Comparing transurethral and suprapubic catheterization for long-term bladder drainage: a qualitative study of the patients' perspective.
OBJECTIVE
To explore why men and women decide to have a suprapubic catheter, how the decision is made, and to compare people's experiences of suprapubic and transurethral catheterization for long-term bladder drainage.


METHODS
Narrative interviews followed by thematic analysis.


METHODS
Thirty-six long-term catheter users living in England, Wales, or Scotland were interviewed. The sample included men and women from various socioeconomic backgrounds, with a wide range of conditions. They were aged 22 to 96 years (M = 57 years).


METHODS
Interviews lasted between 1 and 3 hours; they were audiotaped and fully transcribed for analysis. A qualitative interpretive approach was taken, combining thematic analysis with constant comparison.


RESULTS
Some respondents were satisfied with or preferred a urethral catheter; others preferred a suprapubic catheter because they perceived that suprapubic catheters led to fewer infections, were more hygienic, more comfortable, improved self-image, allowed a sense of control, and were better suited for sexual relations. Participants also mentioned the decision-making process, including how the decision was made to have a suprapubic catheter and where to insert the catheter at a particular point in the abdomen. Even with a suprapubic catheter, some worried about sex or were put off sexual intimacy because of the catheter.


CONCLUSIONS
Our findings suggest that patients should be better informed before a suprapubic catheter is inserted and that issues such as sex should be raised in consultations when appropriate.
Alison Chapple, PhD, Research Lecturer, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom. Suman Prinjha, PhD, Senior Qualitative Researcher, Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, United Kingdom. Roger Feneley, MChir (Cantab), Emeritus Consultant Urologist, the North Bristol NHS Trust, Bristol, United Kingdom.
Alison
A
Chapple
Suman
S
Prinjha
Roger
R
Feneley
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003559:Cystostomy / Q000592:standards*; D004322:Drainage / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D036301:Qualitative Research; D001743:Urinary Bladder / Q000601:surgery*; D014546:Urinary Catheterization / Q000379:methods* / Q000523:psychology*