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Weighing options to go for SPC

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  • Weighing options to go for SPC

    Dear All,

    I am Sam from India. I am C-4 C5 quadriplegic since 2005. Up to now, I was on the intermittent catheter. I want to go to SPC. Whatever queries, threats, & other details are available they are old. I want what is the present perception, Practices, and things to keep in mind regarding SPC. Please let me know? Thanks and regards

  • #2
    Hi Sam, I've had mine for almost 10 years and wish I had it done sooner.

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    • #3
      Thanks dear

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      • #4
        I wonder if SPC could be done at the local level through a urologist or I could go to specialty hospitals for SCI. Please suggest to me. Also, let me know thinks to keep in mind.Thanks and regards

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        • #5
          There have been many threads on Care Cure that have discussed supra pubic catheters. I suggest you search this site (search box, upper right of this page) for "supra pubic."

          That said, I've had my supra pubic for about 8 years. I'm very satisfied with my decision. My injury level is C6/7 complete.

          In the United States. supra pubic catheter placement is a general procedure that can be done by a urologist in a local hospital, on an outpatient basis. It is a good idea to consult with a nurse who has expertise in identifying the best placement for the supra pubic stoma. After the surgery, the area will be bandaged. Follow your doctor's directions about removing the dressing, usually 5 or 6 days after the surgery.

          It is best practice to have a smaller diameter catheter placed initially. I had a 16Fr foley catheter placed and have stayed with that size. Some doctors will use 18Fr or 20Fr initially, and that isn't necessary. You can up size the catheter if you are having problems with passing urine or have a good deal of sediment. The smaller and more flexible the catheter, the better. Four to six weeks after the placement surgery, you will visit your doctor to have the catheter changed for the first time.

          You may need to take an anticholinergic medication to help with bladder spasms and help to keep the bladder from shrinking a great deal. Oxybutynin is an anticholinergic medication.

          The supra pubic catheter needs to be changed once a month. Likely, you will need someone who is trained in removing the old catheter and inserting the new one. Some people go to a clinic for a catheter change, others have family members or home heath care aids who are trained by a doctor or nurse to change a supra pubic catheter. When a catheter is removed from the stoma, it will quickly try to heal closed. Make sure that you have all of your supplies; syringe to remove fluid from the balloon of the old catheter, garbage can or plastic bag to dispose of the old catheter, new catheter, syringe with sterile water to fill the balloon of the new catheter, lubricant, antiseptic wipes (betadine etc.) to clean the stoma area and any other supplies recommended by your doctor or nurse.

          Washing the stoma area once or twice a day with soap and water is a good practice to help eliminate bacteria. I like to use an alcohol wipe to clean the catheter tubing (not the stoma). Use medical paper tape or a securement device to hold the catheter in place on your leg to help keep the catheter from moving in and out of the stoma (Several types are available). Inspect the stoma daily for any abnormal secretions, redness, and swelling.

          Good luck.

          Securement Device:
          Attached Files
          Last edited by gjnl; 03-22-2019, 07:34 PM.

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          • #6
            hello c6c7 could not cathe had sp has I left shephards and went home

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            • #7
              I've had my sp almost 29 years. I use a 18fr Duette catheter. I highly recommend them. I'm very happy with my sp!

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              • #8
                Thanks a lot!
                It was thorough and quite informative.
                I ask again… At local level, SPC might be done occasionally. Will they be able to do all the care or I would have to move to SCI hospital?
                Please suggest me…

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                • #9
                  I had mine done at a local hospital.

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                  • #10
                    You will be far less prone to bladder/kidney infections by staying with intermittent cath. I don't understand why you would want to risk that with the SPC.

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                    • #11
                      The answer to your question depends on what your local hospital does routinely. If an SPC is not routine for someone there, look for a hospital where it is routine. You really have to ask locally, not here. I would begin by contacting the best place for SCI in India and asking their advice. Possibly you can find a doctor or Urologist who specializes in SCI on the internet.

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                      • #12
                        Originally posted by Oldtimer View Post
                        You will be far less prone to bladder/kidney infections by staying with intermittent cath. I don't understand why you would want to risk that with the SPC.
                        Sometimes, you don't have a choice. In the case of the original poster of this thread, he is C4/5 and maybe finding it difficult to continue to try to cath himself or if he need help with catheterization, finding care may be difficult. Intermittent catheterization takes a good deal of hand function to maintain a clean or sterile field, which can result in frequent urinary tract infections (UTI). He just may not be able to manage on his own.

                        In my case, urodynamics showed high bladder pressures and I was having to be cathed approximately every 2 hours round the clock. I was unable to cath myself competently, and NL had to cath me that frequently. Our quality of life was abysmal. We/she couldn't be away for more than about 1.5 hours at a time, we were't getting any sleep and life was pretty miserable. With the supra pubic, our quality of life has improved greatly, and I've not experienced frequent and recurring UTIs.

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                        • #13
                          Originally posted by gjnl View Post
                          Sometimes, you don't have a choice. In the case of the original poster of this thread, he is C4/5 and maybe finding it difficult to continue to try to cath himself or if he need help with catheterization, finding care may be difficult. Intermittent catheterization takes a good deal of hand function to maintain a clean or sterile field, which can result in frequent urinary tract infections (UTI). He just may not be able to manage on his own.
                          In post #1 the OP states, "
                          I was on the intermittent catheter. I want to go to SPC." Want, not must. I have quad paws and have been doing self cath for almost 41 years, for 8 years before that I had a foley and many infections. Just trying to inform the OP of possible complications.

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                          • #14
                            Originally posted by Oldtimer View Post
                            In post #1 the OP states, "
                            I was on the intermittent catheter. I want to go to SPC." Want, not must. I have quad paws and have been doing self cath for almost 41 years, for 8 years before that I had a foley and many infections. Just trying to inform the OP of possible complications.
                            The original poster is from India. Yes English is a primary language in India, but maybe "want," ("not must" ---your words and/or interpretion), is a language, cultural difference in expression of which you are making too much of an issue. I'm not trying to be argumentative, but a supra pubic catheter is not an out of the mainstream practice or procedure and in certain circumstances is just as efficacious as intermittent catheterization.

                            I hope in that we have all given our input to the original poster, he will make a determination for himself after consulting with his local resources.

                            The other thing I know after being on this Care Cure Community site for as long as I have been is that most posters don't tell us the whole story, so any of us who reply aren't dealing with a full deck of information. There is always more background story that isn't initially shared.
                            Last edited by gjnl; 03-23-2019, 11:18 PM.

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                            • #15
                              Thanks a lot

                              I have no hand movement. From the last 14 years, it is because of my family members… Up to now, my bladder condition is okay and I do not have frequent UTI… But you know, the family is getting exhausted, More than eight months, here I have extreme summer and in those days it's quite hard to limit water… And here any caregiver cannot provide that much of sincerity and hygiene…That is why I want to go for SPC…
                              Dr. can do it at the local level but their conviction and feedback are not up to the mark…
                              the specialized hospital is quite far… But they are doing it quite frequently… That is why I was asking…
                              By the way thanks to all of you for your valuable feedbacks…

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