many patients with a long-term suprapubic catheter have bacteria in the urine (called asymptomatic bacteriuria), but this is normal and does not need treatment. Antibiotics are only used when you have actual UTI symptoms — fever, pain, or worsening leakage. Routine antibiotics can do more harm than good.

Can the catheter be permanent?

Yes. A suprapubic catheter can be used for years if needed. As long as the catheter is changed on schedule and the site is cared for, long-term use is safe and well-tolerated.

Can I travel with a suprapubic catheter?

Absolutely. Bring extra catheter supplies, drainage bags, and a few catheter-change kits if you'll be away for a while. Carry a copy of your urology team's contact information in case you need help on the road.

Expert Suprapubic Catheter Care

Whether you are considering a suprapubic catheter for the first time or you already have one and need ongoing care, our urology team can help. We place, change, and troubleshoot suprapubic catheters at all of our Atlanta-area offices.

  • ✅ Initial placement and routine changes
  • ✅ Help with leakage, blockage, or skin issues
  • ✅ Caregiver training
  • ✅ Same-day support for unexpected problems
Schedule Your Consultation

Call 678-344-8900 to speak with our team