Suprapubic catheterization (SPC) plays an important role in managing urinary symptoms in some conditions. When patients are not able to volitionally void, clean intermittent catheterization is the best choice. However, this may be not convenient at many circumstances. It may be time consuming or not socially feasible especially for caregivers. SPC may offer an acceptable alternative to these patients.  Advantages of SPC include that it provides easy access to the catheter, prevents trauma and erosion to the urethra and is associated with improved quality of life for patients. However, many of these patients are usually dependents on caregivers to provide their care. 
In this study, we are trying to determine the impact of SPC on quality of life for the caregivers of patients who need catheterization when compared to the patients’ quality of life.

This study is part of a quality-control review for patients who were managed by clean intermittent catheterization or urethral catheterization and subsequently had placement of a SPC.  Data were collected at 3 months and 6 months post-placement. This will help to assess the patients and caregivers after being familiarized with SPC care and education. 
Patients and their caregivers completed the validated Patient Global Impression of Improvement (PGI-I) questionnaire written if possible and verbally if not possible. Caregivers and patients were asked if they would recommend the SPC again for their patients. PGI-S include the following answers ( very much better, much better, a little better, no change, a little worse, much worse, very much worse)
When answers in PGI-I were much improved, or improved were placed in one category while answered of little worse, much worse, very much worse were placed in a category.

A total 36 patients (19 female and 17 male) were included in the study who were reviewed during the time of quality control review.  Average age at the time of data collection was 58.8 ± 19.7 years old. Four patients had cerebral palsy, 10 patients with spinal cord injury, 6 patients with neurogenic bladder due to neurologic disease, and HIV. The rest of the patient had retention of urine associated with dementia or mental disability. A significantly higher percentage of patients (86%) reported improvement of their quality of life as regards urologic condition with SPC (Chi-square test, p <0.05) comparted to prior to SPC and only 6% reported worsening of their quality of life. For caregivers, reported improvement of their quality of life regarding care for their patients. About 87 % of caregivers rank their care for patients’ urologic condition has improved with SPC (Chi-square test, p <0.05) compared to 13% who thought it did not make a difference.
  Furthermore, most patients (82.9%, N=29) said that they would recommend SPC to others or maintain SPC.  Most caregivers (86%, N=29) said that they would recommend SPC.
Patients most common problems with SPC was related to bladder spams, hematuria after exchange of the tubes and difficulty with tube change with silicon catheters

SPC offers a good option for management of urologic conditions associated with retention of urine when indicated. It may help to improve the quality of life of selected patients as well as the quality of life of caregivers. 
When thinking about treatment options for patients with retention of urine, caregivers quality of life should be considered in decision making process to improve compliance with patient care.

When thinking about treatment options for patients with retention of urine, it is important to consider the caregivers quality of life. In  patients who are dependent on caregivers to provide care, the quality of life of caregivers may negatively affect patient care if not appropriately addressed. It is important to keep this in mind in the management decision process to improve compliance of patient care.