Sue Walker

Sue Walker

Guest Blogger at See Full Details
Sue is a Registered Nurse and holds a Masters Degree in Primary Health Care majoring in Palliative Care. Sue has extensive experience both as a clinician, educator, and senior manager in the aged care, mental health, and palliative care settings.
Sue Walker

Have you ever seen purple urine in a catheterised Patient? I haven’t and I believe it to be a rare occurrence, however, I was reading a few articles the other day and came across a picture of purple urine.

At first, I thought it was a prank – a few Condy’s Crystals in the urine bag to create a Nursing meme but then I realised it was a true clinical phenomenon. In a review of PubMed articles researchers, Hsiu-Wu Yang and Yu-Jang Su only found 106 articles from 1980 to 2016 identifying the issue of purple urine.

Purple Urine Bag Syndrome occurs in long term catheterised patients, “the purple colour results from indigo and indirubin, accumulated from bacteria-mediated tryptophan conversion.” It would appear that it is more common in elderly women, alkaline urine, history of constipation, poor bowel hygiene practice, and urine bags and tubing of a certain plastic (polyvinyl chloride plastic).

The purple colour can obviously cause panic in the patient and their family – also in health care professionals if they are not aware of the syndrome. The purple clour itself is no need for concern. Once cultures identify the bacterium causing the infection and treatment is initiated with appropriate antibiotics the catheter can be changed and you would expect the urine to turn its usual colour within a few days. Obviously encouraging increased fluids if medically appropriate would also be useful.

I’ve popped the links to two articles that you may be interested in should you wish to explore how the purple colour results from indigo and indirubin, accumulated from bacteria-mediated tryptophan conversion, and also case studies and a literature review.

    1.  Trends in the epidemiology of purple urine bag syndrome: A systematic review  РClick here>>
    2. Case Report: Purple urine bag syndrome in a woman with neurogenic bladder – click here>>