Anyone know anything about a Supra Pelvic tube to urinate?

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My father went to his urologist today and complained about peeing through his Depends or dropping his urinal and this is what the doctor suggested that he get. I have never heard about it and looked it up on the internet. All the urine is collected in a bag. My dad was all for it and agreed to set it up before my brother came back in the room and said we needed to discuss this more. I understand this is done with general anesthesia, and I have learned on this website how debilitating that can be on the elderly. My father had two massive strokes 23 years ago, almost completely recovered for several years but has been in a wheelchair for the last 14 years. He is incontinent both ways and has to be lifted with a Hoyer sling into bed in order to be cleaned, but we are all trained in how to use it. He sometimes can use a urinal but most of the time doesn’t even know when he needs to pee. He is 87, with few ADLs and dementia though he can converse and be lucid at times. We have run into this before with his cardiologist telling him he needed a pacemaker about 6 years ago. He didn’t get it and surprisingly enough all his subsequent heart visits have been excellent. Did his heart heal itself? My father has excellent medical insurance in addition to Medicare. I think my dad is easily led by his doctors and I get the idea that he thinks this will solve all his leaking problems, but he is still bowel incontinent! Any thoughts?

Answers 1 to 10 of 14
How about trying a condom catheter?

And if your use of Depends really means that brand, there are many more absorbent kinds available out there.
Top Answer
Treeartist,
A Suprapubic catheter is a catheter that is placed in a surgically made opening in the lower abdomen. The catheter goes directly into the bladder. Once it's in the bladder, it's held in place with a balloon filled with sterile water. It's connected to tubing which is connected to a bag. You'll need to empty the bag around twice a day.

It is a sterile procedure to change the catheter. The stoma (the surgical opening) will need to be cleaned daily (wipe with wet gauze) and the catheter will need to be replaced every couple of weeks. You can be taught how to do it or have a home health nurse come out.

I would also suggest a condom catheter first. They aren't perfect and, if he moves around a lot, it can fall off. Also difficult if there is a large amount of pubic hair or an inverted penis.

I would NOT recommend a urethral catheter (put in the tip of the penis). The constant friction from the cath moving around causes urethral erosion. I've seen male patients that have a third of their penis eroded away from a urethral cath.

Read up on Suprapubic catheters before having him go for the surgery.
My dad has a suprapubic catheter. It was put in just before he was released from spinal cord injury rehab. He was 81 at the time and thankfully didn't seem to have any ill effects from the general anesthesia; he doesn't have dementia though.

It has worked great for us. One urologist at the rehab wanted us to do the urethra sort of catheter, but we freaked out the more we learned about it and observed it and all the nurses agreed it wouldn't be best for Dad or my sister and I. Home health changes the catheter for us once a month. We haven't had any sort of leakage.
Supra pubic catheter? That’s an extreme solution to your father’s problems. It is an invasive procedure and yes, under general anesthesia.

The Supra pubic catheter would be great in a patient with spinal injuries, when the bladder is no longer properly enervated. 

It is dangerous for someone in as poor health as your father. Your instincts are correct.
Diana, yes, that is what I thought too. There is nothing wrong with my father’s spine, kidneys, or his bladder other than the fact that he can’t hold it like he used to and is clumsy when using a urinal. He also is often unaware that he even needs to urinate. Aren’t most of the oldest old people incontinent? Is this the new treatment for incontinent seniors? We were floored at the suggestion of his urologist and the ready acceptance of my father. I wonder what happens to the elderly with no one to advocate for them? My parents are of the generation that did not question their doctors’ orders.
My sister was in an appointment with my mother a couple of years ago and my mother complained of pain in her body. The doctor asked her to tell her how bad it was on a scale of 1 to 10, and my mother, who always exaggerates, said 9 (this was news to us as she had not complained once of pain). The doctor suggested that she have a procedure done in which a pump would be inserted into her body and pain medicine administered more effectively. My mother once in a while will ask for an extra strenth Tylenol. She did not get the pump, and years later, though there is a lot wrong with my mother, debilitating pain is not one of them.
The first thing that I would do is to upgrade his Depends to disposable underwear with greater capacity. Check out Abena Abri-Flex. They're more expensive, but will hold 3x the amount of fluid.
Tree artist,
Nowadays, everyone wants a "quick fix". Doctors are going along with the trend. They give you the options, you choose.

Believe it or not, there are people opting for a SP cath without many physical problems, just for "convenience".

That's why we have gazillions of medications out there too. Sign of the times.
My uncle had it done because he was in such pain with the catheter. He was 89. He also had dementia. I’m not sure what it did for him but the nursing home said he was in less pain after it was done. So my question to you is: is your father in pain when he urinates?
My dad suffered with a swollen prostrate and at times were attached to a catheter. He had bowel leaks and had to wear diapers most time at 86yrs. It is tough and the doctors sis not suggest anything else. He was on Cardigen Meds for the prostrate, which helped a lot.
LindaD I wonder if maybe your dad was describing discomfort (from being wet or feeling the cath) with pain, I know my mom often uses the term "pain" when it isn't really pain per se she is experiencing, in fact her pain tolerance and or complaint threshold is so high we aren't learning about problems until they have advanced far beyond necessary. That said of course a regular catheter particularly in a male I believe, can often cause discomfort, pain because of the way it rubs depending on how active they are. Just thinking about it doesn't sound comfortable. This is all exactly why having people who know and care about you as you age, who can speak up for you and your best interest makes such a difference. Each individual case and point in time is different just as individuals are so having several choices to balance the pros and cons with is a blessing as much as a PIA! ;) Good luck with this Treeartist, your dad is very fortunate to have you watching out for him and whether or not he is able to verbalize that often he knows it.

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