What is the main difference between a suprapubic catheter and a urethral Foley catheter?

• A. Suprapubic catheter is inserted through the urethra; Foley is inserted via the bladder above the pubic bone
• B. Suprapubic catheter is inserted through the bladder above the pubic bone; Foley is inserted via the urethra
• C. They are identical except for the material
• D. Suprapubic catheter is only for short-term use

Answer: (B)

The key difference is the route the catheter takes to reach the bladder. A suprapubic catheter is placed by puncturing through the lower abdominal wall and entering the bladder, so urine flows through a tube that comes up from the bladder itself. A urethral Foley catheter travels through the urethra and into the bladder. This distinction matters because suprapubic placement is chosen when urethral catheterization isn’t possible or desirable (such as urethral injury or strictures, or for long-term drainage), offering the benefit of avoiding the urethra. However, it carries its own risks, like infection at the bladder or abdominal wall tract and potential bladder injury. The urethral Foley is typically used when the urethra is accessible and intact, and is often suitable for shorter-term use or easier placement.