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?
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.
And if your use of Depends really means that brand, there are many more absorbent kinds available out there.
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.
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.
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.
I'm an RN and my Dad has a suprapubic catheter due to an enlarged prostate. They are placed in a short procedure under general anesthesia. Your father's primary doctor would have to evaluate him for fitness under general anesthesia. As far as upkeep, etc., it may be a good solution for your Dad since he has to be lifted to be changed. It would be less friction overall on his skin, plus less skin breakdown from wet underpants, etc. The stoma or opening is rather small, and is covered with gauze. Self care means changing the gauze daily, and regular urology visits to check the catheter. The urine collects in a bag that can be hung on his wheelchair, or they have leg bags that will fit under clothing if your Dad would prefer that. They are MUCH easier to take care of and much less likely to start an infection as opposed to one that comes out of the penis. Have a urologist explain the procedure to you. I would feel comfortable saying you should check it out, but a lot will depend on how your Dad would tolerated surgery.
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