Suprapubic catheter falls out during a swim

Suprapubic catheter falls out – introduction

I acquired a spinal cord injury (SCI) in 2009 after being hit by a tree, and have no control over my bladder. There are multiple methods available that utilise a catheter to empty the bladder and I have a suprapubic catheter. During an operation, a urologist made a hole, just below my belly button, allowing a suprapubic catheter to drain urine from my bladder and into a leg bag. I empty the bag before it fills up and the catheter is changed by a nurse every six weeks. The suprapubic catheter is held within the bladder by a balloon, that fills with sterile water. A suprapubic catheter should stay in for six weeks, but the balloon can deflate, and I’ve recently written a blog about my experience when the suprapubic catheter falls out. It has occurred about four times when I’ve taken my clothes off, and I’ve pushed them back in and kept them in until being changed the next day.

Suprapubic catheter falls out during a swim

After swimming for twenty-five minutes, being in the pool for about forty minutes and drinking a few times during exercise, I detected that my catheter had fallen out. This has occurred five times now with the water escaping and the balloon deflating. The other four times occurred in bed, as I was removing my clothes, and I quickly reinserted the catheter and kept it in, until a nurse is able to change it the next day.

This failure was my first experience like this in the pool, and given the pool is chlorinated and private, I didn’t think there were too many bacteria in the water that could cause a UTI (urinary tract infection) when I reinserted the catheter. I failed to reconnect the catheter, as my hands were slippery and I was floating in a vertical position.

Stay calm and take action

I tried staying calm to make the best decisions, but I’d been in the pool for forty-five minutes, consumed 400ml of water and my leg bag was empty. My bladder is filling up, increasing blood pressure that can cause the medical condition autonomic dysreflexia. I’ve experienced the dangerous condition three times with cramping sensations in my abdomen, feeling hot and then the most terrible headache. If the blood pressure gets too high and stays high, there is the possibility of a stroke or heart attack.

After swimming to my lifter, I rose in the air, moved to my wheelchair, partly dried my body and spoke to my carer. I asked Janet to grab my mobile phone and blood pressure machine, and my BP was slightly high and I started feeling cramps in my abdomen.
I dried my hands, put on latex gloves, attempted to sterilise the end of the catheter with alcohol hand wash, and once again failed to reinsert the catheter. Something was blocking the tube and the force was causing the site to bleed, and I asked Janet for a few old towels. It was time to dial 000 and request a visit by a paramedic from SA Ambulance, as my bladder may soon be full. Unfortunately, the call centre operator suggested I may need to wait for an hour, and suggested I don’t attempt reinserting the catheter.

Stroke or UTI?

I was disappointed at the length of time I need to wait for help and decided to get the catheter back in, as getting a UTI is much better than a serious heart issue.
After using my bedroom lifter I landed on my bed and tried the reinsertion using gloves and alcohol hand wash. Once again I failed and assumed that whatever is between my skin and the bladder must have moved around, making the task difficult. How much force should I use, and will I damage my body? I didn’t know but was keen to avoid any possible heart issues.
Finally, the catheter goes in and the leg bag takes less than a minute to get to the point of filling up. The urine has a slight pink colour due to the blood and there are small bits of skin moving around the leg bag.

SA Ambulance arrive

A few minutes later the doorbell rings, and Janet shows the paramedic the way to my bedroom. After explaining my actions, he suggested that I may have needed a trip to the hospital to change the catheter, as he may not have been keen to push as hard as I described. Avoiding another stay in the hospital, even for a short time was important, as it’s an inconvenience and there are plenty of bad bacteria and viruses lurking there.
The paramedic departed after changing my catheter, I finished drying myself, and Janet heated my dinner, and later helped me clean my teeth while staying in bed.
As I write this blog, five days after the incident, I’m still free of UTI symptoms and the catheter has stayed in.

Suprapubic catheter falls out – conclusion

After acquiring an SCI, it is important to understand

  • How your body is affected by the injury
  • The care required
  • What actions to take when faced with an emergency situation, such as your bladder filling

There are times when a solution requires

  • inventive thinking
  • taking a guess
  • asking for help
  • going against medical advice – you know your body better than anyone else, and you live with the consequences of the action you take or do not take

And always keeping calm.

It would be better for the SA Ambulance Service to update clients about the estimated time of arrival for the ambulance, such as an SMS. If I knew the paramedic was only a few minutes away, I wouldn’t have reinserted the catheter and avoided the chance of a UTI.

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