Mrs. Perez is paraplegic and has had a suprapubic catheter for over 10 years. Which of the following is a common and significant complication in the long term use of suprapubic catheters?

Mrs. Perez is paraplegic and has had a suprapubic catheter for over 10 years. Which of the following is a common and significant complication in the long term use of suprapubic catheters?

• A. Development of bladder calculi (stones)
• B. Interference with sexual activity
• C. Development of intrinsic sphincter deficiency
• D. Increases the risk of urethral cancer

Answer: (A)

Long-term use of a suprapubic catheter promotes bladder stone formation because the catheter creates a persistent nidus for minerals to deposit, and chronic infection with urease-producing bacteria raises urine pH, enabling stone-forming crystals to precipitate. Over many years, these encrustations and stones become a common and clinically significant problem, often accompanied by recurrent infections, pain, or obstruction, and may require intervention to remove the stones and adjust catheter care. Interference with sexual activity can occur, but it is not as consistently seen as a long-term, objective complication like bladder stones. Intrinsic sphincter deficiency is more related to neurological mechanisms of continence rather than a direct consequence of catheter use. While chronic catheterization carries various risks, cancer risk—though discussed in some contexts—is not as common or pressing a long-term complication as stone formation.

Long-term use of a suprapubic catheter promotes bladder stone formation because the catheter creates a persistent nidus for minerals to deposit, and chronic infection with urease-producing bacteria raises urine pH, enabling stone-forming crystals to precipitate. Over many years, these encrustations and stones become a common and clinically significant problem, often accompanied by recurrent infections, pain, or obstruction, and may require intervention to remove the stones and adjust catheter care.

Interference with sexual activity can occur, but it is not as consistently seen as a long-term, objective complication like bladder stones. Intrinsic sphincter deficiency is more related to neurological mechanisms of continence rather than a direct consequence of catheter use. While chronic catheterization carries various risks, cancer risk—though discussed in some contexts—is not as common or pressing a long-term complication as stone formation.