British Association of Urological Surgeons’ suprapubic catheter practice guidelines (original) (raw)

The Surgical Risk of Suprapubic Catheter Insertion and Long-Term Sequelae

The Annals of The Royal College of Surgeons of England, 2006

INTRODUCTION Suprapubic catheter (SPC) insertion is a common urological procedure, which is often referred to as safe and simple even in inexperienced hands. There is, however, very little published evidence on the safety of this procedure. Our study aimed to provide evidence on the associated morbidity and mortality and provide guidance for practising clinicians. PATIENTS AND METHODS A total of 219 patients who underwent SPC insertion under cystoscopic guidance at two urology institutions between 1994 and 2002 were identified and their case notes reviewed. RESULTS The intra-operative complication rate was 10% and the 30-day complications rate was 19%. Mortality rate was 1.8%. Long-term complications included recurrent UTIs (21%), catheter blockage (25%) resulting in multiple accident and emergency attendance (43%). Despite this, the satisfaction rate was high (72%) and most patients (89%) prefer the SPC over the urethral catheter. CONCLUSIONS SPC bladder drainage results in a high ...

An audit of suprapubic catheter insertion performed by a urological nurse specialist

Indian Journal of Urology, 2013

Aims: Aims: To introduce the concept that a urological Nurse Specialist can perform Suprapubic Catheter (SPC) insertions independently without signifi cant complications, if systematic training is given. Settings and Design: Settings and Design: Retrospective study. Materials and Methods: Materials and Methods: A retrospective audit of Suprapubic Catheter insertions performed by a Urological Nurse Specialist was conducted between April 2009 and April 2011. Results: Results: Of the total 53 patients, in 49 (92.45%) the procedure was successful. Out of the remaining four, two (3.77%) were done by a urologist. One patient's (1.89 %) SPC did not drain after placement and ultrasonography reported that the Foley balloon was lying within the abdominal wall. The other patient's SPC drained well for a month and failed to drain after the fi rst scheduled change in a month. Since the ultrasonography showed the Foley balloon to be anterior to the distended bladder, an exploration was performed and this revealed that the SPC tract had gone through a fold of peritoneum before reaching the bladder. None had bowel injury. Conclusions: Conclusions: If systematic training is given, a urological Nurse Specialist can perform SPC insertions independently without signifi cant complications.

Safe percutaneous suprapubic catheterisation

Annals of The Royal College of Surgeons of England, 2012

INTRODUCTION We describe our technique of percutaneous suprapubic catheter insertion with special reference to steps that help to avoid common complications of haematuria and catheter misplacement. METHODS The procedure is performed using a stainless steel reusable trocar under local infiltrative anaesthesia, usually at the bedside. After clinical confirmation of a full bladder, the trocar is advanced into the bladder through a skin incision. Once the bladder is entered, the obturator is removed and the assistant inserts a Foley catheter followed by rapid balloon inflation. Slight traction is applied to the catheter for about five minutes. Patients with previous lower abdominal surgery, an inadequately distended bladder or acute pelvic trauma do not undergo suprapubic catheterisation using this method. RESULTS The procedure was performed in 72 men (mean age: 42.4 years, range: 18–78 years) with urinary retention with a palpable bladder. The average duration of the procedure was less...

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

Spinal Cord, 1998

We report on the clinical outcome and satisfaction survey of long-term suprapubic catheterisation in patients with neuropathic bladder dysfunction. Between early 1988 and later 1995, 185 suprapubic catheters were inserted under direct cystoscopic vision. Anticholinergic therapy was given to all patients with signi®cant detrusor hyper-re¯exia; the catheters clamped daily for two hours and changed every six weeks. Ultrasonography and assessment of the serum creatinine were used to assess the upper renal tracts, and the results of the pre-and post-catheter video-cystometrography was used to evaluate bladder morphology, cystometric capacity, maximum detrusor pressure and the presence of vesico-ureteric re¯ux. There were equivalent numbers of males and females. The follow-up ranges from 3 ± 68 months. Following catheterisation, there was a 50% reduction in the average maximum detrusor pressure, bladder morphology improved in 85% of the cases; the bladder capacity and upper renal tracts remained unchanged. Vesico-ureteric re¯ux was abolished in 33% of the cases. Complaints were common consisting of recurrent catheter blockage, persistent urinary leakage and recurrent urinary tract infections. There was a 2.7% incidence of small bowel injury with one fatality. However, the general level of satisfaction was high. It is concluded that suprapubic catheterisation is an eective and well tolerated method of management in selected patients with neuropathic bladder dysfunction for whom only major surgery would otherwise provide a solution to incontinence. We are encouraged to ®nd preservation of renal function with maintained bladder volumes and reduced maximum detrusor pressures thus justifying the policy of catheter clamping and anti-cholinergic therapy in the presence of signi®cant detrusor hyper-re¯exia. However, even in expert hands this procedure is not without hazards.

Suprapubic Catheter Migration: A Review of a Rare Complication

Case Reports in Urology

Background. Suprapubic catheter migration to the vesicoureteral junction is an unusual complication, causing an obstruction that led to hydronephrosis and dilation of the pelvicalyceal system. Case presentation. A 30-year-old man with a suprapubic catheter (SPC) that was inserted one month before this current Emergency Department (ED) visit had severe left flank pain for 48 hours. The SPC was inserted in the context of urethral injury after falling astride. Point-of-Care Ultrasound (POCUS) showed a semifilled urinary bladder and moderate hydronephrosis on the left side. A computed tomography scan (CT scan) of the abdomen was performed and showed migration of the suprapubic catheter’s tip into the left vesicoureteral junction, causing ureteral obstruction dilation of the ipsilateral pelvicalyceal system. The suprapubic catheter was changed in the ED, causing relief of symptoms, and the patient was referred to the urology department for follow-up. It was uneventful on the follow-up fr...

A Novel, Inexpensive, Double Lumen Suprapubic Catheter for Urodynamics

The Journal of Urology, 2004

Purpose: We describe a novel, double lumen, intravesical, suprapubic catheter designed to meet the requirements of pediatric urodynamics that is easy to use and has minimal complications. Materials and Methods: A commercially available 10Fr pediatric suprapubic pigtail catheter forms the outer lumen for instilling filling media. A 16 gauge epidural catheter is inserted through the outer catheter providing an inner lumen for measuring intravesical pressures. The resultant double-lumen catheter is inserted suprapubically using a peel away needle supplied with the 10Fr catheter, with the patient under general anesthetic. Results: The catheter has been used for 15 years in more than 700 patients with good reliability and few complications. The concentric construction of the double lumens and the rigidity of the inner intravesical pressure channel ensure there is no transmission of pressure from the filling channel to the inner lumen. The catheter has a circular cross section and a pigtail distal end which help to retain it within the bladder. There is low resistance to filling that allows adequate filling rates to be achieved by gravity rather than necessitating a pump. The catheter is easily made from readily available components and is less expensive than other double-lumen catheters suitable for suprapubic use. Conclusions: A reliable, double lumen catheter that fulfills criteria not found in commercially available alternatives can be inexpensively made for urodynamics.