Ron (and all):
I'm c5, 36 years post injury and got the suprapubic a little over a year and a
half ago. For me it has been one of the best decisions I've made. If I could
turn back time I would've done it years ago. For the preceding 34 years I wore
a condom cath and legbag. My bladder always voided reflexively and my residual
amount (urine not voided) was not too much. However, having any residual urine
sitting in the bladder is a perfect setup for UTIs, and I got my share. Over
the years, as my bladder slowly stretched out, my residuals increased and so
did my UTIs.
Two years ago I was having multiple UTIs, which caused my penis to do the
"frightened turtle," when I peed, which, in turn caused my catheters to
constantly leak. I was at my wits end and VERY frustrated. That's when I made
the decision to look into a suprapubic (a number of my quad friends had them
already.) Looking back, I'm not sure why I was ever adverse to getting a
suprapubic. I think it seemed "unnatural" to have another hole in my body. An
external condom seemed more "normal." Now that I have the "supertube," as I've
heard it called, I see that pissing myself or constantly having UTIs was more
unnatural than a small tube through my lower belly.
I haven't had a UTI in over a year! (*knocks on wood*) That's a record for me!
So, the actual procedure was a breeze. It was outpatient surgey. I went in at
10am, they knocked me out for a few minutes and when I woke up the surgery was
done. My buddy drove me home by 2pm. No pain, no complications. Of course, that
doesn't mean everyone has the same experience.
The suprapubic is simply a foley catheter that goes into your bladder through
your pubic area rather than through your penis/urethra. My tube is 16fr, but
they can be different sizes (one of my friends has a 24fr suprapubic.) You'll
want to discuss the size with your urologist--I'm really not sure why the
different sizes. Anyone? It might have to do with how much sediment you
void--some people seem to produce more sediment which may clog up the tube,
hence needing a larger tube.
The suprapubic should be changed by a qualified medical person about once a
month. I have a homecare nurse who changes mine on a monthly visit. The site of
the entry hole (stoma) should be kept clean and dry as much as possible. I
still have some light bleeding and weeping over a year after the surgery, but
it's very minor and the care is minimal. Some guys use a small gauze pad around
the site to help keep it dry. I don't have sensation at the site of the
suprapubic, so I can't say if it hurts. I do know it's sensitive when I wash
it.
I hook up to a legbag during the day and a nightbag at night. I can drink as
much as I want without ever having to worry about a leaky condom catheter
(hooray!) or AD from a too-full bladder (double hooray!) Just make sure to
empty the bag as needed. Also, if the tube becomes pinched or clogged it's
possible you could get a little AD, but that has not happened to me.
If you're sexually active it sure is nice having your penis free and
unobstructed for sex. My girlfriend is a fan of the suprapubic--no more bladder
accidents during sexual activity. My urologist assured me that the surgery
would not affect my ability to get a reflexogenic erection, as the surgery goes
nowhere near those nerves. However, for about 6 months post-surgery I noticed
my erections were not as good as pre-surgery so I was concerned. That all
changed with time, and everything is back to normal for me--I'm very happy.
Of course, *cue standard disclaimer*: everyone is different, so be sure to
check all your options.
Best of luck to you.
DonTempe, AZC5
