Supra Pubic Tube Placement

[Lyn-Birlew]

Posted by Lynn Birlew on May 19, 1999 at 14:21:09
My 20 year old son was paralized 2 yrs. ago in a 4-wheeler accident.  He also suffered severe internal injuries which we still do not know to what extent.  Last November, Mark, had to have 2" cut off of his tailbone due to staff infection and at the same time they flapped a large bedsore.  Incontinence problems started immediately after he left the hospital.  Prior, Mark, would straight cath every 4 - 6 hours with an output of approximately 400 to 600cc.  He has tremendous pressure now that only allows 125cc to be held.  The doctors have had him on many different types of bladder control med. including Ditropan XL.  He can not wear condom catheters.  He has tried at least 6 different types and they do not stay on or he actually bleeds.
Bladder augmentation or supra pubic tube placement were his options and he chose the less dangerous of the two.  He has surgery Monday, 5/24. I have two questions about this tube placement. (1) will Mark be able to swim ever again? and (2) is this a "same day surgery" or should he be kept in the hospital at least over night.  Mark is having the surgery done at Cardinal Glennon Children's Hospital only because his doctor specializes in this and we have to go where he is.  I'm worried about taking him home if there could be complications post surgery.  
I would really appreciate your response to my questions.  Mark especially wants to know about the swimming since he swims all summer long in our pool.
Thank you

Posted by HFHS M.D.-BE on May 24, 1999 at 12:58:20
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Dear Lynn,
The choice of supra-pubic tube vs. bladder augmentation is, as you said, the "less dangerous" of the two.  However, a supra-pubic tube has its own set of long term (potential) complications and problems, and you may eventually have to resort to a bladder augmentation at a future point.  Usually, a supra-pubic tube placement is an outpatient procedure (the patient goes home the same day of the surgery), unless the patient has complicating factors.  In the case of your son, because I do not have the benefit of a complete history, I cannot tell you what is the proper time frame for him to be in the hospital, but most likely it will be done as an outpatient.  As for swimming, (I am assuming he is a paraplegic and has full use of his arms), he could swim as long as the catheter is well secured and taped at the entry site as well as plugged (to prevent any pool water from entering).  His urologist can best teach you how to protect the site to try to prevent any complications at the entry site or other kinds of complications.  He should not go swimming for several weeks following the procedure to allow time for the site to heal.  In any event, he should consult his urologist before going in the pool this summer, just to make sure it is ok with him.  
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BE
*keyword:  suprapubic tube