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When you have an indwelling suprapubic catheter placed via stoma, you should perform a few aspects of at-home catheter care to ensure that your catheter and urinary tract remain clean and in good working order. You can use this guide to care for your indwelling suprapubic catheter in your home.


What is a stoma, and how do I care for it?

A stoma is a small opening created to allow the placement of an indwelling suprapubic catheter when placement through the urethra is not possible. You may have a suprapubic stoma (meaning that the catheter goes into your bladder through a small hole above your pubic bone) or a Mitrofanoff stoma. Your stoma requires care and cleaning every day. 

Remove the old dressing:

  1.  Gather your cleaning supplies (a washcloth, mild soap, warm water, a clean gauze drain bandage, a clean towel).
  2.  Wash your hands.
  3.  Put on clean medical gloves.
  4.  Remove the old gauze dressing and tape and discard them into the trash.
  5.  Remove the gloves and wash your hands.

Wash the area around your catheter:

  1.  Wash your hands.
  2.  Put on a new pair of medical gloves.
  3.  Hold the end of the catheter near the place where it enters your body to avoid pulling it out while cleaning.
  4.  Rinse your stoma and the skin around it with warm water.
  5.  Using a clean washcloth, mild soap, and warm water, clean the skin around your stoma.
  6.  Wash the catheter tubing in the direction away from the stoma to remove any mucus or debris.
  7.  Rinse the skin around your stoma and the catheter tubing with warm water.
  8.  Gently pat the skin around the stoma dry with a clean towel.
  9.  Remove the gloves and wash your hands.
  10.  Apply a new gauze drain bandage and tape in place around your stoma.

Do not use any creams, powders, or sprays near your stoma site.


How do I empty my catheter drainage bag?

Empty your drainage bag when it is just over half-full. Remember: you will need to empty a leg bag more often than a larger bedside bag. To empty the drainage bag attached to your catheter, follow these steps:

  1.  Wash your hands with soap and water.
  2.  If you're supposed to keep track of your urine output, use a container that displays measurement markings.
  3.  Remove the drain tube from the cover (or holder) on the bottom of the bag. Hold the bag drain over the container. Open the clamp on the drain tube so urine empties into the container.
  4.  When the drainage bag is empty, close the clamp on the drain tube. Use a clean paper towel or tissue to dry the end of the drain tube, then place the tube back into the cover/holder.
  5.  Take note of your urine's color, smell, and amount. Urine should be clear and have a light-yellow color with a mild smell. If you are supposed to keep track of your urine output, write down the amount along with the current date and time.
  6.  Pour the urine into the toilet and flush. Rinse the container with water and then pour the water into the toilet. Set the container in a clean area until you need to use it again.
  7.  Wash your hands with soap and water.

How do I clean my drainage bag?

If you are wearing an indwelling suprapubic catheter for more than a month straight, you will need a new drainage bag once per month – or more often if the drainage bag has a leak. Throw old drainage bags and tubing into the garbage.

If you are using a catheter long-term, clean your drainage bag once every two days with a mixture of vinegar and water.

  1.  Mix 1 1/2 cups of white vinegar with 2 quarts (8 cups or 64 ounces) of water.
  2.  Pour the vinegar-water mixture into the drainage bag through the drain tube and swish it around in the bag. Set the bag in a bathtub, sink, or large basin to allow the mixture to soak for 30 minutes. Be sure that the tubing (not just the bag) is also full of the mixture.
  3.  Drain the mixture out and rinse the drainage bag with clean water. Dry the outside of the bag and tubing.

Do not use a bleach solution to clean your drainage bag or tubing, as bleach can damage your catheter equipment.


How do I flush my catheter?

Flushing is a procedure used to help keep urine flowing if you suspect that your catheter is plugged. If you were sent home with an indwelling suprapubic catheter, it may be necessary to flush the catheter. The following are signs that your catheter may be plugged, and how you can try to resolve the issue before flushing the catheter:

  • No urine draining from catheter: Check to see if the tubing is twisted or bent and move the tubing into a straight line to see if urine begins to flow. Make sure the drainage bag is located below your bladder and try changing your position. If urine still does not flow, the catheter may be plugged and need flushing.
  • Urine leaking from your stoma or urethra: Wet clothes or wet bedding are a sign that your catheter is not draining. You may experience some leaking from your stoma or urethra if you have bladder spasms, but a large amount of urine leaking is not normal. The catheter may be plugged and needs to be flushed.

To flush your catheter, you need the following supplies:

  • Saline syringe
  • Alcohol wipes

Follow these steps to flush your catheter:

  1.  Wipe the access port with an alcohol wipe.
  2.  Remove the cap from the saline syringe.
  3.  Attach the syringe to the access port.
  4.  Pinch off the tubing below the access port to stop urine flow.
  5.  Slowly push in the saline solution.
  6.  Once the syringe is empty, disconnect it from the access port.
  7.  Keeping the tubing pinched, repeat steps 2-5 as needed until you have instilled 30-60mL of saline into the bladder.
  8.  Release the pinched tubing to allow urine to flow.

What if I am supposed to irrigate my bladder?

If your provider has instructed you to irrigate your bladder, please refer to the Bladder Irrigation protocol.


What about bladder instillation with vinegar?

If your provider has instructed you to instill your bladder with a vinegar solution, please refer to the Vinegar Bladder Instillation Protocol.


How do I clean my catheter supplies?

You can clean your catheter supplies with a mixture of vinegar and water. Do not use bleach or a bleach solution to clean your catheter supplies, as bleach may damage them.

Follow these steps to clean your catheter supplies:

  1.  Mix 1 1/2 cups of white vinegar with 2 quarts of water.
  2.  Disconnect any connected syringes and pull the plunger(s) out. Place the syringe, plunger, and the container used for irrigation or flushing into a bathtub, sink, or large basin to allow the equipment to soak in the mixture for 30 minutes.
  3.  Drain the vinegar-water mixture out and rinse the supplies with clean water. Dry the outside of the bag and tubing.

When should I call Gillette?

Call Gillette Children's Telehealth at (651) 229-3890 if you experience any of the following:

  • Signs or symptoms of a urinary tract infection (UTI):
    • Fever
    • Chills
    • Frequent, urgent, and/or painful urination
    • Abdominal cramping
    • Increased urine leakage
    • Increased odor
  • Signs or symptoms that your catheter might be plugged:
    • Feeling of bladder fullness
    • Putting out an unusually small amount of urine
    • No drainage of urine since you last emptied your drainage bag
    • Urine leaking around the tube
    • Blood in your urine
    • Large amounts of mucus or sediment visible in your urine

This information is for educational purposes only. It is not intended to replace the advice of your health care providers. If you have any questions, talk with your doctor or others on your health care team. If you are a Gillette patient with urgent questions or concerns, please contact Telehealth Nursing at 651-229-3890.