A suprapubic catheter is an alternative method of draining the urinary bladder that does not require insertion into the urethra. This procedure is often used in patients who cannot empty their bladder using a urethral catheter.
The suprapubic drainage tube enters the bladder through the abdominal wall above the pubic bone. It exits through a midline site but may also be escaped off-center (through the rectus muscle).
Definition
A suprapubic catheter (SPC) is a drainage tube inserted into your bladder just above your pubic bone instead of through your urethra. It’s more comfortable than a regular catheter because it doesn’t go through your genital area.
Suprapubic tubes are often used to drain patients who can’t urinate independently. They also can be used for specific surgical procedures.
The technique of placing a suprapubic catheter can vary, depending on the patient’s condition and the practitioner’s preference. The two main types of placement are open and percutaneous techniques.
A urologist usually performs the procedure, but other practitioners such as general surgeons, gynecologists, and urogynecologists may perform it. An interprofessional team approach is recommended to ensure quality care for patients undergoing this procedure.
Complications
A suprapubic catheter is placed into the urinary bladder just above the pubic symphysis. These are often used to manage bladder dysfunction or urinary retention, which cannot be managed using a urethral catheter.
Suprapubic catheterization is typically performed by a urologist or a surgeon specializing in the genitourinary tract. Gynecologists and urogynecologists can also achieve it.
The procedure requires general or local anesthesia, depending on the situation. The lower abdomen is shaved and prepped for the process, which may involve entrance via the urethra or a more flexible approach.
The tube is dilated with either mechanical or balloon dilators and then secured. This is typically done under vision with a rigid or flexible cystoscope, though it can also be done with a portable ultrasound device. A suction catheter is also attached to the dilator for easy removal. Other ancillary equipment, such as a self-retaining retractor and dissolvable suture, are commonly used to help make the procedure less traumatic.
Preparation
Suprapubic catheters can be used when the bladder is drained through an opening that connects to the skin rather than through the urethra. They are used to empty the bladder after surgery or treatment of conditions that block the urinary flow, such as benign prostatic hyperplasia (BPH), traumatic disruption of the urethra, congenital disabilities of the urinary tract, and obstructions that may pass through the urethra into the bladder, such as kidney stones.
In this procedure, a suprapubic catheter is placed through an incision in the abdominal wall above the pubic bone (cystotomy). The urologist inserts the tube to drain urine into a collection bag and then removes it to prevent infection.
Depending on the method, the tube is placed percutaneously using a large-bore needle and a guide wire and peel-away catheter insertion sheath or by open techniques using a rigid or flexible cystoscope. A specialized retractor called a Lousley prostatic retractor might help the physician find the appropriate tube position within the bladder.
Procedure
A suprapubic catheter (SPC) is a drainage tube placed into your bladder just above your pubic bone. This allows urine to drain without a line through your urethra, which is full of sensitive tissue.
The procedure is usually performed by a urologist or another physician specializing in the urinary tract. However, it can also be performed by a general surgeon or gynecologist.
Your doctor will use local anesthesia to numb the area during the procedure. They will then insert the device using a Stamey device that helps guide the catheter into your bladder.
After inserting and changing the SPC a few times, your doctor may give you instructions on how to take care of it at home. You can use the SPC for up to four to eight weeks before it needs to be changed or removed.
A suprapubic catheter is typically placed for patients who can’t void independently, such as after surgery. It can also be used for irrigation.
