From the Guidelines
Suprapubic catheters should not be changed routinely at fixed intervals, as there is no evidence to support this practice in reducing the risk of catheter-associated urinary tract infections (CA-UTI) or catheter blockage 1. When considering the management of suprapubic catheters, it's essential to prioritize the prevention of complications such as blockage, encrustation, infection, and tissue damage.
- The frequency of catheter changes may need to be adjusted based on individual factors, including:
- Catheter material, with silicone catheters potentially lasting longer than latex ones
- Tendency for blockage or encrustation
- Presence of infection
- Manufacturer recommendations
- Patients should be educated to monitor for signs of catheter problems, such as:
- Decreased or no urine output
- Leakage around the catheter
- Cloudy or foul-smelling urine
- Pain
- Fever These signs may necessitate earlier catheter replacement, regardless of the scheduled change interval. The current evidence does not support routine catheter change at fixed intervals, such as every 2-4 weeks, as stated in the 2009 international clinical practice guidelines from the Infectious Diseases Society of America 1.
- Instead, healthcare providers should focus on individualized care, taking into account the patient's specific needs and circumstances.
- The formation of biofilms on the catheter surfaces, which can protect uropathogens from antimicrobials and the host immune response, should also be considered when deciding on the frequency of catheter changes 1.
From the Research
Suprapubic Catheter Change Frequency
- The frequency of suprapubic catheter changes is recommended to be every 2-6 weeks 2
- One study found that suprapubic catheter drainage results in markedly later urinary tract infection, with 50% of patients infected on day 40, suggesting that the catheter may not need to be changed as frequently as other types of catheters 3
- Another study found that changing the suprapubic catheter every 2 weeks was effective in preventing complications in spinal cord injury patients 4
Considerations for Catheter Change
- The decision to change a suprapubic catheter should take into account the individual patient's needs and risk factors for complications 2, 5
- Patients with certain medical conditions, such as bleeding disorders or bladder cancer, may require more frequent catheter changes or alternative management strategies 3
- The use of proper technique and awareness of potential risks can help prevent complications during catheter changes 2