[joye]

Hi all . . . this is my very first post! Although I've come to know you all very well in the past year, you do not know me. This site is such a great resource, all I've had to do is read a learn and haven't needed to ask a thing (until now). My name is Joye and my husband Andrew became quadriplegic about a year ago (C2, complete . . . latest diagnosis) . . . due to spinal surgery gone way wrong.

He was fitted with a suprapubic cath in August 08 and I don't think I'm exagerating by saying that I believe he has had a UTI since that time. He's since had one hospital stay with sepsis and I'm pretty sure his current infection is getting worse each day (again).

I requested he be seen by an infectious disease doc. That doc looked at the suprapubic site and noticed some urine had leaked through the cath "hole" and had great concern for this. This leaking is something that has happened since day one and I thought it was normal. By the way, Andrew never leaks through his penis.

Doc was also concerned about the size cath (French 24) being used. He advised us to go back to urologist, have suprapubic cath removed, cath through penis until suprapubic site was healed, and then re-do the suprapubic cath in smaller size. Went to urologist and he completely disagreed. Told us the leakage through the cath site was normal and nothing we could do about it. Getting second opinion . . .having some insurance issues (of course).

So here's my questions:

Should suprapubic site leak daily (or at all)?
Is French 24 cath too big?

Thanks so much for this wonderful resource. I read daily and have learned more in this one place than the 5 hospitals Andrew has been in, in the past year.

Joye

[aggzy]

hey Joye

first of all with your husbands uti's does he drink enough water 2-3 litres a day

also get him on some cranberry tabblets asap they make the bladder wall to slippery for bugs to stick

next:
leaking around the spc site shouldn't happen AT ALL! im not sure what a "french" 24 cath is

i use a size 18 spc which means the inside diameter is 1.8mm and have never had leaking around the site

hope this helps

Ag's

This post has been edited by aggzy: 29 April 2009 - 12:52 PM

[Hawkeye]

I've had a 24 French supra pubic catheter since 1980. I consider that size to be a minimum. I wish mine were larger, and my urologist agrees, but it's not worth the effert at this point to change.

A little leakage is normal. Even after the stoma is completely healed, it's never a perfect seal. The key is to determine what is normal for your husband. If your doctor is not a urologist I would wait until you can get a second opinion from one, before making any changes.

+1 on the cranberry pills and drinking LOTS of water.

Good Luck...

Joe

[joye]

Thank you aggzy and hawkeye for your quick responses.

Yes . . . he drinks at least 2 to 3 liters of water per day and more. About the cranberrry pills . . . Andrew did his rehab at Craig Hospital and was given a list of "what not to eat" due to his blood thinner, and cranberry juice was a new addition last year; therefore, I had not considered the pills as he is on massive about of coumadin. Andrew has a blood dissorder (type 8 deficiency) which does not allow his blood to break up clots so he will always have the blood thinner.

We just found out today that every other urologist besides the one he already sees (that disagreed with removing it) will not negotiate with our insurance (of course). So we are going to have to make the decision on whether or not we can just pay . . . also a hard decision because no one can give us a ball park as to how much it will cost to even get the second opinion.

Now these cranberry tablets . . . will any do that can be purchased over the counter or do you recommend a specific kind/brand? I'm thinking I will start him on them and deal with the I and R levels with his next blood draw, and I suppose just adjust the coumadin as necessary. I think if it's a consistant thing it should be ok.

I'm also considering those catheters with the silver in them as well. I've read on here that some have had luck with them . . . I will have to go back and read to see what they are actually called.

Thanks again . . . I appreciate it.

Good Day . . . Joye

[alex4bs]

joye before administreing cranberry can not be given to anyone prone to clotting igive you this advice on allmy meds warfrin do not take cranberry please seek advice from gp size of catheter im a size 16 my weight is 78kilo and no it should not weep info from my staff in my nursing home hope this info helps you and hubby

[russ1]

Is it actually urine leaking out? my stoma has weeped slightly more often than not since I had it 6yrs ago, it's not urine however. 24 is on the large side but not I'd have thought excessive, mines an 18.

I fail to see how redoing the SP is going to help. Yes SP caths make one slightly more prone to UTI's and a background infection will always be present because of the foreign body in the bladder. If I'm tested on a dipstick it'll always show a positive result even though i've not had a UTI since rehab.

How often is the cath changed? Horrible things uti's. I assume he's on antibiotics to treat this one. The silver coating is supposed to help and may well be worth a try. If the leak is urine (which personally I suspect unlikely) then there's an obvious path for infection so a dressing over the stoma would be one thing to consider.

I'd be trusting a urologists advice over an infectious disease doc every time - my bet would be that he (the infectious disease doc) doesn't see many supra pubic caths and in the absence of any other advice to give you has made a shot in the dark knowing that sending you back to the urologist at the very least makes it 'somebody else's problem'.

Russ

[Murray]

Hello Joye -

Some more info (too much?)....

I'm a lifer with coumadin. Do 5mg daily, 7.5mg each Monday. Have managed to keep it in the 2-3 range for a long time. (Occasional spikes; no big deal)

Also have an SP - 20 Fr. Have for about 3 yrs. Occasional leakage, but nothing worrisome.

Ditto on the hydration bit!

I do a glass of 100% cranberry juice daily and take 1000mg vit C twice daily.

Manage to keep the UTI's to a minimum.

Good luck to you and the ol' man.

Lynn

[keidra]

my fiance also has a suprapubic cath and since he got 2 years ago he has had way more bladder infections than before when he had his foley cath !! He is allergic to soo many antibioticsso that presents a problem when being treated !! He drinks water all day long and also takes cranberry pills!! He went to the hospital a few weeks ago and he actually didnt have a bladder infection but was having severe pain in the stomach !! The Dr. changed his cath while in the hospital and guess what he got a uti after they changed the cath !!!