Voiding with a Suprapubic Catheter in Place
Yes, it is normal and actually advantageous for patients with suprapubic catheters to continue voiding regularly through the urethra. This is one of the key benefits that distinguishes suprapubic from urethral catheterization.
Why This Occurs and Why It's Beneficial
Suprapubic catheters allow patients to attempt normal voiding without requiring recatheterization, which is a major advantage over urethral catheters 1, 2, 3.
The ability to void naturally through the urethra while the suprapubic catheter remains in place enables assessment of bladder function and voiding ability without needing to remove the catheter 3.
This feature is particularly valuable because it allows clinicians to evaluate whether the patient has regained adequate voiding function before removing the suprapubic catheter entirely, thus avoiding the need for recatheterization if voiding remains inadequate 1, 3.
Clinical Implications
Patients may experience urinary leakage through the urethra despite suprapubic drainage, and this should be recognized as a known occurrence rather than a complication 1.
The preserved ability to void naturally contributes to better quality of life compared to urethral catheterization, as it maintains more normal urinary function and interferes less with daily activities 1.
This dual drainage pathway (both suprapubic catheter and urethral voiding) is particularly beneficial for patients with overactive bladder or neurogenic bladder who are being managed with suprapubic tubes 1.
Important Caveats
While voiding around a suprapubic catheter is normal, ensure the suprapubic catheter itself continues to drain adequately - if the catheter stops draining entirely while urethral voiding continues, verify proper catheter positioning and patency 4.
If a patient develops new inability to void urethrally after previously doing so, or experiences pain, bleeding, or signs of infection, evaluate for catheter-related complications such as malposition or obstruction 5, 4.